title: Erlotinib exhibits antineoplastic off-target effects in AML and MDS: a preclinical study.
abstract: Erlotinib, an inhibitor of the epidermal growth factor receptor (EGFR), induces differentiation, cell-cycle arrest, and apoptosis of EGFR-negative myeloblasts of patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML), as well as in EGFR-negative cell lines representing these diseases (P39, KG-1, and HL 60). This off-target effect can be explained by inhibitory effects on JAK2. Apoptosis induction coupled to mitochondrial membrane permeabilization occurred independently from phenotypic differentiation. In apoptosis-sensitive AML cells, erlotinib caused a rapid (within less than 1 hour) nucleocytoplasmic translocation of nucleophosmin-1 (NPM-1) and p14(ARF). Apoptosis-insensitive myeloblasts failed to manifest this translocation yet became sensitive to apoptosis induction by erlotinib when NPM-1 was depleted by RNA interference. Moreover, erlotinib reduced the growth of xenografted human AML cells in vivo. Erlotinib also killed CD34(+) bone marrow blasts from MDS and AML patients while sparing normal CD34(+) progenitors. This ex vivo therapeutic effect was once more associated with the nucleocytoplasmic translocation of NPM-1 and p14(ARF). One patient afflicted with both MDS and non-small cell lung cancer manifested hematologic improvement in response to erlotinib. In summary, we here provide novel evidence in vitro, ex vivo, and in vivo for the potential therapeutic efficacy of erlotinib in the treatment of high-risk MDS and AML.
authors.affiliation: Inserm, U848, Villejuif, France.
authors.forename: Simone
authors.initials: S
authors.lastname: Boehrer
authors.forename: Lionel
authors.initials: L
authors.lastname: Adès
authors.forename: Thorsten
authors.initials: T
authors.lastname: Braun
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Galluzzi
authors.forename: Jennifer
authors.initials: J
authors.lastname: Grosjean
authors.forename: Claire
authors.initials: C
authors.lastname: Fabre
authors.forename: Génèviève
authors.initials: G
authors.lastname: Le Roux
authors.forename: Claude
authors.initials: C
authors.lastname: Gardin
authors.forename: Antoine
authors.initials: A
authors.lastname: Martin
authors.forename: Stéphane
authors.initials: S
authors.lastname: de Botton
authors.forename: Pierre
authors.initials: P
authors.lastname: Fenaux
authors.forename: Guido
authors.initials: G
authors.lastname: Kroemer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use* / Q000633:toxicity; D017209:Apoptosis / Q000187:drug effects; D002453:Cell Cycle / Q000187:drug effects; D045744:Cell Line, Tumor; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use* / Q000633:toxicity; D011799:Quinazolines / Q000627:therapeutic use* / Q000633:toxicity; D012016:Reference Values
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride