A Novel Triple-Action Inhibitor Targeting B-Cell Receptor Signaling and BRD4 Demonstrates Preclinical Activity in Chronic Lymphocytic Leukemia

  • Int J Mol Sci. 2022 Jun 16;23(12):6712. doi: 10.3390/ijms23126712.
Audrey L Smith  1 Alexandria P Eiken  1 Sydney A Skupa  1 Dalia Y Moore  1 Lelisse T Umeta  1 Lynette M Smith  2 Elizabeth R Lyden  2 Christopher R D'Angelo  3 Avyakta Kallam  3 Julie M Vose  3 Tatiana G Kutateladze  4 Dalia El-Gamal  1
Affiliations
  • 1. Eppley Institute for Research in Cancer and Allied Diseases, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE 68198, USA.
  • 2. Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA.
  • 3. Division of Hematology and Oncology, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE 68198, USA.
  • 4. Department of Pharmacology, University of Colorado School of Medicine, Aurora, CO 80045, USA.
Abstract

B-cell chronic lymphocytic leukemia (CLL) results from intrinsic genetic defects and complex microenvironment stimuli that fuel CLL cell growth through an array of survival signaling pathways. Novel small-molecule agents targeting the B-cell receptor pathway and anti-apoptotic proteins alone or in combination have revolutionized the management of CLL, yet combination therapy carries significant toxicity and CLL remains incurable due to residual disease and relapse. Single-molecule inhibitors that can target multiple disease-driving factors are thus an attractive approach to combat both drug resistance and combination-therapy-related toxicities. We demonstrate that SRX3305, a novel small-molecule Btk/PI3K/BRD4 Inhibitor that targets three distinctive facets of CLL biology, attenuates CLL cell proliferation and promotes Apoptosis in a dose-dependent fashion. SRX3305 also inhibits the activation-induced proliferation of primary CLL cells in vitro and effectively blocks microenvironment-mediated survival signals, including stromal cell contact. Furthermore, SRX3305 blocks CLL cell migration toward CXCL-12 and CXCL-13, which are major chemokines involved in CLL cell homing and retention in microenvironment niches. Importantly, SRX3305 maintains its anti-tumor effects in ibrutinib-resistant CLL cells. Collectively, this study establishes the preclinical efficacy of SRX3305 in CLL, providing significant rationale for its development as a therapeutic agent for CLL and related disorders.

Keywords
B-cell receptor signaling; BET/BRD4 proteins; BTK; PI3K; chronic lymphocytic leukemia; targeted small molecule inhibitor.
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