Combinatorial treatment rescues tumour-microenvironment-mediated attenuation of MALT1 inhibitors in B-cell lymphomas

  • Nat Mater. 2023 Apr;22(4):511-523. doi: 10.1038/s41563-023-01495-3.
Shivem B Shah  1  2 Christopher R Carlson  3  4 Kristine Lai  3  4 Zhe Zhong  3  4 Grazia Marsico  3  4 Katherine M Lee  1 Nicole E Félix Vélez  5 Elisabeth B Abeles  6 Mayar Allam  3 Thomas Hu  3 Lauren D Walter  7 Karen E Martin  4 Khanjan Gandhi  8 Scott D Butler  9 Rishi Puri  9 Angela L McCleary-Wheeler  9 Wayne Tam  10 Olivier Elemento  11 Katsuyoshi Takata  12  13 Christian Steidl  12  14 David W Scott  12  14 Lorena Fontan  15  16 Hideki Ueno  17 Benjamin D Cosgrove  1 Giorgio Inghirami  10 Andrés J García  4  18 Ahmet F Coskun  3 Jean L Koff  8 Ari Melnick  15 Ankur Singh  19  20  21  22
Affiliations
  • 1. Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA.
  • 2. Columbia University, New York, USA.
  • 3. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University School of Medicine, Atlanta, GA, USA.
  • 4. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
  • 5. College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA.
  • 6. College of Arts and Sciences, Cornell University, Ithaca, NY, USA.
  • 7. Department of Molecular Biology & Genetics, Cornell University, Ithaca, NY, USA.
  • 8. Winship Cancer Center, Emory University School of Medicine, Atlanta, GA, USA.
  • 9. College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
  • 10. Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA.
  • 11. Englander Institute for Precision Medicine, Weill Cornell Medical College, New York, NY, USA.
  • 12. Centre for Lymphoid Cancer, British Columbia Cancer Center, Vancouver, British Columbia, Canada.
  • 13. Niigata University, Niigata, Japan.
  • 14. Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
  • 15. Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
  • 16. Janssen Pharmaceuticals, Inc., Beerse, Belgium.
  • 17. Department of Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
  • 18. Petit Institute for Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, GA, USA.
  • 19. Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA. [email protected].
  • 20. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University School of Medicine, Atlanta, GA, USA. [email protected].
  • 21. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA. [email protected].
  • 22. Petit Institute for Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, GA, USA. [email protected].
Abstract

Activated B-cell-like diffuse large B-cell lymphomas (ABC-DLBCLs) are characterized by constitutive activation of nuclear factor κB driven by the B-cell receptor (BCR) and Toll-like Receptor (TLR) pathways. However, BCR-pathway-targeted therapies have limited impact on DLBCLs. Here we used >1,100 DLBCL patient samples to determine immune and extracellular matrix cues in the lymphoid tumour microenvironment (Ly-TME) and built representative synthetic-hydrogel-based B-cell-lymphoma organoids accordingly. We demonstrate that Ly-TME cellular and biophysical factors amplify the BCR-MYD88-TLR9 multiprotein supercomplex and induce cooperative signalling pathways in ABC-DLBCL cells, which reduce the efficacy of compounds targeting the BCR pathway members Bruton tyrosine kinase and mucosa-associated lymphoid tissue lymphoma translocation protein 1 (MALT1). Combinatorial inhibition of multiple aberrant signalling pathways induced higher antitumour efficacy in lymphoid organoids and implanted ABC-DLBCL patient tumours in vivo. Our studies define the complex crosstalk between malignant ABC-DLBCL cells and Ly-TME, and provide rational combinatorial therapies that rescue Ly-TME-mediated attenuation of treatment response to MALT1 inhibitors.

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