罗马西克利布是一种CDK8/CDK19抑制剂,可以通过组合策略克服venetoclax耐药性
bioRxiv : the preprint server for biology
|December 25, 2025
概括
与venetoclax结合的Romacliclib在克服急性髓性白血病 (AML) 的抗药性方面表现有前途. 这种组合疗法有效地向耐性白血病细胞,并支持骨髓恢复,为AML患者提供了新的希望.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 分子生物学分子生物学
背景情况:
- 威尼托克拉克斯 (VEN) 加上低甲基化剂 (HMA) 是老年患者不适合进行密集化疗的标准AML治疗.
- 大多数接受VEN/HMA治疗的患者最终会复发,需要新的治疗策略.
- 流体细胞和转录性变化有助于AML中的VEN耐药性.
研究的目的:
- 评估罗马西克利布 (一种CDK8/CDK19抑制剂) 与VEN (RVU120+VEN) 结合用于克服急性髓性白血病 (AML) 中的VEN抵抗.
- 在敏感和耐药AML模型中研究RVU120+VEN的协同机制.
主要方法:
- 评估了RVU120+VEN在AML细胞系和患者衍生模型 (敏感和耐药) 中的疗效.
- 利用蛋白质组,功能组和转录组分析来阐明作用机制.
- 使用患者衍生异种移植 (PDX) 模型进行的体内研究,对VEN耐药AML.
主要成果:
- RVU120+VEN在AML细胞系和8/11例患者样本中表现出协同作用,通过MCL-1裂变诱导亡.
- 组合疗法克服了以斯特罗玛为媒介和转录依赖的VEN耐药性.
- 在体内研究表明白血病细胞根除,骨髓恢复,并减少白血病负担在PDX模型.
结论:
- RVU120+VEN表现出一种协同机制,以克服复发性/耐药性AML中的初级和获得性VEN耐药性.
- 这种组合有效地抑制了关键的抵抗通路,如IL6/JAK/STAT3和TGF-β.
- 结果支持正在进行的临床试验,并表明它有可能成为VEN-naïveAML患者的前线治疗方法.
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