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Exploration of Predictive Biomarkers for Combined BCL2 and Methylation Inhibitor Therapies in Elderly Leukemia Patients

Research Project

Project/Area Number 21K20913
Research Category

Grant-in-Aid for Research Activity Start-up

Allocation TypeMulti-year Fund
Review Section 0902:General internal medicine and related fields
Research InstitutionJuntendo University

Principal Investigator

YAMATANI KOTOKO  順天堂大学, 医学部, 非常勤助教 (90909805)

Project Period (FY) 2021-08-30 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥3,120,000 (Direct Cost: ¥2,400,000、Indirect Cost: ¥720,000)
Fiscal Year 2022: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2021: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords急性骨髄性白血病 / ベネトクラクス / デシタビン / 治療抵抗性 / デシダビン / ベネトクラックス / RNA-seq / メチル化 / BCL2阻害剤 / DNAメチル化阻害剤 / 治療予測マーカー / methylation assay / 白血病 / DNAメチル基転移酵素阻害剤 / 治療効果予測マーカー
Outline of Research at the Start

高齢白血病患者の予後は不良で、副作用の低減と治療効果の向上を両立する治療戦略が模索されている。近年、BCL2阻害剤ベネトクラクスとDNAメチル化阻害剤デシタビンの併用療法が有望な治療効果が示され、第Ⅱ臨床研究まで進行している。しかし、併用療法によっても25%程度の症例で治療抵抗性が生じる。そのため、治療反応性を予測し、適した患者に適した治療を選別することが課題であるが、治療効果を裏付ける分子的基盤は不明な点が多い。本研究では、同臨床研究で採取された治療前後の患者検体を用いて、奏効群と非奏効群での遺伝子発現パターンやエピジェネティクス変化を解析し、治療効果予測マーカーの探索を行う。

Outline of Final Research Achievements

The combination of venetoclax (VEN), an inhibitor of the anti-apoptotic factor BCL2, with the hypomethylating agent, decitabine (DEC) is the current frontline standard of care for elderly patients with acute myeloid leukemia (AML). Despite the success of VEN/DEC in inducing remission in AML, a significant proportion of patients remain refractory to combination therapy. Our RNA sequencing analysis revealed that genes related to fatty acid metabolism were significantly upregulated in leukemia cells obtained from non-responders after treatment with VEN/DEC. We identified significantly increased expression of Peroxisome Proliferator-Activated Receptor gamma (PPARG) in these non-responders after treatment. Furthermore, AML cells overexpressing PPARG acquired VEN/DEC resistance with up-regulation of fatty acid metabolism. These findings suggest that elevated PPARG expression affects cellular energy metabolism and contributes to treatment resistance.

Academic Significance and Societal Importance of the Research Achievements

本研究は、高齢者白血病に対するベネトクラクスとデシタビン併用療法の治療抵抗性の分子機構を解明し、がん治療における新たな知見を提供する。PPARGを含むエネルギー代謝に関与する遺伝子発現パターンを識別マーカーとして利用することで、個別化医療に応用できる可能性を示唆する。さらに、PPARGおよび脂肪酸代謝経路が治療抵抗性に関与することを示し、新たな治療標的を提案する。本研究は、治療効果を最大化し、患者の生存率と生活の質を向上させ、医療コストの削減にも寄与し、がん治療の選択肢を広げる基盤を提供する。

Report

(4 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • Research Products

    (6 results)

All 2023 2022 2021

All Journal Article (1 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 1 results,  Open Access: 1 results) Presentation (5 results) (of which Int'l Joint Research: 4 results)

  • [Journal Article] Inhibition of BCL2A1 by STAT5 inactivation overcomes resistance to targeted therapies of FLT3-ITD/D835 mutant AML2022

    • Author(s)
      Yamatani K, Ai T, Saito K, Suzuki K, Hori A, Kinjo S, Ikeo K, Ruvolo V, Zhang W, Mak PY, Kaczkowski B, Harada H, Katayama K, Sugimoto Y, Myslinski J, Hato T, Miida T, Konopleva M, Hayashizaki Y, Carter BZ, Tabe Y, Andreeff M
    • Journal Title

      Translational Oncology

      Volume: 18 Pages: 101354-101354

    • DOI

      10.1016/j.tranon.2022.101354

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Presentation] PPARG and ASS1: Targets of metabolic alteration in Venetoclax / Decitabine resistant AML2023

    • Author(s)
      Kotoko Yamatani, Tatsuro Watanabe, Kaori Saito1, Abhishek Maiti, Satoshi Yamashita, Abdullah Khasawneh, Faith Jessica Paran, Kala Hayes, Gautam Borthakur, Joe R Harman, Shinya Kimura, Courtney D. DiNardo, Thomas A Milne, Michael Andreeff, Yoko Tabe, Marina Konopleva
    • Organizer
      65th ASH Annual Meeting and Exposition
    • Related Report
      2023 Annual Research Report
  • [Presentation] Diverse mechanisms of resistance to Decitabine and Venetoclax therapy in newly diagnosed and relapsed/refractory AML inferred by transcriptome analysis2022

    • Author(s)
      Kotoko Yamatani, Tatsuro Watanabe, Kaori Saitoh, KaZuhiro Nitta, Kanako Kinjo, Kazuho Ikeo, Takashi Miida, Shinya Kimura, Su Xiaoping, Marina Konopleva,Yoko Tabe
    • Organizer
      The 17th Congress of Asian Society of Clinical Pathology and Laboratory Medicine
    • Related Report
      2022 Research-status Report
    • Int'l Joint Research
  • [Presentation] Biomarkers of clinical resistance to Decitabine and Venetoclax therapy inferred by transcriptome and methylation analyses2022

    • Author(s)
      Kotoko Yamatani, Abhishek Maiti, Tatsuro Watanabe, Kaori Saitoh, Kala Hayes, Sonoko Kinjo, Kazuho Ikeo, Takashi Miida, Shinya Kimura, Courtney D. DiNardo, Su Xiaoping, Yoko Tabe, Marina Konopleva
    • Organizer
      64th ASH Annual Meeting and Exposition
    • Related Report
      2022 Research-status Report
    • Int'l Joint Research
  • [Presentation] Diverse mechanisms of resistance to Decitabine and Venetoclax therapy in newly diagnosed vs relapsed/refractory AML inferred by transcriptome analysis2021

    • Author(s)
      1)Kotoko Yamatani, Yoko Tabe, Abhishek Maiti, Tomohiko Ai, Kaori Saitoh, Kazuhiro Nitta, Kanako Kinjo, Kazuho Ikeo, Takashi Miida, Courtney D. DiNardo, Su Xiaoping, Marina Konopleva
    • Organizer
      63nd ASH Annual Meeting and Exposition
    • Related Report
      2021 Research-status Report
    • Int'l Joint Research
  • [Presentation] BCL2A1: A Novel Target in Refractory/Relapsed AML with FLT3-ITD/D835 Double Mutations2021

    • Author(s)
      2)Kotoko Yamatani, Bing Z. Carter, Marina Konopleva, Yoko Tabe, Michael Andreeff
    • Organizer
      SOHO 2021 Annual Meeting
    • Related Report
      2021 Research-status Report
    • Int'l Joint Research

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Published: 2021-10-22   Modified: 2025-01-30  

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