SHMT inhibition is effective and synergizes with methotrexate in T-cell acute lymphoblastic leukemia.
Juan Carlos García-CañaverasOlga LanchoGregory S DuckerJonathan M GhergurovichXincheng XuVictoria da Silva-DizSonia MinuzzoStefano IndraccoloHahn KimDaniel HerranzJoshua D RabinowitzPublished in: Leukemia (2020)
Folate metabolism enables cell growth by providing one-carbon (1C) units for nucleotide biosynthesis. The 1C units are carried by tetrahydrofolate, whose production by the enzyme dihydrofolate reductase is targeted by the important anticancer drug methotrexate. 1C units come largely from serine catabolism by the enzyme serine hydroxymethyltransferase (SHMT), whose mitochondrial isoform is strongly upregulated in cancer. Here we report the SHMT inhibitor SHIN2 and demonstrate its in vivo target engagement with 13C-serine tracing. As methotrexate is standard treatment for T-cell acute lymphoblastic leukemia (T-ALL), we explored the utility of SHIN2 in this disease. SHIN2 increases survival in NOTCH1-driven mouse primary T-ALL in vivo. Low dose methotrexate sensitizes Molt4 human T-ALL cells to SHIN2, and cells rendered methotrexate resistant in vitro show enhanced sensitivity to SHIN2. Finally, SHIN2 and methotrexate synergize in mouse primary T-ALL and in a human patient-derived xenograft in vivo, increasing survival. Thus, SHMT inhibition offers a complementary strategy in the treatment of T-ALL.
Keyphrases
- high dose
- acute lymphoblastic leukemia
- induced apoptosis
- low dose
- endothelial cells
- oxidative stress
- cell cycle arrest
- endoplasmic reticulum stress
- allogeneic hematopoietic stem cell transplantation
- protein kinase
- squamous cell carcinoma
- emergency department
- pluripotent stem cells
- social media
- papillary thyroid
- free survival
- combination therapy
- drug delivery
- adverse drug