title: Pralatrexate is synergistic with the proteasome inhibitor bortezomib in in vitro and in vivo models of T-cell lymphoid malignancies.
abstract: OBJECTIVE
  Pralatrexate (10-propargyl-10-deazaaminopterin) is an antifolate with improved cellular uptake and retention due to greater affinity for the reduced folate carrier (RFC-1) and folyl-polyglutamyl synthase. Based on the PROPEL data, pralatrexate was the first drug approved for patients with relapsed and refractory peripheral T-cell lymphoma. Bortezomib is a proteasome inhibitor that has shown some activity in patients with T-cell lymphoma.
  
  
  METHODS
  Assays for cytotoxicity including mathematical analysis for synergism, flow cytometry, immunoblotting, and a xenograft severe combined immunodeficient-beige mouse model were used to explore the in vitro and in vivo activities of pralatrexate alone and in combination with bortezomib in T-cell lymphoid malignancies.
  
  
  RESULTS
  In vitro, pralatrexate and bortezomib exhibited concentration- and time-dependent cytotoxicity against a broad panel of T-lymphoma cell lines. Pralatrexate showed synergism when combined with bortezomib in all cell lines studied. Pralatrexate also induced potent apoptosis and caspase activation when combined with bortezomib across the panel. Cytotoxicity studies on normal peripheral blood mononuclear cells showed that the combination was not more toxic than the single agents. Western blot assays for proteins involved in broad growth and survival pathways showed that p27, NOXA, HH3, and RFC-1 were all significantly modulated by the combination. In a severe combined immunodeficient-beige mouse model of transformed cutaneous T-cell lymphoma, the addition of pralatrexate to bortezomib enhanced efficacy compared with either drug alone.
  
  
  CONCLUSIONS
  Collectively, these data suggest that pralatrexate in combination with bortezomib represents a novel and potentially important platform for the treatment of T-cell malignancies.
authors.affiliation: New York University Cancer Institute, NYU Langone Medical Center, New York, New York 10016, USA.
authors.forename: Enrica
authors.initials: E
authors.lastname: Marchi
authors.forename: Luca
authors.initials: L
authors.lastname: Paoluzzi
authors.forename: Luigi
authors.initials: L
authors.lastname: Scotto
authors.forename: Venkatraman E
authors.initials: VE
authors.lastname: Seshan
authors.forename: Jasmine M
authors.initials: JM
authors.lastname: Zain
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Zinzani
authors.forename: Owen A
authors.initials: OA
authors.lastname: O'Connor
mesh_terms: D000630:Aminopterin / Q000031:analogs & derivatives* / Q000494:pharmacology; D000818:Animals; D017209:Apoptosis / Q000187:drug effects; D001897:Boronic Acids / Q000494:pharmacology*; D000069286:Bortezomib; D053181:Caspase 8 / Q000378:metabolism; D053453:Caspase 9 / Q000378:metabolism; D045744:Cell Line, Tumor; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D006801:Humans; D016399:Lymphoma, T-Cell / Q000188:drug therapy*; D051379:Mice; D016513:Mice, SCID; D009368:Neoplasm Transplantation; D011719:Pyrazines / Q000494:pharmacology*; D023041:Xenograft Model Antitumor Assays
chemical_list: C418863:10-propargyl-10-deazaaminopterin; D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib; D053181:Caspase 8; D053453:Caspase 9; D000630:Aminopterin