Surface pTα expression predicts LCK activation and preclinical synergy of LCK and JAK coinhibition in adult T-ALL.

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Tác giả: Guillaume P Andrieu, Vahid Asnafi, André Baruchel, Nicolas Boissel, Aurelie Cabannes-Hamy, Guillaume Charbonnier, Marianne Courgeon, Lucien Courtois, Hervé Dombret, Marie-Emilie Dourthe, Nicolas Gaidot, Grégoire Huré, Ludovic Lhermitte, Elizabeth A Macintyre, Antoine Pinton, Mélodie Queri, Philippe Rousselot, Mathieu Simonin, Charlotte Smith, Aurore Touzart

Ngôn ngữ: eng

Ký hiệu phân loại: 912.01 Philosophy and theory

Thông tin xuất bản: United States : Blood , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 220452

Refractory and/or relapsing T-cell acute lymphoblastic leukemia (T-ALL) remains a major therapeutic challenge. The pre-TCR pathway has recently emerged as a therapeutic target via LCK inhibition in this context. However, there is a need for simple and quickly assessable biomarkers to predict sensitivity to LCK inhibitors. Moreover, targeting LCK alone by tyrosine kinase inhibitors, such as Dasatinib, often results in transient clinical responses, emphasizing the need for efficient combination strategies. Here, we assessed pre-TCR alpha chain (pTα) surface expression by flow cytometry in a unique series of 50 adult T-ALL patient-derived xenografts (PDX). We show that cases displaying a cortical phenotype often express high levels of surface pTα (pre-TCR+ T-ALL) and that the latter associates with LCK activation. Furthermore, we show that ectopic interleukin-7 receptor (IL-7R) expression can rescue pre-TCR+ T-ALL from Dasatinib cytotoxicity (5 PDX). We tested whether co-inhibition of pre-TCR and IL-7R signaling pathways could be synergetic in pre-TCR+ IL-7R+ T-ALL (11 PDX). Combination of JAK-inhibitors, Ruxolitinib or Tofacitinib, with Dasatinib elicited strong and specific synergy in IL-7R+ pre-TCR+ T-ALL in vitro, including in the relapse setting (4/28 patient-derived primary samples). Using 3 adult-PDX models, we show that in vivo treatment with this combination significantly delayed leukemic progression and prolonged survival compared to either monotherapy. This preclinical study thus proposes the use of pTα as a biomarker of LCK-inhibitor sensitivity in T-ALL, and suggests that dual targeting of IL-7R and pre-TCR signaling pathways may be a relevant therapeutic strategy in a substantial proportion of adult T-ALL.
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