title: Selective Inhibitors of Histone Deacetylases 1 and 2 Synergize with Azacitidine in Acute Myeloid Leukemia.
abstract: Acute myeloid leukemia (AML) is a heterogeneous group of hematopoietic stem cell disorders characterized by defects in myeloid differentiation and increased proliferation of neoplastic hematopoietic precursor cells. Outcomes for patients with AML remain poor, highlighting the need for novel treatment options. Aberrant epigenetic regulation plays an important role in the pathogenesis of AML, and inhibitors of DNA methyltransferase or histone deacetylase (HDAC) enzymes have exhibited activity in preclinical AML models. Combination studies with HDAC inhibitors plus DNA methyltransferase inhibitors have potential beneficial clinical activity in AML, however the toxicity profiles of non-selective HDAC inhibitors in the combination setting limit their clinical utility. In this work, we describe the preclinical development of selective inhibitors of HDAC1 and HDAC2, which are hypothesized to have improved safety profiles, for combination therapy in AML. We demonstrate that selective inhibition of HDAC1 and HDAC2 is sufficient to achieve efficacy both as a single agent and in combination with azacitidine in preclinical models of AML, including established AML cell lines, primary leukemia cells from AML patient bone marrow samples and in vivo xenograft models of human AML. Gene expression profiling of AML cells treated with either an HDAC1/2 inhibitor, azacitidine, or the combination of both have identified a list of genes involved in transcription and cell cycle regulation as potential mediators of the combinatorial effects of HDAC1/2 inhibition with azacitidine. Together, these findings support the clinical evaluation of selective HDAC1/2 inhibitors in combination with azacitidine in AML patients.
authors.affiliation: Acetylon Pharmaceuticals Inc., Boston, Massachusetts, United States of America.
authors.forename: Chengyin
authors.initials: C
authors.lastname: Min
authors.affiliation: Acetylon Pharmaceuticals Inc., Boston, Massachusetts, United States of America.
authors.forename: Nathan
authors.initials: N
authors.lastname: Moore
authors.affiliation: Acetylon Pharmaceuticals Inc., Boston, Massachusetts, United States of America.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Shearstone
authors.affiliation: Acetylon Pharmaceuticals Inc., Boston, Massachusetts, United States of America.
authors.forename: Steven N
authors.initials: SN
authors.lastname: Quayle
authors.affiliation: Acetylon Pharmaceuticals Inc., Boston, Massachusetts, United States of America.
authors.forename: Pengyu
authors.initials: P
authors.lastname: Huang
authors.affiliation: Acetylon Pharmaceuticals Inc., Boston, Massachusetts, United States of America.
authors.forename: John H
authors.initials: JH
authors.lastname: van Duzer
authors.affiliation: Acetylon Pharmaceuticals Inc., Boston, Massachusetts, United States of America.
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Jarpe
authors.affiliation: Acetylon Pharmaceuticals Inc., Boston, Massachusetts, United States of America.
authors.forename: Simon S
authors.initials: SS
authors.lastname: Jones
authors.affiliation: Acetylon Pharmaceuticals Inc., Boston, Massachusetts, United States of America.
authors.forename: Min
authors.initials: M
authors.lastname: Yang
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000494:pharmacology*; D001374:Azacitidine / Q000494:pharmacology*; D015415:Biomarkers; D001854:Bone Marrow Cells; D045744:Cell Line, Tumor; D002470:Cell Survival / Q000187:drug effects; D004195:Disease Models, Animal; D004357:Drug Synergism; D005260:Female; D050989:GATA2 Transcription Factor / Q000235:genetics / Q000378:metabolism; D020869:Gene Expression Profiling; D015973:Gene Expression Regulation, Leukemic / Q000187:drug effects; D056284:Histone Deacetylase 1 / Q000037:antagonists & inhibitors*; D056464:Histone Deacetylase 2 / Q000037:antagonists & inhibitors*; D056572:Histone Deacetylase Inhibitors / Q000494:pharmacology*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000235:genetics / Q000378:metabolism*; D051379:Mice; D058990:Molecular Targeted Therapy; D023041:Xenograft Model Antitumor Assays
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D050989:GATA2 Transcription Factor; D056572:Histone Deacetylase Inhibitors; D056284:Histone Deacetylase 1; D056464:Histone Deacetylase 2; D001374:Azacitidine