Anlotinib exerts potent antileukemic activities in Ph chromosome negative and positive B-cell acute lymphoblastic leukemia via perturbation of PI3K/AKT/mTOR pathway

• Published in: Translational oncology 2022-11, Vol.25, p.101516-101516, Article 101516
• Main Authors: Chen, Qiuling, Lai, Qian, Jiang, Yuelong, Yao, jingwei, Chen, Qinwei, Zhang, Li, Wang, Caiyan, Zhou, Yong, Deng, Manman, Xu, Bing
• Format: Article
• Language: English
• Subjects: Acute lymphoblastic leukemia (ALL); Anlotinib; Original Research; PI3K/AKT/mTOR; Tyrosine kinase inhibitor (TKI); VEGF/VEGFR2
• ISSN: 1936-5233; 1936-5233
• DOI: 10.1016/j.tranon.2022.101516

•Anlotinib that is developed to block the proangiogenic roles of VEGFR, PDGFR, and FGFR potently decreased cell viability, promoted cell apoptosis and blocked cell cycle at G2/M phase in B-ALL cellular models.•treatment with Anlotinib significantly abrogated leukemia burden and prolonged survival period in a patient-derived-xenograft B-ALL mouse model.•Anlotinib treatment significantly diminished the phosphorylation levels of PI3K, AKT and mTOR, which are common downstream targets of proangiogenic signals. Despite advances in the development of novel targeted therapies, the need for B-ALL alternative treatments has not been met. Anlotinib could blunt the proangiogenic activity of VEGFR, PDGFR, and FGFR, and has shown strong antitumor activities across multiple tumors. However, anlotinib cytotoxicity against B-ALL has not ever been evaluated, thus prompting us to initiate this study. Expression2Kinases program was used to identify potential treatment targets. Cell viability and apoptosis were determined by CCK-8 and Annexin V/PI staining kit, respectively. qRT-PCR and Western blotting were utilized to investigate the molecular mechanisms. In vivo antileukemia activity of Anlotinib was evaluated in a Ph+ B-ALL patient-Derived Xenograft (PDX) model. Compared with treatment-naive B-ALL cases, RR B-ALL patients had higher activities in the VEGF/VEGFR signaling and the PI3K/AKT/mTOR pathway. Exposure of Ph− and Ph+ B-ALL cells to anlotinib resulted in significant cell viability reduction, apoptosis enhancement, and cell cycle arrest at G2/M phase. Importantly, anlotinib treatment led to remarkably decreased leukemia burdens and extended the survival period in a Ph+ B-ALL PDX model. Blockade of the role of the proangiogenic mediators, comprising VEGFR2, PDGFR-beta, and FGFR3, played a critical role in the cytotoxicity of anlotinib against Ph− and Ph+ B-ALL. Moreover, anlotinib dampened the activity of PI3K/AKT/mTOR pathway that resides in the convergence of the three mentioned proangiogenic signals. This work provides impressive preclinical evidence of anlotinib against Ph− and Ph+ B-ALL and raises a rationale for future clinical evaluation of this drug in the management of Ph− and Ph+ B-ALL.