Inhibition of Notch signaling enhances chemosensitivity in B cell precursor acute lymphoblastic leukemia.

Research paper by Paul P Takam Kamga, Giada G Dal Collo, Martina M Midolo, Annalisa A Adamo, Pietro P Delfino, Angela A Mercuri, Simone S Cesaro, Elda E Mimiola, Massimiliano M Bonifacio, Angelo A Andreini, Marco M Chilosi, Mauro M Krampera

Indexed on: 20 Dec '18Published on: 20 Dec '18Published in: Cancer research


Notch3 and Notch4 support survival of primary B cell acute lymphoblastic leukemia (B-ALL) cells, suggesting a role for Notch signaling in drug response. Here we used in vitro, in silico, and in vivo mouse xenograft model-based approaches to define the role of the Notch pathway in B-ALL chemosensitivity. We observed significant Notch receptor and ligand expression in B-ALL primary cells and cell lines. Primary leukemia cells from high-risk patients overexpressed Notch3, Notch4, and Jagged2 while displaying a reduction in expression levels of Notch1-4 following chemotherapy. We then analyzed in vitro, cell survival of B-ALL cells treated with conventional chemotherapeutic agents alone or in combination with Notch signaling inhibitors. Gamma-secretase inhibitors (GSI) and anti-Notch4 were all capable of potentiating drug-induced cell death in B-ALL cells by upregulating intracellular levels of reactive oxygen species, which in turn modulated mTOR, NF-κB, and ERK expression. In NOG-mouse-based xenograft models of B-ALL, co-administration of the Notch inhibitor GSI-XII with the chemotherapeutic agent Ara-C lowered bone marrow leukemic burden compared to DMSO or Ara-C alone, thus prolonging mouse survival. Overall, our results support the potential effectiveness of Notch inhibitors in B-ALL patients. Copyright ©2018, American Association for Cancer Research.

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