Methods and Pharmaceutical Compositions for Treating Lymphoid Malignancy
20190209570 ยท 2019-07-11
Assignee
Inventors
Cpc classification
C12N9/1205
CHEMISTRY; METALLURGY
A61K31/713
HUMAN NECESSITIES
C12Y207/01137
CHEMISTRY; METALLURGY
A61K31/573
HUMAN NECESSITIES
C12Y207/01153
CHEMISTRY; METALLURGY
International classification
C12N15/113
CHEMISTRY; METALLURGY
A61K31/713
HUMAN NECESSITIES
G01N33/50
PHYSICS
C12N9/12
CHEMISTRY; METALLURGY
Abstract
The present invention provides, inter alia, methods for treating, preventing, or ameliorating the effects of a lymphoid malignancy, such as those associated with a mutated phosphatase and tensin homolog (PTEN) gene, or T-cell acute lymphoblastic leukemia (T-ALL). These methods include administering to a subject an effective amount of a phosphoinositide 3-kinase-delta (PI3K?) inhibitor and a phosphoinositide 3-kinase-gamma (PI3K?) inhibitor. The present invention also provides pharmaceutical compositions for treating the effects of a lymphoid malignancy. This invention further provides a method for identifying a subject who may benefit from co-treatment with a PI3K? inhibitor and a PI3K? inhibitor. This method includes determining from a sample of the subject whether the subject has a mutated PTEN gene. Additionally, this invention provides methods for identifying a compound that has both PI3K? and PI3K? inhibitory activity.
Claims
1. A method for treating, preventing, or ameliorating the effects of a lymphoid malignancy comprising administering to a subject in need thereof an effective amount of a phosphoinositide 3-kinase-delta (PI3K?) inhibitor and a phosphoinositide 3-kinase-gamma (PI3K?) inhibitor.
2. The method according to claim 1, wherein the lymphoid malignancy is T-cell acute lymphoblastic leukemia (T-ALL) or T-cell acute lymphoblastic lymphoma.
3. The method according to claim 2, wherein the lymphoid malignancy is T-ALL.
4. The method according to claim 1, wherein the PI3K? inhibitor is selected from the group consisting of a biologic, a chemical, and combinations thereof.
5. The method according to claim 4, wherein the PI3K? inhibitor is selected from the group consisting of AMG-3 19; PI3-delta inhibitors, Celizonne; PI3-deltaigamma inhibitors, Cellzome; CHR-4432; XL-499; CAL-120; CAL-129; CAL-130; CAL-253; CAL-263; GS-1101 (CAL-101); benzimidazole series, Genentech; PI13 kinase delta inhibitors, Genentech; PI3 kinase inhibitor, Roche-4; PI3 kinase inhibitors, Roche; PI3 kinase inhibitors, Roche-5; pictilisib; PI3 kinase delta inhibitors, Incozen; PI3 kinase delta inhibitors-2, Incozen; PI3-delta inhibitors, Intellikine; PI3-delta/gamma inhibitors, Intellikine; PI3K delta/gamma inhibitors, Intellikine-1; KAR-4139; KAR-4141; PI3 kinase delta inhibitor, Merck KGaA; OXY-11 IA; PI3-alpha/delta inhibitors, Pathway Therapeutics; PI3-delta inhibitors, Pathway Therapeutics-1; PI3-delta inhibitors, Pathway Therapeutics-2; PI3-delta/gamma inhibitors, Pathway Therapeutics; SF-1126; X-339; IC87114; TG100-115; and combinations thereof.
6. The method according to claim 5, wherein the PI3K? inhibitor is CAL-130.
7. The method according to claim 4, wherein the PI3K? inhibitor is a nucleic acid comprising an shRNA.
8. The method according to claim 1, wherein the PI13K? inhibitor is selected from the group consisting of a biologic, a chemical, and combinations thereof.
9. The method according to claim 8, wherein the PI3K? inhibitor is selected from the group consisting of PI3-delta/gamma inhibitors, Cellzonne; PI3-gamma inhibitor, Cellzonne; PI3-gamma inhibitor Evotec; PI3 kinase inhibitors, Roche; pictilisib; IPI-145; PI3-delta/gamma inhibitors, Intellikine; PI3K delta/gamma inhibitors, Intellikine-1; K_IN-1; PI3-delta/gamma inhibitors, Pathway Therapeutics; PI3-gamma inhibitors, Pathway Therapeutics; SC-103980; SF-1126; AS-041164; AS-604850; TG100-115; AS-605240; CAL-130; and combinations thereof.
10. The method according to claim 9, wherein the PI3K? inhibitor is CAL-130.
11. The method according to claim 8, wherein the PI3K? inhibitor is a nucleic acid comprising an shRNA.
12. The method according to claim 1, further comprising co-administering to the subject at least one chemotherapeutic agent.
13. The method according to claim 12, wherein the chemotherapeutic agent is selected from the group consisting of actinomycin, amsacrine, anthracycline, busulfan, cisplatin, Cytoxan, epirubicin, hexamethylmelamineoxaliplatin, iphosphamide, mitoxantrone, taxotere, teniposide, triethylenethiophosphoramide, hydrocortisone, cortisone, methylprednisolone, prednisolone, dexamethasone, prednisone, betamethasone, triamcinolone, beclometasone, fludrocortisones, deoxycorticosterone, aldosterone, oxaliplatin, zoledronic acid, ibandronate, verapamil, podophyllotoxin, carboplatin, procarbazine, mechlorethamine, cyclophosphamide, camptothecin, ifosfamide, melphalan, chlorambucil, bisulfan, nitrosurea, dactinomycin, daunorubicin, doxorubicin, bleomycin, plicomycin, mitomycin, etoposide (VP16), tamoxifen, transplatinum, 5-fluorouracil, vincristin, vinblastin, methotrexate, L-asparaginase, rapamycin, dibenzazepine (DBZ), uramustine, carmustine, lomustine, streptozocin, temozolomide, oxaliplatin, idarubicin, topotecan, premetrexed, 6-mercaptopurine, darcarbazine, fludarabine, 5-fluorouracil, arabinosycytosine, 5-fluorouracil, arabinosylcytosine, capecitabine, gemcitabine, decitabine, vinca alkaloids, paclitaxel (Taxol?), docetaxel (Taxotere?), ixabepilone (Ixempra?), and combinations thereof.
14. The method according to claim 12, wherein the chemotherapeutic agent is a glucocorticoid selected from the group consisting of hydrocortisone, cortisone, methylprednisolone, prednisolone, dexamethasone, prednisone, betamethasone, triamcinolone, beclometasone, fludrocortisones, deoxycorticosterone, aldosterone, and combinations thereof.
15. The method according to claim 12, wherein the chemotherapeutic agent is dexamethasone.
16. A method for treating, preventing, or ameliorating the effects of a lymphoid malignancy associated with a mutated phosphatase and tensin homolog (PTEN) gene in a subject comprising administering to the subject an effective amount of a phosphoinositide 3-kinase-delta (PI3K?) inhibitor and a phosphoinositide 3-kinase-gamma (PI3K?) inhibitor.
17. The method according to claim 16, wherein the PI3K? inhibitor and the PI3K? inhibitor are CAL-130.
18. A pharmaceutical composition for treating the effects of a lymphoid malignancy comprising a pharmaceutically acceptable carrier and an effective amount of a phosphoinositide 3-kinase-delta (PI3K?) inhibitor and a phosphoinositide 3-kinase-gamma (PI3K?) inhibitor.
19. The pharmaceutical composition according to claim 18, which is in a unit dosage form.
20. The pharmaceutical composition according to claim 8, further comprising an effective amount of dexamethasone.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION OF THE INVENTION
[0044] One embodiment of the present invention is a method for treating, preventing, or ameliorating the effects of a lymphoid malignancy. This method comprises administering to a subject in need thereof an effective amount of a PI3K? inhibitor and a PI3K? inhibitor.
[0045] As used herein, the terms treat, treating, treatment and grammatical variations thereof mean subjecting an individual subject to a protocol, regimen, process or remedy, in which it is desired to obtain a physiologic response or outcome in that subject, e.g., a patient. In particular, the methods and compositions of the present invention may be used to slow the development of disease symptoms or delay the onset of the disease or condition, or halt the progression of disease development. However, because every treated subject may not respond to a particular treatment protocol, regimen, process or remedy, treating does not require that the desired physiologic response or outcome be achieved in each and every subject or subject, e.g., patient, population. Accordingly, a given subject or subject, e.g., patient, population may fail to respond or respond inadequately to treatment.
[0046] As used herein, the terms ameliorate, ameliorating and grammatical variations thereof mean to decrease the severity of the symptoms of a disease in a subject.
[0047] As used herein, the terms prevent, preventing and grammatical variations thereof mean to administer a compound or a composition of the present invention to a subject who has not been diagnosed as having the disease or condition at the time of administration, but who could be expected to develop the disease or condition or be at increased risk for the disease or condition. Preventing also includes administration of at least one compound or a composition of the present invention to those subjects thought to be predisposed to the disease or condition due to age, familial history, genetic or chromosomal abnormalities, due to the presence of one or more biological markers for the disease or condition and/or due to environmental factors.
[0048] As used herein, a subject is a mammal, preferably, a human. In addition to humans, categories of mammals within the scope of the present invention include, for example, agricultural animals, domestic animals, laboratory animals, etc. Some examples of agricultural animals include cows, pigs, horses, goats, etc. Some examples of domestic animals include dogs, cats, etc. Some examples of laboratory animals include rats, mice, rabbits, guinea pigs, etc.
[0049] As used herein, a lymphoid malignancy means an abnormal growth of bodily tissue or cells in the lymphoid system. Such abnormal growth may invade and destroy nearby tissue, and may spread to other parts of the body. The term lymphoid system refers to all of the cells, tissue aggregates, and organs which function together to produce specific resistance to disease, including without limitation, the bone marrow, the thymus, lymphatic vessels, T-cells and their progenitor cells, as well as B-cells and their progenitor cells.
[0050] Lymphoid malignancies may be divided into three classes, Hodgkin's lymphoma, non-Hodgkin's lymphoma (NHL), and composite Hodgkin's lymphoma and NHL. Hodgkin's lymphoma include lymphocyte-rich classical Hodgkin's lymphoma, mixed-cellularity classical Hodgkin's lymphoma, lymphocyte-depleted classical Hodgkin's lymphoma, and nodular lymphocyte predominant Hodgkin's lymphoma. NHL may be further divided into B-cell NHL, T-cell NHL, and NHL of unknown lineage. Exemplary B-cell NHL include without limitation precursor B-cell NHL (such as B lymphoblastic leukemia and B lymphoblastic lymphoma), chronic lymphocytic leukemia, small lymphocytic lymphoma, prolymphocytic leukemia, mantel-cell lymphoma, lymphoplasmacytic lymphoma, Waldenstr?m macroglobulinemia, Burkitt lymphoma, follicular lymphoma, splenic marginal-zone lymphoma, extranodal marginal-zone lymphoma, nodal marginal-zone lymphoma, hairy-cell leukemia, diffuse large B-cell lymphoma, intravascular large B-cell lymphoma, primary effusion lymphoma, mediastinal large B-cell lymphoma, plasmacytoma, and multiple myeloma/plasma cell leukemia. T-cell NHL include precursor T-cell NHL (such as T-cell acute lymphoblastic leukemia (T-ALL) and T-cell acute lymphoblastic lymphoma), mycosis fungoides, Sezary syndrome, adult T-cell leukemia, adult T-cell lymphoma, NK/T-cell lymphoma, aggressive NK-cell leukemia, T-cell large granular lymphocytic leukemia, T-cell prolymphocytic leukemia, and peripheral T-cell lymphoma (such as angioimmunoblastic lymphoma, subcutaneous panniculitis-like T-cell lymphoma, anaplastic large-cell lymphoma, hepatoplenic T-cell lymphoma, enteropathy-type T-cell lymphoma, cutaneous T-cell lymphoma, primary cutaneous anaplastic large-cell lymphoma). Preferably, the lymphoid malignancy is T-ALL or T-cell acute lymphoblastic lymphoma. In another preferred embodiment, wherein the lymphoid malignancy is T-ALL.
[0051] As used herein, a PI3K? inhibitor is an agent that is able to lower the activity level or the expression level of PI3K?. Preferably, the PI3K? inhibitor has few or no off-target effects; except that it is permissible, in accordance with the present invention, to also have an inhibitory effect on PI3K? as set forth in more detail below. The PI3K? inhibitor according to the present invention may be a biologic, a chemical, or combinations thereof. PI3K? inhibitors include, without limitation, AMG-319 (Amgen, Thousand Oaks, Calif.); PI3-delta inhibitors, Cellzome (Cellzome AG, Heidelberg, Germany); PI3-delta/gamma inhibitors, Cellzome (Cellzome AG); CHR-4432 (Chroma Therapeutics, Ltd., Abingdon, UK); XL-499 (Evotech, Hamburg, Germany); CAL-120 (Gilead Sciences, Foster City, Calif.); CAL-129 (Gilead Sciences); CAL-130 (Gilead Sciences); CAL-253 (Gilead Sciences); CAL-263 (Gilead Sciences); GS-1101 (CAL-101) (Gilead Sciences); benzimidazole series, Genentech (Roche Holdings Inc., South San Francisco, Calif.); PI3 kinase delta inhibitors, Genentech (Roche Holdings Inc.); PI3 kinase inhibitor, Roche-4 (Roche Holdings Inc.); PI3 kinase inhibitors, Roche (Roche Holdings Inc.); PI3 kinase inhibitors, Roche-5 (Roche Holdings Inc.); pictilisib (Roche Holdings Inc.); PI3 kinase delta inhibitors, Incozen (Incozen Therapeutics, Pvt. Ltd., Hydrabad, India); PI3 kinase delta inhibitors-2, Incozen (Incozen Therapeutics); PI3-delta inhibitors, Intellikine (Intellikine Inc., La Jolla, Calif.); PI3-delta/gamma inhibitors, Intellikine (Intellikine Inc.); PI3K delta/gamma inhibitors, Intellikine-1 (Intellikine Inc.); KAR-4139 (Karus Therapeutics, Chilworth, UK); KAR-4141 (Karus Therapeutics); PI3 kinase delta inhibitor, Merck KGaA (Merck & Co., Whitehouse Station, N.J.); OXY-111A (NormOxys Inc., Brighton, Mass.); PI3-alpha/delta inhibitors, Pathway Therapeutics (Pathway Therapeutics Ltd., South San Francisco, Calif.); PI3-delta inhibitors, Pathway Therapeutics-1 (Pathway Therapeutics Ltd.); PI3-delta inhibitors, Pathway Therapeutics-2 (Pathway Therapeutics Ltd.); PI3-delta/gamma inhibitors, Pathway Therapeutics (Pathway Therapeutics Ltd.); SF-1126 (Semafore Pharmaceuticals, Indianapolis, Ind.); X-339 (Xcovery, West Palm Beach, Fla.); IC87114 (Gilead Science); TG100-115 (Targegen Inc., San Diego, Calif.); and combinations thereof. Preferably, the PI3K? inhibitor is CAL-130. PI3K? inhibitor may also be a nucleic acid comprising an shRNA or an siRNA, preferably an shRNA.
[0052] As used herein, a biologic means a substance which is derived from or produced by a living organism or synthesized to mimic an in vivo-derived agent or a derivative or product thereof. A biologic may be, for example, a nucleic acid, a polypeptide, or a polysaccharide. Preferably, the biologic is a nucleic acid, a protein, or a combination thereof. More preferably, the nucleic acid comprises an shRNA.
[0053] As used herein, a chemical means a substance that has a definite chemical composition and characteristic properties and that is not a biologic. Non-limiting examples of chemicals include small organic compounds and small inorganic compounds.
[0054] As used herein, a PI3K? inhibitor is an agent that is able to lower the activity level or the expression level of PI3K?. Preferably, the PI3K? inhibitor has few or no off-target effects; except that it is permissible, in accordance with the present invention, to also have an inhibitory effect on PI3K? as set forth in more detail above. The PI3K? inhibitor according to the present invention may be a biologic, a chemical, and combinations thereof. PI3K? inhibitors include, without limitation, PI3-delta/gamma inhibitors, Cellzome (Cellzome AG); PI3-gamma inhibitor, Cellzome (Cellzome AG); PI3-gamma inhibitor Evotec (Evotec); PI3 kinase inhibitors, Roche (Roche Holdings Inc.); pictilisib (Roche Holdings, Inc.); IPI-145 (Intellikine Inc.); PI3-delta/gamma inhibitors, Intellikine (Intellikine Inc.); PI3K delta/gamma inhibitors, Intellikine-1 (Intellikine Inc.); KIN-1 (Karus Therapeutics); PI3-delta/gamma inhibitors, Pathway Therapeutics (Pathway Therapeutics Ltd.); PI3-gamma inhibitors, Pathway Therapeutics (Pathway Therapeutics Ltd.); SC-103980 (Pfizer, New York, N.Y.); SF-1126 (Semafore Pharmaceuticals); AS-041164 (5-benzo[1,3]dioxol-5-ylmethylene-thiazolidine-2,4-dione); AS-604850 (5-(2,2-Difluoro-benzo[1,3]dioxol-5-ylmethylene)-thiazolidine-2,4-dione); TG100-115 (Targegen Inc., San Diego, Calif.); AS-605240 (5-quinoxilin-6-methylene-1,3-thiazolidine-2,4-dione); CAL-130 (Gilead Sciences); and combinations thereof. Preferably, the PI3K? inhibitor is CAL-130. PI3K? inhibitor may also be a nucleic acid comprising an shRNA or an siRNA, preferably an shRNA.
[0055] In the present invention, a single agent that inhibits both PI3K? and PI3K?, but has no or limited effect on other PI3K isoforms, is also contemplated. Non-limiting examples of such an agent having dual inhibitory function include CAL-130; TG100-115; PI3-delta/gamma inhibitors, Cellzome; PI3 Kinase inhibitors, Roche-5; pictilisib; PI3-delta/gamma inhibitors, Intellikine; PI3-delta/gamma inhibitors, Intellikine-1; PI3-delta/gamma inhibitors, Pathway Therapeutics, and SF-1126. As disclosed previously, the present invention also includes co-treatment with one or more PI3K? and one or more PI3K? inhibitors. Such co-treatment may be by co-administration of each inhibitor or administration of one inhibitor followed by another inhibitor with each such administration being temporally spaced apart to achieve a clinically effective result. Determination of such dosing regimens may be determined empirically for each subject or be based on the treating physicians' knowledge and experience.
[0056] In one aspect of this embodiment, this method further comprises co-administering to the subject at least one chemotherapeutic agent. Such chemotherapeutic agent includes, without limitation, actinomycin, amsacrine, anthracycline, busulfan, cisplatin, cytoxan, epirubicin, hexamethylmelamineoxaliplatin, iphosphamide, mitoxantrone, taxotere, teniposide, triethylenethiophosphoramide, hydrocortisone, cortisone, methylprednisolone, prednisolone, dexamethasone, prednisone, betamethasone, triamcinolone, beclometasone, fludrocortisones, deoxycorticosterone, aldosterone, oxaliplatin, zoledronic acid, ibandronate, verapamil, podophyllotoxin, carboplatin, procarbazine, mechlorethamine, cyclophosphamide, camptothecin, ifosfamide, melphalan, chlorambucil, bisulfan, nitrosurea, dactinomycin, daunorubicin, doxorubicin, bleomycin, plicomycin, mitomycin, etoposide (VP16), tamoxifen, transplatinum, 5-fluorouracil, vincristin, vinblastin, methotrexate, L-asparaginase, rapamycin, dibenzazepine (DBZ), uramustine, carmustine, lomustine, streptozocin, temozolomide, oxaliplatin, idarubicin, topotecan, premetrexed, 6-mercaptopurine, darcarbazine, fludarabine, 5-fluorouracil, arabinosycytosine, 5-fluorouracil, arabinosylcytosine, capecitabine, gemcitabine, decitabine, vinca alkaloids, paclitaxel (Taxol?), docetaxel (Taxotere?), ixabepilone (Ixempra?), and combinations thereof. Preferably, the chemotherapeutic agent is a glucocorticoid, such as hydrocortisone, cortisone, methylprednisolone, prednisolone, dexamethasone, prednisone, betamethasone, triamcinolone, beclometasone, fludrocortisones, deoxycorticosterone, aldosterone, and combinations thereof. In a preferred embodiment, the chemotherapeutic agent is dexamethasone.
[0057] In the present invention, one or more PI3K? and/or PI3K? inhibitors and/or one or more chemotherapeutic agents may be co-administered to a subject in need thereof together in the same composition, simultaneously in separate compositions, or as separate compositions administered at different times, as deemed most appropriate by a physician.
[0058] In the present invention, an effective amount or therapeutically effective amount of a PI3K inhibitor, whether a PI3K? inhibitor or a PI3K? inhibitor, is an amount of such an inhibitor that is sufficient to effect beneficial or desired results as described herein when administered to a subject. Effective dosage forms, modes of administration, and dosage amounts may be determined empirically, and making such determinations is within the skill of the art. It is understood by those skilled in the art that the dosage amount will vary with the route of administration, the rate of excretion, the duration of the treatment, the identity of any other drugs being administered, the age, size, and species of mammal, e.g., human patient, and like factors well known in the arts of medicine and veterinary medicine. In general, a suitable dose of a PI3K inhibitor according to the invention will be that amount of the PI3K inhibitor, which is the lowest dose effective to produce the desired effect with no or minimal side effects. The effective dose of a PI3K? inhibitor or a PI3K? inhibitor may be administered as two, three, four, five, six or more sub-doses, administered separately at appropriate intervals throughout the day, with the proviso that the doses of the PI3K? inhibitor or a PI3K? inhibitor simultaneously reduce or inhibit the activity or the expression levels of PI3K? and PI3K?.
[0059] A suitable, non-limiting example of a dosage of a PI3K inhibitor according to the present invention, particularly a PI3K? inhibitor and/or a PI3K? inhibitor, is from about 1 ng/kg to about 1000 mg/kg, such as from about 1 mg/kg to about 100 mg/kg, including from about 5 mg/kg to about 50 mg/kg. Other representative dosages of a PI3K inhibitor include about 1 mg/kg, 5 mg/kg, 10 mg/kg, 15 mg/kg, 20 mg/kg, 25 mg/kg, 30 mg/kg, 35 mg/kg, 40 mg/kg, 45 mg/kg, 50 mg/kg, 60 mg/kg, 70 mg/kg, 80 mg/kg, 90 mg/kg, 100 mg/kg, 125 mg/kg, 150 mg/kg, 175 mg/kg, 200 mg/kg, 250 mg/kg, 300 mg/kg, 400 mg/kg, 500 mg/kg, 600 mg/kg, 700 mg/kg, 800 mg/kg, 900 mg/kg, or 1000 mg/kg.
[0060] Another embodiment of the present invention is a method for treating, preventing, or ameliorating the effects of a lymphoid malignancy associated with a mutated phosphatase and tensin homolog (PTEN) gene in a subject. This method comprises administering to the subject an effective amount of a PI3K? inhibitor and a PI3K? inhibitor.
[0061] As used herein, a mutated phosphatase and tensin homolog (PTEN) gene means having one or more variations in the exon or the intron sequence of PTEN. A lymphoid malignancy associated with a mutated PTEN gene means a lymphoid malignancy in which one or more variations in the PTEN gene sequence is found. Such lymphoid malignancies include, e.g., T-ALL, lymphoblastic lymphoma, large B-cell lymphoma, Burkitt's lymphoma, large B-cell lymphoma, and myeloma.
[0062] The PI3K? inhibitor and the PI3K? inhibitor are as disclosed herein. Preferably, the PI3K? inhibitor and the PI3K? inhibitor are CAL-130.
[0063] In one aspect of this embodiment, the method further comprises administering an effective amount of a chemotherapeutic agent as disclosed herein, such as a glucocorticoid. Preferably, the chemotherapeutic agent is dexamethasone.
[0064] Yet another embodiment of the present invention is a pharmaceutical composition for treating the effects of a lymphoid malignancy. This pharmaceutical composition comprises a pharmaceutically acceptable carrier and an effective amount of a PI3K? inhibitor and a PI3K? inhibitor.
[0065] In one aspect of this embodiment, the pharmaceutical composition is in a unit dosage form.
[0066] In another aspect of this embodiment, the pharmaceutical composition further comprises an effective amount of a chemotherapeutic agent as disclosed herein, such as a glucocorticoid. Preferably, the chemotherapeutic agent is dexamethasone.
[0067] An additional embodiment of the present invention is a method for treating a subject suffering from T-ALL. This method comprises administering to the subject an effective amount of a pharmaceutical composition comprising a PI3K? inhibitor and a PI3K? inhibitor.
[0068] The PI3K? inhibitor and the PI3K? inhibitor are as disclosed herein. Preferably, the PI3K? inhibitor and the PI3K? inhibitor are CAL-130. The pharmaceutical composition of this embodiment may be a single composition containing a dual inhibitor such as, e.g., CAL-130, a single composition containing two active agents, one a PI3K? inhibitor and the other a PI3K? inhibitor, or two or more compositions each containing at least one active agent that is a PI3K? inhibitor or a PI3K? inhibitor.
[0069] In one aspect of this embodiment, the method further comprises administering an effective amount of a chemotherapeutic agent as disclosed herein, such as a glucocorticoid. Preferably, the chemotherapeutic agent is dexamethasone.
[0070] Another embodiment of the present invention is a method for lowering tumor burden in a subject suffering from T-ALL. This method comprises administering to the subject an effective amount of a pharmaceutical composition comprising a PI3K? inhibitor and a PI3K? inhibitor.
[0071] As used herein, tumor burden means the number of tumor (whether benign or malignant) cells in the subject's body, or the size of a tumor.
[0072] The PI3K? inhibitor and the PI3K? inhibitor are as disclosed herein. Preferably, the PI3K? inhibitor and the PI3K? inhibitor are CAL-130.
[0073] In one aspect of this embodiment, the method further comprises administering an effective amount of a chemotherapeutic agent as disclosed herein, such as a glucocorticoid also as defined herein. Preferably, the chemotherapeutic agent is dexamethasone.
[0074] Yet another embodiment of the present invention is a method for identifying a subject who may benefit from co-treatment with a PI3K? inhibitor and a PI3K? inhibitor. This method comprises determining from a sample of the subject whether the subject has a mutated PTEN gene, wherein the presence of the mutated PTEN gene is indicative of a subject who may benefit from co-treatment.
[0075] In this embodiment, the sample is obtain from the subject by any conventional means. Such a sample contains DNA and may be a tissue and/or blood sample, such as a peripheral blood sample. Such a sample may also be biopsy from a tumor. Determining whether a subject has a mutated PTEN gene may be carried out using any conventional genotyping methods known in the art, or by assaying for the PTEN gene product using any conventional means, including the methods disclosed herein, including in the Examples.
[0076] The PI3K? inhibitor and the PI3K? inhibitor are as disclosed herein. Preferably, the PI3K? inhibitor and the PI3K? inhibitor are CAL-130.
[0077] An additional embodiment of the present invention is a method for identifying a compound that has both PI3K? and PI3K? inhibitory activity. This method comprises: [0078] (a) contacting a cell with the compound; and [0079] (b) determining whether the compound modulates an antigen receptor-induced activity in the cell;
wherein a compound that modulates the antigen receptor-induced activity has both PI3K? and PI3K? inhibitory activity.
[0080] As used herein, an antigen receptor-induced activity means an event resulting from T-cell receptor signaling, such as, e.g., phosphorylation of AKT, GSK3?, mTOR, p70S6K, BAD proteins and calcium flux in CD4.sup.+ T cells. Assays for such activities are as disclosed herein.
[0081] A pharmaceutical composition of the present invention may be administered in any desired and effective manner: for oral ingestion, or as an ointment or drop for local administration to the eyes, or for parenteral or other administration in any appropriate manner such as intraperitoneal, subcutaneous, topical, intradermal, inhalation, intrapulmonary, rectal, vaginal, sublingual, intramuscular, intravenous, intraarterial, intrathecal, or intralymphatic. Further, a pharmaceutical composition of the present invention may be administered in conjunction with other treatments. A pharmaceutical composition of the present invention maybe encapsulated or otherwise protected against gastric or other secretions, if desired.
[0082] The pharmaceutical compositions of the invention are pharmaceutically acceptable and comprise one or more active ingredients in admixture with one or more pharmaceutically-acceptable carriers and, optionally, one or more other compounds, drugs, ingredients and/or materials. Regardless of the route of administration selected, the agents/compounds of the present invention are formulated into pharmaceutically-acceptable dosage forms by conventional methods known to those of skill in the art. See, e.g., Remington, The Science and Practice of Pharmacy (21.sup.st Edition, Lippincott Williams and Wilkins, Philadelphia, Pa.).
[0083] Pharmaceutically acceptable carriers are well known in the art (see, e.g., Remington, The Science and Practice of Pharmacy (21.sup.st Edition, Lippincott Williams and Wilkins, Philadelphia, Pa.) and The National Formulary (American Pharmaceutical Association, Washington, D.C.)) and include sugars (e.g., lactose, sucrose, mannitol, and sorbitol), starches, cellulose preparations, calcium phosphates (e.g., dicalcium phosphate, tricalcium phosphate and calcium hydrogen phosphate), sodium citrate, water, aqueous solutions (e.g., saline, sodium chloride injection, Ringer's injection, dextrose injection, dextrose and sodium chloride injection, lactated Ringer's injection), alcohols (e.g., ethyl alcohol, propyl alcohol, and benzyl alcohol), polyols (e.g., glycerol, propylene glycol, and polyethylene glycol), organic esters (e.g., ethyl oleate and tryglycerides), biodegradable polymers (e.g., polylactide-polyglycolide, poly(orthoesters), and poly(anhydrides)), elastomeric matrices, liposomes, microspheres, oils (e.g., corn, germ, olive, castor, sesame, cottonseed, and groundnut), cocoa butter, waxes (e.g., suppository waxes), paraffins, silicones, talc, silicylate, etc. Each pharmaceutically acceptable carrier used in a pharmaceutical composition of the invention must be acceptable in the sense of being compatible with the other ingredients of the formulation and not injurious to the subject. Carriers suitable for a selected dosage form and intended route of administration are well known in the art, and acceptable carriers for a chosen dosage form and method of administration can be determined using ordinary skill in the art.
[0084] The pharmaceutical compositions of the invention may, optionally, contain additional ingredients and/or materials commonly used in such pharmaceutical compositions. These ingredients and materials are well known in the art and include (1) fillers or extenders, such as starches, lactose, sucrose, glucose, mannitol, and silicic acid; (2) binders, such as carboxymethylcellulose, alginates, gelatin, polyvinyl pyrrolidone, hydroxypropylmethyl cellulose, sucrose and acacia; (3) humectants, such as glycerol; (4) disintegrating agents, such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, sodium starch glycolate, cross-linked sodium carboxymethyl cellulose and sodium carbonate; (5) solution retarding agents, such as paraffin; (6) absorption accelerators, such as quaternary ammonium compounds; (7) wetting agents, such as cetyl alcohol and glycerol monostearate; (8) absorbents, such as kaolin and bentonite clay; (9) lubricants, such as talc, calcium stearate, magnesium stearate, solid polyethylene glycols, and sodium lauryl sulfate; (10) suspending agents, such as ethoxylated isostearyl alcohols, polyoxyethylene sorbitol and sorbitan esters, microcrystalline cellulose, aluminum metahydroxide, bentonite, agar-agar and tragacanth; (11) buffering agents; (12) excipients, such as lactose, milk sugars, polyethylene glycols, animal and vegetable fats, oils, waxes, paraffins, cocoa butter, starches, tragacanth, cellulose derivatives, polyethylene glycol, silicones, bentonites, silicic acid, talc, salicylate, zinc oxide, aluminum hydroxide, calcium silicates, and polyamide powder; (13) inert diluents, such as water or other solvents; (14) preservatives; (15) surface-active agents; (16) dispersing agents; (17) control-release or absorption-delaying agents, such as hydroxypropylmethyl cellulose, other polymer matrices, biodegradable polymers, liposomes, microspheres, aluminum monosterate, gelatin, and waxes; (18) opacifying agents; (19) adjuvants; (20) wetting agents; (21) emulsifying and suspending agents; (22), solubilizing agents and emulsifiers, such as ethyl alcohol, isopropyl alcohol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1,3-butylene glycol, oils (in particular, cottonseed, groundnut, corn, germ, olive, castor and sesame oils), glycerol, tetrahydrofuryl alcohol, polyethylene glycols and fatty acid esters of sorbitan; (23) propellants, such as chlorofluorohydrocarbons and volatile unsubstituted hydrocarbons, such as butane and propane; (24) antioxidants; (25) agents which render the formulation isotonic with the blood of the intended recipient, such as sugars and sodium chloride; (26) thickening agents; (27) coating materials, such as lecithin; and (28) sweetening, flavoring, coloring, perfuming and preservative agents. Each such ingredient or material must be acceptable in the sense of being compatible with the other ingredients of the formulation and not injurious to the subject. Ingredients and materials suitable for a selected dosage form and intended route of administration are well known in the art, and acceptable ingredients and materials for a chosen dosage form and method of administration may be determined using ordinary skill in the art.
[0085] Pharmaceutical compositions suitable for oral administration may be in the form of capsules, cachets, pills, tablets, powders, granules, a solution or a suspension in an aqueous or non-aqueous liquid, an oil-in-water or water-in-oil liquid emulsion, an elixir or syrup, a pastille, a bolus, an electuary or a paste. These formulations may be prepared by methods known in the art, e.g., by means of conventional pan-coating, mixing, granulation or lyophilization processes.
[0086] Solid dosage forms for oral administration (capsules, tablets, pills, dragees, powders, granules and the like) may be prepared, e.g., by mixing the active ingredient(s) with one or more pharmaceutically-acceptable carriers and, optionally, one or more fillers, extenders, binders, humectants, disintegrating agents, solution retarding agents, absorption accelerators, wetting agents, absorbents, lubricants, and/or coloring agents. Solid compositions of a similar type maybe employed as fillers in soft and hard-filled gelatin capsules using a suitable excipient. A tablet may be made by compression or molding, optionally with one or more accessory ingredients. Compressed tablets may be prepared using a suitable binder, lubricant, inert diluent, preservative, disintegrant, surface-active or dispersing agent. Molded tablets may be made by molding in a suitable machine. The tablets, and other solid dosage forms, such as dragees, capsules, pills and granules, may optionally be scored or prepared with coatings and shells, such as enteric coatings and other coatings well known in the pharmaceutical-formulating art. They may also be formulated so as to provide slow or controlled release of the active ingredient therein. They may be sterilized by, for example, filtration through a bacteria-retaining filter. These compositions may also optionally contain opacifying agents and may be of a composition such that they release the active ingredient only, or preferentially, in a certain portion of the gastrointestinal tract, optionally, in a delayed manner. The active ingredient can also be in microencapsulated form.
[0087] Liquid dosage forms for oral administration include pharmaceutically-acceptable emulsions, microemulsions, solutions, suspensions, syrups and elixirs. The liquid dosage forms may contain suitable inert diluents commonly used in the art. Besides inert diluents, the oral compositions may also include adjuvants, such as wetting agents, emulsifying and suspending agents, sweetening, flavoring, coloring, perfuming and preservative agents. Suspensions may contain suspending agents.
[0088] Pharmaceutical compositions for rectal or vaginal administration may be presented as a suppository, which maybe prepared by mixing one or more active ingredient(s) with one or more suitable nonirritating carriers which are solid at room temperature, but liquid at body temperature and, therefore, will melt in the rectum or vaginal cavity and release the active compound. Pharmaceutical compositions which are suitable for vaginal administration also include pessaries, tampons, creams, gels, pastes, foams or spray formulations containing such pharmaceutically-acceptable carriers as are known in the art to be appropriate.
[0089] Dosage forms for the topical or transdermal administration include powders, sprays, ointments, pastes, creams, lotions, gels, solutions, patches, drops and inhalants. The active agent(s)/compound(s) may be mixed under sterile conditions with a suitable pharmaceutically-acceptable carrier. The ointments, pastes, creams and gels may contain excipients. Powders and sprays may contain excipients and propellants.
[0090] Pharmaceutical compositions suitable for parenteral administrations comprise one or more agent(s)/compound(s) in combination with one or more pharmaceutically-acceptable sterile isotonic aqueous or non-aqueous solutions, dispersions, suspensions or emulsions, or sterile powders which may be reconstituted into sterile injectable solutions or dispersions just prior to use, which may contain suitable antioxidants, buffers, solutes which render the formulation isotonic with the blood of the intended recipient, or suspending or thickening agents. Proper fluidity can be maintained, for example, by the use of coating materials, by the maintenance of the required particle size in the case of dispersions, and by the use of surfactants. These compositions may also contain suitable adjuvants, such as wetting agents, emulsifying agents and dispersing agents. It may also be desirable to include isotonic agents. In addition, prolonged absorption of the injectable pharmaceutical form may be brought about by the inclusion of agents which delay absorption.
[0091] In some cases, in order to prolong the effect of a drug (e.g., pharmaceutical formulation), it is desirable to slow its absorption from subcutaneous or intramuscular injection. This may be accomplished by the use of a liquid suspension of crystalline or amorphous material having poor water solubility.
[0092] The rate of absorption of the active agent/drug then depends upon its rate of dissolution which, in turn, may depend upon crystal size and crystalline form. Alternatively, delayed absorption of a parenterally-administered agent/drug may be accomplished by dissolving or suspending the active agent/drug in an oil vehicle. Injectable depot forms may be made by forming microencapsule matrices of the active ingredient in biodegradable polymers. Depending on the ratio of the active ingredient to polymer, and the nature of the particular polymer employed, the rate of active ingredient release can be controlled. Depot injectable formulations are also prepared by entrapping the drug in liposomes or microemulsions which are compatible with body tissue. The injectable materials can be sterilized for example, by filtration through a bacterial-retaining filter.
[0093] The formulations may be presented in unit-dose or multi-dose sealed containers, for example, ampules and vials, and may be stored in a lyophilized condition requiring only the addition of the sterile liquid carrier, for example water for injection, immediately prior to use. Extemporaneous injection solutions and suspensions may be prepared from sterile powders, granules and tablets of the type described above.
ADDITIONAL DEFINITIONS
[0094] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. As used in the specification and the appended claims, the singular forms a, an, and the include plural referents unless the context clearly dictates otherwise.
[0095] For recitation of numeric ranges herein, each intervening number there between with the same degree of precision is explicitly contemplated. For example, for the range of 6-9, the numbers 7 and 8 are contemplated in addition to 6 and 9, and for the range 6.0-7.0, the numbers 6.0, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.8, 6,9, and 7.0 are explicitly contemplated.
[0096] Nucleic Acid
[0097] Nucleic acid or oligonucleotide or polynucleotide used herein mean at least two nucleotides covalently linked together. Many variants of a nucleic acid may be used for the same purpose as a given nucleic acid. Thus, a nucleic acid also encompasses substantially identical nucleic acids and complements thereof.
[0098] Nucleic acids may be single stranded or double stranded, or may contain portions of both double stranded and single stranded sequences. The nucleic acid may be DNA, both genomic and cDNA, RNA, or a hybrid, where the nucleic acid may contain combinations of deoxyribo- and ribo-nucleotides, and combinations of bases including uracil, adenine, thymine, cytosine, guanine, inosine, xanthine hypoxanthine, isocytosine and isoguanine. Nucleic acids may be synthesized as a single stranded molecule or expressed in a cell (in vitro or in vivo) using a synthetic gene. Nucleic acids may be obtained by chemical synthesis methods or by recombinant methods.
[0099] The nucleic acid may also be a RNA such as a mRNA, tRNA, short hairpin RNA (shRNA), short interfering RNA (siRNA), double-stranded RNA (dsRNA), transcriptional gene silencing RNA (ptgsRNA), Piwi-interacting RNA, pri-miRNA, pre-miRNA, micro-RNA (miRNA), or anti-miRNA, as described, e.g., in U.S. patent application Ser. Nos. 11/429,720, 11/384,049, 11/418,870, and 11/429,720 and Published International Application Nos. WO 2005/116250 and WO 2006/126040.
[0100] siRNA gene-targeting may be carried out by transient siRNA transfer into cells, achieved by such classic methods as lipid-mediated transfection (such as encapsulation in liposome, complexing with cationic lipids, cholesterol, and/or condensing polymers, electroporation, or microinjection). siRNA gene-targeting may also be carried out by administration of siRNA conjugated with antibodies or siRNA complexed with a fusion protein comprising a cell-penetrating peptide conjugated to a double-stranded (ds) RNA-binding domain (DRBD) that binds to the siRNA (see, e.g., U.S. Patent Application Publication No. 2009/0093026).
[0101] An shRNA molecule has two sequence regions that are reversely complementary to one another and can form a double strand with one another in an intramolecular manner. shRNA gene-targeting may be carried out by using a vector introduced into cells, such as viral vectors (lentiviral vectors, adenoviral vectors, or adeno-associated viral vectors for example). The design and synthesis of siRNA and shRNA molecules are known in the art, and may be commercially purchased from, e.g., Gene Link (Hawthorne, N.Y.), Invitrogen Corp. (Carlsbad, Calif.), Thermo Fisher Scientific, and Dharmacon Products (Lafayette, Colo.).
[0102] The nucleic acid may also be an aptamer, an intramer, or a spiegelmer. The term aptamer refers to a nucleic acid or oligonucleotide molecule that binds to a specific molecular target. Aptamers are derived from an in vitro evolutionary process (e.g., SELEX (Systematic Evolution of Ligands by EXponential Enrichment), disclosed in U.S. Pat. No. 5,270,163), which selects for target-specific aptamer sequences from large combinatorial libraries. Aptamer compositions may be double-stranded or single-stranded, and may include deoxyribonucleotides, ribonucleotides, nucleotide derivatives, or other nucleotide-like molecules. The nucleotide components of an aptamer may have modified sugar groups (e.g., the 2-OH group of a ribonucleotide may be replaced by 2-F or 2-NH.sub.2), which may improve a desired property, e.g., resistance to nucleases or longer lifetime in blood. Aptamers may be conjugated to other molecules, e.g., a high molecular weight carrier to slow clearance of the aptamer from the circulatory system. Aptamers may be specifically cross-linked to their cognate ligands, e.g., by photo-activation of a cross-linker (Brody, E. N. and L. Gold (2000) J. Biotechnol. 74:5-13).
[0103] The term intramer refers to an aptamer which is expressed in vivo. For example, a vaccinia virus-based RNA expression system has been used to express specific RNA aptamers at high levels in the cytoplasm of leukocytes (Blind, M. et al. (1999) Proc. Natl. Acad. Sci. USA 96:3606-3610).
[0104] The term spiegelmer refers to an aptamer which includes L-DNA, L-RNA, or other left-handed nucleotide derivatives or nucleotide-like molecules. Aptamers containing left-handed nucleotides are resistant to degradation by naturally occurring enzymes, which normally act on substrates containing right-handed nucleotides.
[0105] A nucleic acid will generally contain phosphodiester bonds, although nucleic acid analogs may be included that may have at least one different linkage, e.g., phosphoramidate, phosphorothioate, phosphorodithioate, or O-methylphosphoroamidite linkages and peptide nucleic acid backbones and linkages. Other analog nucleic acids include those with positive backbones; non-ionic backbones, and non-ribose backbones, including those disclosed in U.S. Pat. Nos. 5,235,033 and 5,034,506. Nucleic acids containing one or more non-naturally occurring or modified nucleotides are also included within the definition of nucleic acid. The modified nucleotide analog may be located for example at the 5-end and/or the 3-end of the nucleic acid molecule. Representative examples of nucleotide analogs may be selected from sugar- or backbone-modified ribonucleotides. It should be noted, however, that also nucleobase-modified ribonucleotides, i.e. ribonucleotides, containing a non-naturally occurring nucleobase instead of a naturally occurring nucleobase such as uridines or cytidines modified at the 5-position, e.g. 5-(2-amino)propyl uridine, 5-bromo uridine; adenosines and guanosines modified at the 8-position, e.g. 8-bromo guanosine; deaza nucleotides, e.g. 7-deaza-adenosine; O- and N-alkylated nucleotides, e.g. N6-methyl adenosine are suitable. The 2-OH-group may be replaced by a group selected from H, OR, R, halo, SH, SR, NH.sub.2, NHR, NR.sub.2 or ON, wherein R is C.sub.1-C.sub.6 alkyl, alkenyl or alkynyl and halo is F, Cl, Br or I. Modified nucleotides also include nucleotides conjugated with cholesterol through, e.g., a hydroxyprolinol linkage as disclosed in Krutzfeldt et al., Nature (Oct. 30, 2005), Soutschek et al., Nature 432:173-178 (2004), and U.S. Patent Application Publication No. 20050107325. Modified nucleotides and nucleic acids may also include locked nucleic acids (LNA), as disclosed in U.S. Patent Application Publication No. 20020115080. Additional modified nucleotides and nucleic acids are disclosed in U.S. Patent Application Publication No. 20050182005. Modifications of the ribose-phosphate backbone may be done for a variety of reasons, e.g., to increase the stability and half-life of such molecules in physiological environments, to enhance diffusion across cell membranes, or as probes on a biochip. Mixtures of naturally occurring nucleic acids and analogs may be made; alternatively, mixtures of different nucleic acid analogs, and mixtures of naturally occurring nucleic acids and analogs may be made.
[0106] Peptide, Polypeptide, Protein
[0107] The terms peptide, polypeptide, and protein are used interchangeably herein. In the present invention, these terms mean a linked sequence of amino acids, which may be natural, synthetic, or a modification, or combination of natural and synthetic. The term includes antibodies, antibody mimetics, domain antibodies, lipocalins, targeted proteases, and polypeptide mimetics. The term also includes vaccines containing a peptide or peptide fragment intended to raise antibodies against the peptide or peptide fragment.
[0108] Polysaccharides
[0109] The term polysaccharides means polymeric carbohydrate structures, formed of repeating units (either mono- or di-saccharides) joined together by glycosidic bonds. The units of mono- or di-saccharides may be the same or different. Non-limiting examples of polysaccharides include starch, glycogen, cellulose, and chitin.
[0110] Small Organic or Inorganic Molecules
[0111] The phrase small organic or small inorganic molecule includes any chemical or other moiety, other than polysaccharides, polypeptides, and nucleic acids, that can act to affect biological processes. Small molecules can include any number of therapeutic agents presently known and used, or can be synthesized in a library of such molecules for the purpose of screening for biological function(s). Small molecules are distinguished from macromolecules by size. The small molecules of this invention usually have a molecular weight less than about 5,000 daltons (Da), preferably less than about 2,500 Da, more preferably less than 1,000 Da, most preferably less than about 500 Da.
[0112] As used herein, the term organic compound refers to any carbon-based compound other than biologics such as nucleic acids, polypeptides, and polysaccharides. In addition to carbon, organic compounds may contain calcium, chlorine, fluorine, copper, hydrogen, iron, potassium, nitrogen, oxygen, sulfur and other elements. An organic compound may be in an aromatic or aliphatic form. Non-limiting examples of organic compounds include acetones, alcohols, anilines, carbohydrates, mono-saccharides, di-saccharides, amino acids, nucleosides, nucleotides, lipids, retinoids, steroids, proteoglycans, ketones, aldehydes, saturated, unsaturated and polyunsaturated fats, oils and waxes, alkenes, esters, ethers, thiols, sulfides, cyclic compounds, heterocyclic compounds, imidizoles, and phenols. An organic compound as used herein also includes nitrated organic compounds and halogenated (e.g., chlorinated) organic compounds. Collections of small molecules, and small molecules identified according to the invention are characterized by techniques such as accelerator mass spectrometry (AMS; see Turteltaub et al., Curr Pharm Des 2000 6:991-1007, Bioanalytical applications of accelerator mass spectrometry for pharmaceutical research; and Enjalbal et al., Mass Spectrom Rev 2000 19:139-61, Mass spectrometry in combinatorial chemistry.)
[0113] Preferred small molecules are relatively easier and less expensively manufactured, formulated or otherwise prepared. Preferred small molecules are stable under a variety of storage conditions. Preferred small molecules may be placed in tight association with macromolecules to form molecules that are biologically active and that have improved pharmaceutical properties. Improved pharmaceutical properties include changes in circulation time, distribution, metabolism, modification, excretion, secretion, elimination, and stability that are favorable to the desired biological activity. Improved pharmaceutical properties include changes in the toxicological and efficacy characteristics of the chemical entity.
[0114] The following examples are provided to further illustrate the methods and compositions of the present invention. These examples are illustrative only and are not intended to limit the scope of the invention in any way.
EXAMPLES
Example 1
Materials and Methods
Mice and Animal Procedures.
[0115] All mice were kept in a specific pathogen-free facility at Columbia University Medical Center. All mice studies and breeding were carried out under the approval of the Institutional Animal Care and Use Committee of Columbia University.
[0116] Mice (p110?.sup.?/? and p110?.sup.?/?) on a mixed B6/129 background were described previously (Sasaki et al., 2000; Clayton et al., 2002). Animals were bred to generate a deficiency in both p110 catalytic subunits, the p110?.sup.?/? mice. Other names for the mouse include p110??.sup.ko and Pik3cg.sup.?/?; Pik3cd.sup.?/?, because p110? is encoded by Pik3cg and p110? is encoded by Pik3cd.
[0117] NOD.Cg-Prkdc.sup.scid Il2rgt.sup.tm1Wjl/Sz mice for xenograft experiments and Gt(ROSA)26Sor.sup.tm1(Luc)Kael/J for bioimaging studies were obtained from The Jackson Laboratory (Bar Harbor, Me.). Mice deficient for PTEN in the T cell lineage were generated by crossing Lck-cre with floxed Pten (Hennet et al., 1995; Trotman et al., 2003). P110?.sup.?/? and p110?.sup.?/? mice were intercrossed with Lckcre/Pten.sup.fl/fl animals to generate mice homozygous mutant for either p110? or p110? and Pten or homozygous mutant for p110?, 110?, and Pten.
[0118] For subcutaneous xenograft experiments, luminescent CCRF-CEM (CEM-luc) cells were generated by lentiviral infection with FUW-luc and selection with neomycin. Luciferase expression was verified with the Dual-Luciferase Reporter Assay kit (Promega Corp., Madison, Wis.). 2.5?10.sup.6 CEM-luc cells embedded in Matrigel (BD Biosciences, San Jose, Calif.) were injected into the flank of NOD.Cg-Prkdc.sup.scid Il2rg.sup.tm1Wjl/Sz mice. After 1 week, mice were treated by oral gavage with vehicle (0.5% methyl cellulose, 0.1% Tween-80), or CAL-130 (10 mg kg.sup.?1) (Gilead Sciences, Foster City, Calif.) every 8 hours daily for 4 days and then tumors imaged as follows: mice anesthetized by isoflurane inhalation were injected intraperitoneally with D-luciferin (50 mg kg.sup.?1, Xenogen, Calipers Life Sciences, Hopkinton, Mass.). Photonic emission was imaged with the In Vivo Imaging System (IVIS, Xenogen). Tumor bioluminescence was quantified by integrating the photonic flux (photons per second) through a region encircling each tumor using the LIVING IMAGES software package (Xenogen). Administration of D-luciferin and detection of tumor bioluminescence in Lck/Pten.sup.fl/fl/Gt(ROSA)26Sor.sup.tm1(Luc)Kael/J mice was performed in a similar manner.
[0119] For intravenous xenograft transplantation, 5?10.sup.6 CCRF-CEM cells were injected intravenously in fourteen NOD.Cg-Prkdc.sup.scid Il2rg.sup.tm1Wjl/Sz mice. After 3 days, mice were segregated into two treatment groups that received either CAL-130 or vehicle by oral gavage as described above for 7 days. Mice in both groups were then followed until moribund (and euthanized).
Cell Counts, Antibodies, Flow Cytometry, Cell Lines, and Reagents.
[0120] Cell counts were measured on a Hemavet 850FS system (CDC Technologies, Oxford, Conn.), and standard procedures were followed for staining cells with the following antibody conjugates for flow cytometry (BD Biosciences, San Jose, Calif.) (Cella et al., 2004): phycoerythrin (PE) anti-CD4 (clone H129.19), fluorescein (FITC), PE, cytochrome c (CyC), or biotin anti-CD8a, FITC CD3?, CyC anti-B220, and Thy 1.2. Biotinylated antibodies were detected with either streptavidin-PE or streptavidin-CyC. Subsets of DN thymocytes were analyzed based on expression of CD25 and CD44 after gating out cells that stained with a cocktail of biotinylated antibodies to CD4, CD8, B220, Mac-1, and Gr-1 followed by streptavidin Cy-Chrome.
[0121] For intracellular staining of TCRB, cells were first labeled with PE-CD4 and Cy-Chrome-CD8a, then were fixed and permeabilized in 1% saponin, and finally were stained with FITC-labeled anti-CR-specific antibody. For identifying apoptotic thymocytes, cell suspensions in DMEM and 10% fetal calf serum (FCS; 2?10.sup.6/mL) were first labeled with PE-CD4 or PE-Cy5 CD8a, washed, and incubated with annexin V-FITC (BD Biosciences) according to the manufacturer's recommendations. A viable lymphocyte gate was first established based on forward and side scatter parameters, and dead cells were excluded by the detection of propidium iodide (PI) uptake in the absence of CD4 or CD8 labeling.
[0122] For studies evaluating spontaneous apoptosis, purified thymocytes were resuspended in DMEM, 10% FCS, and 2 mM glutamine (25?10.sup.5 cells/mL), and 200 ?L was placed in 96-well plates (5% CO.sub.2, 37? C.). Cells were harvested at 24 hours to determine the extent of apoptosis, as described. All samples were analyzed on a FACS Calibur flow cytometer (BD Biosciences) using CellQuest or FlowJo software. Data are displayed as histograms or dot blots with logarithmic scale. Each plot represents analysis of 2?10.sup.5 or more events collected as list mode files.
[0123] For cell surface staining in mouse whole blood, following incubation with appropriate antibodies, blood was processed using the BD Bioscience BD FACS Lysing Solution according to the manufacturer's instructions. For intracellular staining of Ki67, immediately after RBC lysis with the BD FACS Lysing solution cells were permeabilized without washing with 0.025% Tween-20 in lysing solution for an additional 15 minutes, washed, and then incubated with Ki67 antibodies.
[0124] Thymic tissue, peripheral blood, spleens, and lymph nodes from the mice displaying the following combinations of PI3K genetic deletion were used: WT (full activity of both PI3K? and PI3K?), ?.sup.het/?.sup.het (50% reduction in activity of both PI3K? and PI3K?), ?.sup.ko/?.sup.het (full reduction of PI3K? activity and 50% reduction of PI3K? activity), ?.sup.het/?.sup.ko (50% reduction of PI3K? activity and full reduction of PI3K? activity) and ?.sup.ko/?.sup.ko (full reduction of PI3K? and PI3K? activity). Analyses included tissue histology of thymi, spleens, and lymph nodes to determine structure and organization of cells, cell counts to determine differences of WBC numbers in tissues and blood for each genotype, and flow cytometry to evaluate differences in total thymocyte populations (CD3.sup.+ and subsets CD4.sup.+/CD8.sup.+).
[0125] CCRF-CEM, CEM/C1, and MOLT-4 cells were obtained from ATCC and grown in RPMI-1640 medium containing 10% FBS and antibiotics.
[0126] Antibodies to Akt (catalog #9272), phospho-Akt (S473, clone 193H12), phosphomTOR (S2448, catalog #2971S), mTOR (catalog #2972), phospho-GSK3?? (S21/9, catalog #9331S), GSK-3? (clone 27C10), phospho-p70S6K (Thr389, catalog #9205S) and p70S6K (catalog #9202) and R-actin (catalog #4967S) were from Cell Signaling Technology (Danvers, Mass.). Antibodies to class I PI3K subunits were as follows: p110? (catalog #4255) from Cell Signaling Technology; p110? (clone Y384) from Millipore and mouse p110? from Santa Cruz Biotechnology (Santa Cruz, Calif.) (catalog #sc-602); p110? (clone H1) from Jena Biosciences (Jena, Germany); p110? (clone H-219) from Santa Cruz Biotechnology. Antibodies to PTEN (clone 6H2.1) were from Cascade Bioscience (Winchester, Mass.). For flow cytometry, antibodies were obtained from BD Biosciences: CD3?-Alexa 488 (clone 145-2C11), CD4-APC (clone RM4-5), CD8-PerCP-Cy5.5 (clone 53-6.7), CD90.2-APC (Thy-1.2, clone 53-2.1), Ki67-FITC (clone B56), and Annexin V-APC. Antibodies to Bim, phospho-Bad, Bad, and BclXL were from Cell Signaling Technology (pro-apoptotic sampler kit #9942S).
[0127] The shRNA construct for p110? (MISSION? shRNA Plasmid DNA; clone ID: NM_002649.2-4744s1c1; TRC number: TRCN0000196870). siRNA constructs for p110? (ON-TARGET plus SMARTpool #L-003018-00) and p1101 (ON-TARGET plus SMARTpool # L-003019-00) were obtained from Dharmacon (Thermo Scientific, Waltham, Mass.).
Primary Leukemia Samples.
[0128] Cryopreserved samples were provided by collaborating institutions in the US (Department of Pediatrics, Columbia Presbyterian Hospital and Departments of Medicine and Pathology, Vanderbilt University), The Netherlands (Erasmus MC-Sophia Children's Hospital), and Italy (Hemato-Oncology Laboratory, Department of Pediatrics, University of Padua). All samples were collected with informed consent and under the supervision of the Medical Ethics Committee of the Erasmus Medical Center, the Columbia University Medical Center Institutional Review Board, the Vanderbilt University Medical Center Institutional Review Board, and the Acute Lymphoblastic Leukemia Strategic Scientific Committee.
Cell Proliferation and Cell Viability Assay.
[0129] Cell proliferation of CCRF-CEM cells or shRNA transfected CCRF-CEM cells, in the presence or absence of appropriate drug, was followed by cell counting of samples in triplicate using a hemocytometer and trypan blue. For apoptosis determinations of untransfected or shRNA transfected CCRF-CEMs, cells were stained with APC-conjugated Annexin-V (BD Biosciences) in Annexin Binding Buffer (Miltyeni Biotec) and analyzed by flow cytometry. For primary T-ALL samples, cell viability was assessed using the BD Cell Viability kit (BD Biosciences) coupled with the use of fluorescent counting beads as previously described (Armstrong et al., 2009). For this, cells were plated with MS5-DL1 stroma cells, and after 72 hours following drug treatment cells were harvested and stained with an APC-conjugated anti-human CD45 followed by a staining with the above kit according to the manufacturer's instructions.
Fetal Liver Reconstitution
[0130] Timed pregnant wild-type (WT) littermates were killed on day 14.5 after coitus, and single-cell suspensions of fetal livers were prepared (Puri et al., 2005). Briefly, 1.5?10.sup.6 cells in PBS were injected intravenously (tail vein) into lethally irradiated 6-week-old p110??.sup.?/? mice (950 rads [9.5 Gy] single dose, 6 hours before injection). At 6 to 8 weeks after transplantation, complete blood cell counts were taken to confirm engraftment before using mice in experiments.
Tissue Histology
[0131] Thymi, spleens, and lymph nodes harvested from 4-week-old mice were either formalin-fixed and paraffin embedded or snap frozen at ?80? C. in liquid nitrogen. Hematoxylin-eosin staining was applied on fixed material for morphologic analysis. Immunohistochemistry was performed according to an indirect immunoperoxidase technique using the following primary antibodies: B220 (Valter Occhiena, Milan, Italy; 1:10), CD3 (Valter Occhiena; 1:10), CD4-biotinylated (Southern Biotechnology, Birmingham, Ala.; 1:200), CD8 (Valter Occhiena; 1:10), cytokeratin 5 (anti-K5, rabbit polyclonal; Covance, Princeton, N.J.; 1:50), and cytokeratin 8 (anti-K8; Progen Biotechnik, Heidelberg, Germany; 1:20). Specimens were visualized using an Olympus BX60 optical microscope, and images were acquired with a DP70 digital camera (Olympus). Image analysis was performed using analySIS (Soft Imaging System, M?nster, Germany).
CAL 130 IC.SUB.50..
[0132] CAL-130 is a derivative of IC87114 (Gilead Sciences, Foster City, Calif.), the synthesis of which has been previously described (Sadhu et al., 2003 and Sadhu et al., U.S. Pat. Nos. 6,518,277 and 6,667,300, which are incorporated by reference as if recited in full herein). IC.sub.50 values for CAL-130 inhibition of PI3K isoforms were determined in ex-vivo PI3 kinase assays using recombinant PI3K. A 10-point kinase inhibitory profile was determined with ATP at a concentration consistent with the K.sub.m for each enzyme (Puri et al., 2004).
Calcium Flux Assay
[0133] Thymocytes or lymphocytes were preloaded with Fluo-4 AM (Molecular Probes, Eugene, Oreg.) at 5 ?g/mL for 30 minutes at 37? C., labeled with anti-CD4-APC conjugate (BD Biosciences) to permit gating on this T-cell subset during analysis, and finally washed and resuspended (2?10.sup.6/mL) in DMEM and 10% FCS. After a baseline was established at quiescence, Ca.sup.2+ flux was induced by the addition in tandem of anti-CD3e (hamster antimouse antibody; BD Biosciences) and the anti-hamster IgG polyclonal antibody (Jackson ImmunoResearch, West Grove, Pa.) for cross-linking. The resultant flux in Ca.sup.2+ was measured for 5 minutes by flow cytometry, and total flux was established by the addition of ionomycin (0.5 ?g/mL). Drug inhibition of Ca.sup.2+ flux was measured after 30 minute pre-incubation with CAL-130 at room temperature of dye loaded cells. Percentage overall change in Ca.sup.2+ flux is reported as (Ca.sup.2+ flux.sub.peak?Ca.sup.2+ flux.sub.baseline/Ca.sup.2+ flux.sub.ionomycin?Ca.sup.2+flux.sub.baseline)?100.
Western Blot Analysis
[0134] Protein extracts from thymus homogenates (30 ?g protein per lane) were electrophoresed in polyacrylamide gels (Invitrogen Life Technologies, Carlsbad, Calif.), transferred to a PVDF membrane (Immobilon-P; Millipore, Billerica, Mass.) and incubated overnight (4? C.) with antibodies to p110?, p110?, p110?, p110?, or p85? (Santa Cruz Biotechnology, Santa Cruz, Calif.) and then with horseradish peroxidase-conjugated secondary antibodies. Bound antibody was detected by chemiluminescence according to the manufacturer's instructions (Amersham Biosciences, Piscataway, N.J.). Membranes were stripped and reblotted with anti-actin antibody (Sigma-Aldrich, St Louis, Mo.) to verify equal loading of protein.
[0135] Cell lysates (from cell lines or thymocytes) were prepared on ice in M-PER Mammalian Protein Extraction reagent (Pierce) containing a cocktail of protease and phosphatase inhibitors (Swat et al., 2006). Equal amounts of total protein from lysates were subjected to SDS-PAGE, transferred to PVDF membrane (Immobilon-P, Millipore), and membranes probed by overnight incubation with appropriate primary antibodies. Bound antibodies were visualized with HRP-conjugated secondary antibodies and ECL chemistry (SuperPico West, Pierce).
Akt/PBK Activation
[0136] To assess the requirement for p1100 in TCR-induced phosphorylation of Akt/PBK, single-cell suspensions of thymocytes (1?10.sup.8/mL) from PI3K?-deficient animals were incubated with the p110?-specific inhibitor IC87114 (10 ?M) or with vehicle control (DMSO) for 30 minutes before TCR cross-linking, as described for the Ca.sup.2+ flux assay. Aliquots (100 ?L) were collected at 0, 10, 30, and 60 minutes after TCR cross-linking, briefly centrifuged to pellet, and subsequently lysed with ice-cold M-Per (Pierce, Rockford, Ill.) (according to the manufacturer's recommendations) that contained a cocktail of phosphatase and protease inhibitors (Puri et al., 2005). Lysates were clarified by centrifugation (12,000 g for 15 minutes at 4? C.), and total and phosphorylated Akt/PBK were determined by Western blot analysis.
In Vivo BrdU Labeling
[0137] BrdU incorporation analyses were performed using a BrdU labeling kit (BD Biosciences). In brief, mice received intraperitoneal injections with 150 ?L BrdU solution (10 mg/mL), and BrdU incorporation was analyzed 20 hours after injection. Thymocyte suspensions were first surface stained with anti-CD4-PE and anti-CD8-CyC antibodies, fixed, and permeabilized in BD Cytofix/Cytoperm buffer, then washed and refixed. To expose incorporated BrdU, cells were treated with DNase solution, washed, stained with anti-BrdU-FITC antibodies, and analyzed by flow cytometry.
Organ Culture of E14.5 Thymus Lobes
[0138] Thymus lobes were obtained from mouse embryos, with embryonic day 0 (E0) considered the day of vaginal plug detection. Fetal thymus organ cultures were used to compare the effects of pharmacologic blockade of p110? activity on thymocyte development in WT, p110.sup.?/?, and p110?.sup.?/? mice. Briefly, 3 to 4 intact thymi were placed on bare filter inserts (transwell, 3-?m pore size; Corning Costar, Cambridge, Mass.) and then were inserted into wells containing DMEM, 10% FCS supplemented with either p110b-specific inhibitor IC87114 (10 ?M) or vehicle control (DMSO), and incubated for 1 week at 37? C. in 5% CO.sub.2. Thymocyte differentiation was evaluated by flow cytometry.
Statistical Analysis
[0139] Statistical analyses were performed using Student's t-test (GraphPad Prizm software). Kaplan-Meier survival curves were analyzed using a logrank test (GraphPad Prism software). Values were considered significant at P<0.5.
Histological and Immunohistochemical Study of Tissue Samples.
[0140] Formalin-fixed paraffin-embedded 5 ?m tissue sections were stained with Hematoxylin & Eosin for histopathological diagnosis. For immunohistochemistry, anti-Ki67 (rabbit monoclonal, Abcam) and anti-CD3 (rabbit polyclonal, Dako) staining were performed on similar tissue sections after antigen retrieval by microwave heating in citrate buffer (pH 6.0). After epitope recovery, slides were incubated with antibody (anti-Ki67 1:50, anti-CD3 1:50) overnight at room temperature before antigen detection with diaminobenzidine (DAB) using a Ventana automated staining platform (Ventana).
shRNA and siRNA Knockdown.
[0141] CCRF-CEMs were transfected using the Amaxa Human T cell Nucleofector kit (Lonza, Basel, Switzerland) according to the manufacturer's optimized protocol kit for this cell line.
[0142] For shRNA knockdown of p110?, CCRF-CEM (2?10.sup.6 cells) were transfected with 2 ?g of purified plasmid DNA, and clones were selected by high dilution in puromycin used at a concentration pre-determined by a killing curve. Expression of p110? and p110? were determined by Western blotting.
[0143] For siRNA knockdown of p110? or p110?, CCRF-CEM (2?10.sup.6 cells) were transfected with 300 nM of siRNA construct. After a brief recovery period, cells were diluted to between 1-2?10.sup.5 per ml and grown for further 48 hours for cell counting, flow cytometry and Western blotting.
Plasma Levels of CAL 130, Glucose and Insulin.
[0144] For CAL-130 level determinations, animals received a single oral dose (10 mg kg.sup.?1 or 20 mg kg.sup.?1) of inhibitor. Plasma was collected at 0, 2, 4, 8, and 12 hours and subjected to high-performance liquid chromatography-MS/MS (sensitivity 1 ng/mL). The concentration of CAL-130 in plasma was determined using a standard curve (analyte peak area versus concentration) generated with calibration standard pools. Values represent the mean (?SD) for four animals per group.
[0145] Plasma glucose and insulin levels were determined following a single oral dose of CAL-130 (10 mg kg.sup.?1). Blood was collected into K.sub.2EDTA tubes by cardiac puncture at baseline and 0, 2, 4, and 8 hours post-dose, and plasma samples frozen at ?80? C. until analysis. The insulin and glucose levels were determined by using an Ultra Sensitive Mouse Insulin ELISA Kit (Crystall Chem Inc.) or WaveSense Presto Blood Glucose Monitoring System (Agamatrix Inc., Boston, Mass.), respectively.
Quantitative Real-Time PCR.
[0146] RNA from cells was isolated using the Qiagen RNeasy Mini Kit (cat#74104) according to the manufacturer's protocol. The isolated total RNA was reverse transcribed using a high capacity cDNA synthesis kit (SuperScript First-Stand Synthesis System, Invitrogen part number 11904-018) according to the manufacturer's protocol. Predesigned labeled primer and probe sets for human p110 alpha (Hs00180679_m1), human p110 beta (Hs00927728_m1), human p110 delta (Hs00192399_m1), human p110 gamma (Hs00277090_m1), human GAPDH (Hs03929097_g1), mouse p110 alpha (Mm00435673_m1), mouse p110 beta (Mm00659576_m1), mouse p110 delta (Mm00435674_m1), mouse p110 gamma (Mm00445038_m1), and mouse GAPDH (Mm99999915_g1) were from Applied Biosystems.
[0147] The PCR reactions were set up following the protocol of USB (hotStart-IT Probe qPCR system Cat#75764). Real time relative quantitative PCR was run on ABI7500 with cycling conditions of 50? C. for 2 minutes, 95? C. for 10 minutes, 40 cycles of 95? C. for 15 seconds and 60? C. for 1 minute. Data exported from the ABI7500 machine were processed and analyzed using an Excel spread sheet. Briefly, target genes were normalized to the housekeeping gene GAPDH to obtain a ?CT value. Relative quantitative expression was calculated with equation (2{circumflex over ()}.sup.???CT) where the ??CT is the difference between the ?CT of tumor samples and control samples (??CT=?CT tumor??CT control). A Student's t-test was used to determine statistical difference in expression levels with P values<0.05 considered significant.
PI3K? ? Isoform Selective Cell-Based Assay.
[0148] For the analysis of p110?-mediated signaling, SW3T3 cells were placed in serum free media (3 hours) and incubated with either CAL-130 or the Pan-PI3K/mTor inhibitor BEZ235 (Selleck Chemicals) for 1 hour prior to stimulation with PDGF (10 ng/ml; Cell Signaling) for 10 minutes at 37? C. After washing once in cold phosphate-buffered saline (PBS), the cell pellet was resuspended in lysis buffer (50 mM HEPES [N-2-hydroxyethylpiperazine-N-2-ethanesulfonic acid], pH 7.4, 150 mM NaCl, 10% glycerol, 1% Triton X-100, 1.5 mM MgCl.sub.2, 1 mM EGTA [ethylene glycol tetraacetic acid], 100 mM NaF, 1 mM phenylmethylsulfonyl fluoride, 1 mM NaVO.sub.4, 1 ?g/ml leupeptin, and 1 ?g/ml aprotinin) for 15 minutes on ice. Whole-cell lysates were obtained by centrifugation, and the soluble protein analyzed by Western blotting for Akt and P-Akt levels. Quantification was done using the LiCOR Odyssey imaging system.
CAL-130 Inhibits Proliferation and Induces Apoptosis in CEM/C1 and MOLT-4 Cell Lines.
[0149] Cell proliferation of CEM/C1 and MOLT-4 was determined in the presence or absence of PI3K? inhibitor IC87114 (Gilead Sciences, Foster City, Calif.), the PI3K? inhibitor AS-650240 (Selleck Chemicals), the PI3K?/? dual inhibitor CAL-130 (Gilead Sciences), or the Pan-PI3K/mTor inhibitor BEZ235 (Selleck Chemicals) by cell counting of samples in triplicate using a hemocytometer and trypan blue. Cells were cultured for 72 hours at 37? C. with or without inhibitors. The percentage of apoptotic cells was determined by Annexin V-FITC/7AAD staining followed by 2-color flow cytometric analysis.
Platelet Aggregation.
[0150] Blood was obtained from anesthetized p110?/? double knockout mice via cardiac puncture. Platelets were purified from PRP by centrifugation and resuspended to a final concentration of 400,000/?l in buffer (145 mM NaCl, 10 mM Hepes, 0.5 mM Na.sub.2HPO.sub.4, 5 mM KCl, 2 mM MgCl.sub.2, 1 mM CaCl.sub.2, 0.1% glucose, pH 7.4). CAL-130 (1 ?M, 2.5 ?M, or 5 ?M final concentration) or DMSO was added to platelet suspensions 5 minutes prior to inducing aggregation with ADP (25 ?M). Mouse fibrinogen (final concentration 200 ?g/ml) was also added to the platelet suspensions just prior to activation as previously described (Magallon et al., 2011). Aggregation was assessed using a Chronolog Lumi-Aggregometer (model 540 VS, Chronolog, Havertown, Pa.). In some experiments, blood was collected 2 hours after administering a single dose of CAL-130 (10 mg kg.sup.?1) or vehicle control and ADP-induced aggregation evaluated.
P110 Catalytic Domain Selectivity of CAL-130 as Assessed by Ambit KinomeScan Screening.
[0151] CAL-130 (10 ?M) was evaluated for its ability to prevent tagged kinases from interacting with immobilized bait ligand (Karaman et al., 2008). Results are reported as % of control binding, where lower numbers indicate stronger interactions with the tagged kinase. Values of >35% are considered no hits. PI3K? had the lowest percentage of control binding at 0.2% followed by PI3K? at 3.2% (See Table 1 below). These values indicate a high probability of a potent interaction. 353 kinases were assessed in the screen (Table 2).
TABLE-US-00001 TABLE 1 P110 catalytic domain selectivity of CAL-130 as assessed by Ambit KinomeScan screening. Ambit Gene Symbol Percent of Control Binding PIK3CA 12 PIK3CG 10 PIK3CB 3.2 PIK3CD 0.2
TABLE-US-00002 TABLE 2 Ambit KinomeScan screening of 353 kinases. Percent of Percent of Control Ambit Gene Control Ambit Gene Symbol Binding Symbol Binding AAK1 100 BMPR2 100 ABL1 100 BMX 100 ABL1(E255K) 100 BRAF 100 ABL1(F317I) 100 BRAF(V600E) 100 ABL1(F317L) 100 BRK 100 ABL1(H396P) 100 BRSK1 100 ABL1(M351T) 100 BRSK2 100 ABL1(Q252H) 100 BTK 100 ABL1(T315I) 100 CAMK1 100 ABL1(Y253F) 100 CAMK1D 100 ABL2 100 CAMK1G 100 ACVR1 100 CAMK2A 100 ACVR1B 100 CAMK2B 100 ACVR2A 100 CAMK2D 100 ACVR2B 100 CAMK2G 100 ACVRL1 100 CAMK4 100 ADCK3 100 CAMKK1 100 ADCK4 100 CAMKK2 18 AKT1 100 CDC2L1 100 AKT2 100 CDC2L2 100 AKT3 100 CDK11 100 ALK 100 CDK2 100 AMPK-?1 100 CDK3 100 AMPK-?2 100 CDK5 100 ANKK1 100 CDK7 100 ARK5 100 CDK8 100 ASK1 100 CDK9 100 ASK2 100 CDKL2 100 AURKA 100 CDKL3 100 AURKB 100 CDKL5 100 AURKC 100 CHEK1 100 AXL 100 CHEK2 100 BIKE 100 CIT 100 BLK 100 CLK1 100 BMPR1A 100 CLK2 100 BMPR1B 100 CLK3 100 CLK4 100 EPHA1 100 CSF1R 100 EPHA2 100 CSK 100 EPHA3 100 CSNK1A1L 100 EPHA4 100 CSNK1D 100 EPHA5 100 CSNK1E 100 EPHA6 100 CSNK1G1 100 EPHA7 100 CSNK1G2 100 EPHA8 100 CSNK1G3 100 EPHB1 100 CSNK2A1 100 EPHB2 100 CSNK2A2 100 EPHB3 100 CTK 100 EPHB4 100 DAPK1 100 EPHB6 100 DAPK2 100 ERBB2 100 DAPK3 100 ERBB3 100 DCAMKL1 100 ERBB4 100 DCAMKL2 100 ERK1 100 DCAMKL3 100 ERK2 100 DDR1 100 ERK3 100 DDR2 100 ERK4 100 DLK 100 ERK5 100 DMPK 100 ERK8 100 DMPK2 100 ERN1 100 DRAK1 100 FAK 100 DRAK2 100 FER 100 DYRK1A 100 FES 100 DYRK1B 100 FGFR1 100 DYRK2 100 FGFR2 100 EGFR 100 FGFR3 100 EGFR(E746-A750DEL) 100 FGFR3(G697C) 100 EGFR(G719C) 100 FGFR4 100 EGFR(G719S) 100 FGR 100 EGFR(L747-E749DEL, 100 FLT1 100 A750P) EGFR(L747-S752DEL, 100 FLT3 100 P753S) EGFR(L747-T751DEL, 100 FLT3(D835H) 100 SINS) EGFR(L858R) 100 FLT3(D835Y) 100 EGFR(L858R, T790M) 100 FLT3(ITD) 100 EGFR(L861Q) 100 FLT3(K663Q) 100 EGFR(S752-I759DEL) 100 FLT3(N841I) 100 FLT4 100 KIT(V559D, V654A) 100 FRK 100 LATS1 100 FYN 100 LATS2 100 GAK 100 LCK 100 GCN2(S808G) 100 LIMK1 100 GRK1 100 LIMK2 100 GRK4 100 LKB1 100 GRK7 100 LOK 100 GSK3A 100 LTK 100 GSK3B 100 LYN 100 HCK 100 LZK 100 HIPK1 100 MAK 100 HIPK2 100 MAP3K1 100 HIPK3 100 MAP3K15 100 HIPK4 100 MAP3K2 100 HPK1 100 MAP3K3 100 HUNK 100 MAP3K4 100 ICK 100 MAP4K2 100 IGF1R 100 MAP4K3 100 IKK-? 100 MAP4K4 100 IKK-? 100 MAP4K5 100 IKK-? 100 MAPKAPK2 100 INSR 100 MAPKAPK5 100 INSRR 100 MARK1 100 IRAK1 100 MARK2 100 IRAK3 100 MARK3 100 ITK 100 MARK4 100 JAK1(JH1domain) 100 MAST1 100 JAK1(JH2domain) 100 MEK1 100 JAK2(JH1domain) 100 MEK2 100 JAK3(JH1domain) 100 MEK3 100 JNK1 100 MEK4 100 JNK2 100 MEK6 100 JNK3 100 MELK 100 KIT 100 MERTK 100 KIT(D816V) 100 MET 100 KIT(L576P) 100 MET(M1250T) 100 KIT(V559D) 100 MET(Y1235D) 100 KIT(V559D, T670I) 100 MINK 100 MKNK1 100 PAK7 100 MKNK2 16 PCTK1 100 MLCK 100 PCTK2 100 MLK1 100 PCTK3 100 MLK2 100 PDGFRA 100 MLK3 100 PDGFRB 100 MRCKA 100 PDPK1 100 MRCKB 100 PFTAIRE2 100 MST1 100 PFTK1 100 MST1R 100 PHKG1 100 MST2 100 PHKG2 100 MST3 100 PI3KCA 12 MST4 100 PI3KCB 10 MUSK 100 PI3KCD 0.1 MYLK 100 PI3KCG 1.2 MYLK2 100 PIK4CB 100 MYO3A 100 PIM1 100 MYO3B 100 PIM2 100 NDR1 100 PIM3 100 NDR2 100 PIP5K1A 100 NEK1 100 PIP5K2B 100 NEK2 100 PKAC-? 100 NEK5 100 PKAC-? 100 NEK6 100 PKMYT1 100 NEK7 100 PKN1 100 NEK9 100 PKN2 100 NIM1 100 PLK1 100 NLK 100 PLK2 100 OSR1 100 PLK3 100 p38-? 100 PLK4 100 p38-? 100 PRKCD 100 p38-? 100 PRKCE 100 p38-? 100 PRKCH 100 PAK1 100 PRKCQ 100 PAK2 100 PRKD1 100 PAK3 100 PRKD2 100 PAK4 100 PRKD3 100 PAK5 100 PRKG1 100 PAK6 100 PRKG2 100 PRKR 100 STK35 100 PRKX 100 STK36 100 PRP4 100 STK39 100 PYK2 100 SYK 100 QSK 100 TAK1 100 RAF1 100 TAO1 100 RET 100 TAOK1 100 RET(M918T) 100 TAOK3 100 RET(V804L) 100 TBK1 100 RET(V804M) 100 TEC 100 RIOK1 100 TESK1 100 RIOK2 100 TGFBR1 100 RIOK3 100 TGFBR2 100 RIPK1 100 TIE1 100 RIPK2 100 TIE2 100 RIPK4 100 TLK1 100 ROCK1 100 TLK2 100 ROCK2 100 TNIK 100 ROS1 100 TNK1 100 RPS6KA1 100 TNK2 100 RPS6KA2 100 TNNI3K 100 RPS6KA3 100 TRKA 100 RPS6KA4 100 TRKB 100 RPS6KA5 100 TRKC 100 RPS6KA6 100 TSSK1B 100 SBK1 100 TTK 11 SgK085 100 TXK 100 SgK110 100 TYK2(JH1domain) 100 SIK 100 TYK2(JH2domain) 100 SIK2 100 TYRO3 100 SLK 100 ULK1 100 SNARK 100 ULK2 100 SRC 100 ULK3 100 SRMS 100 VEGFR2 100 SRPK1 100 WEE1 100 SRPK2 100 WEE2 100 SRPK3 100 YANK2 100 STK16 100 YANK3 100 STK33 100 YES 100 YSK1 100 ZAK 100 YSK4 100 ZAP70 100
Example 2
Abnormal Thymus Size and Structure in p110??.SUP.?/? Mice
[0152] The absence of p110? and p110? catalytic subunits in 4-week-old mice resulted in a significant reduction in thymus size compared with either age-matched WT littermate controls (
Example 3
Depletion of DP Thymocytes but Intact TCRB Expression Define p110?.SUP.?/? Thymi
[0153] To determine the thymocyte population(s) most affected by the absence of PI3K? and PI3K?, flow cytometry analyses were performed to detect markers associated with thymocyte differentiation. Although the total number of CD4.sup.+ and CD8.sup.+ SP and DP cells were reduced overall, the absence of catalytic subunits had the greatest effect on the number of DP cells, typically the largest population of thymocytes in WT mice (
Example 4
Absence of PI3K? and PI3K? Activity Results in Depletion of DP Thymocytes in Vitro
[0154] To confirm the in vivo observations and thus demonstrate that a deficiency in PI3K? contributed to the reduction in the DP thymocyte population, day 14.5 fetal thymi were harvested from WT, p110?.sup.?/?, and p110?.sup.?/? mice and were cultured in the presence of either p110?-selective inhibitor IC87114 or vehicle control. Blockade of p110? activity, in combination with genetic deletion of its gamma counterpart, resulted in a 69.2%?2.7% (mean?SE) reduction in the population of CD4.sup.+CD8.sup.+ DP thymocytes (
Example 5
Increased apoptosis in p110??.SUP.?/? DP thymocytes
[0155] It is conceivable that the observed reduction in the DP thymocyte population in p110??.sup.?/? mice may result from either an increase in cell death or an overall decrease in the generation of this subset of cells. To determine whether this reduced cellularity might have reflected the former, this population of cells was evaluated for evidence of enhanced apoptosis. Flow cytometry analysis of PI-negative DP thymocytes revealed a 42%?6.1% increase in annexin V staining compared with WT littermates (
Example 6
Akt/PBK Phosphorylation and Ca.SUP.2+ Flux in the Absence of PI3K6 and PI3K? Function
[0156] Western blot analysis revealed the presence of a p110? catalytic subunit and other class 1a and class 1b isoforms in thymocytes harvested from WT control mice (
Example 7
Effect of PI3K? and PI3K? Deficiency on T-Cell Numbers and Ca.SUP.2+ Mobilization
[0157] The abnormalities observed in T-cell numbers and TCR-signaling associated with a deficiency in p110? and p110? catalytic subunits was not limited to the thymus but persisted in secondary lymphoid organs. In particular, a defect in DP cell development appears to have a direct effect on extrathymic T-cell populations. Although the white blood cell count was similar among all genetic phenotypes tested, the total lymphocyte count was significantly reduced in p110??.sup.?/? mice compared with WT littermates (2.9?1.1 K/?L vs 6.2?2.1 K/?L, respectively;
[0158] Class 1 PI3Ks are essential for supporting innate and adaptive immune responses. By contrast, previous studies suggest they play a more limited role in thymocyte development and differentiation. Here, a novel defect in thymocyte development in mice that is dependent on the activities of 2 distinct subclasses of PI3Ks is disclosed. Genetic deletion of p110?, in conjunction with its gamma counterpart, had a dramatic and unanticipated effect on thymus size, cellularity, and architecture. In particular, the combined absence of these 2 catalytic subunits resulted in a more than 4-fold reduction in the percentage and a 10- to 30-fold reduction in total numbers of cortical CD4.sup.+CD8.sup.+ DP thymocytes compared with WT littermates. Depletion of DP cells in p110??.sup.?/? thymi was accompanied by a corresponding compensatory increase in percentages, but not total numbers, of DN thymocytes and a paucity in the number of mature CD4.sup.+ and CD8.sup.+ SP T cells found in blood and secondary lymphoid organs. Thus, the reduction in DP thymocytes is of importance as it relates to T-lymphocyte production because there may be insufficient quantities of this subset in p110??.sup.?/? thymi to yield normal numbers of mature SP cells compared with WT animals (1.0?10.sup.6?0.3 vs 109.6?10.sup.6?22.6 DP cells, respectively).
[0159] Mechanistically, it is believed that the combined activity of PI3K? and PI3K? is critical to the survival of DP thymocytes in vivo. Indeed, given the inherent susceptibility of DP thymocytes to programmed cell death, presumably because of the down-regulation of the anti-apoptotic Bcl-2 protein at this stage of development, this population would be particularly vulnerable to the loss of survival signals generated by class 1 PI3Ks. In this context, an anti-apoptotic role has been indicated by the immunologic consequences of constitutive PI3K signaling that occurs in the absence of the tumor-suppressor gene PTEN, a phosphatase that converts PIP3 to PIP2. Selective deletion of PTEN in murine T cells not only results in uncontrolled proliferation of this lymphocyte subset, it leads to autoimmunity that is thought to be a consequence of impaired programmed cell death in the thymus (Penit et al., 1995). Thus, the ability to demonstrate that class 1 PI3Ks do indeed participate in PIP3 generation in thymocytes was central to this hypothesis (
[0160] Although the activity of PI3K? and PI3K? is involved in maintaining DP thymocyte survival, it is conceivable that they could participate in TCRB-selection. During normal development, TCRB chain gene rearrangement and expression reaches completion at the DN3 stage, permitting the formation of the pre-TCR complex. As a result, DN3 thymocytes can activate several signaling pathways, including lck/fyn and ZAP-70/Syk tyrosine kinases, SLP-76 and LAT linker proteins, Vav-family GEFs, and PLC?1 phospholipase, that collectively mediate the transition of these cells to the CD4.sup.+CD8.sup.+ DP stage (Xu et al., 1995; Collins et al., 1997; Jordan et al., 2003; Kong et al., 1998; Reynolds et al., 2002). Consequently, mice lacking structural or signaling components of the pre-TCR complex exhibit a developmental block at the DN3 stage. In this context, PI3K activity has been implicated in Vav and PLC? activation and Ca.sup.2+ flux through direct (PIP3 binding to PH domains) and indirect (induction of Tec-family kinases) mechanisms (Okkenhaug et al., 2003; Okkenhaug et al., 2004). Indeed p110??.sup.?/? thymocytes show impaired TCR-mediated Ca.sup.2+ flux in vitro. Thus, a deficiency in p110? and p110? could result in the perturbation of DN to DP checkpoint through defective pre-TCR signaling. The data above, however, do not appear to support this mechanism because equal proportions of p110??.sup.?/? compared with WT DN3 thymocytes express TCRB intracellularly. Moreover, pre-TCR complex-mediated events such as proliferative expansion, loss of CD25.sup.+ expression (transition to the DN4 stage), and acquisition of CD8.sup.+ and CD4.sup.+ coreceptors (transition to DP stage) were readily visible in thymocytes from p110??.sup.?/? mice. Thus, the resultant phenotype is clearly distinct from that associated with known defects in TCRB selection, such as RAG deficiency (
[0161] Although the combined activities of PI3K? and PI3K? are essential for thymocyte development, it appears that either subclass is sufficient to maintain T-cell production. This potential redundancy in function may ensure that adequate levels of PIP3 are maintained to protect cells from proapoptotic stimuli. How these 2 PI3K subclasses, which are activated through distinct pathways, are linked through receptors (such as the TCR) that promote the development and survival of immature DP thymocytes remains to be determined. That said, it has been demonstrated that ligation of an ITAM-bearing receptor on cells, such as Fc?RI, can result in the activation of class 1a and class 1b PI3Ks (Melendez et al., 1998). Moreover, it was speculated that the activation of p110?, which typically occurs through G protein-coupled receptors, may involve the Tec family of tyrosine kinases, which have the capacity to physically interact with PIP3 and heterotrimeric G-protein subunits (Lewis et al., 2001). Such a scenario may hold true for T cells, because PI3Ks and Tec kinases are intricately linked in TCR-mediated signaling. For example, Tec kinases are required for the regulation of PLC? activity and Ca.sup.2+ signaling, an event that involves PI3K? (Okhenhaug et al., 2002). Thus, it is conceivable that in response to PI3K? activation or other class 1a isoforms, a Tec tyrosine kinase family member will become localized at the plasma membrane through interactions with PIP3, which in turn may recruit a heterotrimeric G-protein that could activate p110? and thus enhance PIP3 production.
Example 8
Effects of Partial Inhibition of Class I PI3K on Immunological Tissues
[0162] As set forth above, the genetic deletion of both p110? and p110? resulted in a significant reduction of thymus size and cellularity (about 8-fold). This deficiency also resulted in a lack of corticomedullary differentiation as compared to WT mice, indicating abnormal T cell development. Although p110?.sup.ko/?.sup.het and p110?.sup.het/?.sup.ko mice exhibited reduced thymus size and cell counts (2.1-fold and 1.6-fold, respectively), there was no obvious defect in corticomedullary differentiation (
[0163] Flow cytometry was utilized to evaluate the expression of the cell surface markers CD4 and CD8 in order to track the development of thymocytes. The double-positive (DP) population, cells expressing both CD4 and CD8 in their second stage of development, was significantly reduced in mice deficient in both PI3K? and PI3K? (9-fold as compared to WT). By contrast, 50% PI3K? or PI3K? activity was sufficient to maintain the normal percentage of DP thymocyte population (
[0164] The observed defects in T cell numbers were not limited to the thymus as they were also seen in the peripheral blood of mice deficient in PI3K activity (
[0165] Thus, a partial reduction in both PI3K? and PI3K? activity can have a profound effect on T cell development, although not to the extent of complete absence in activity. In particular, PI3K? appears to play a more important role in this process than that of PI3K?, because peripheral blood from ?.sup.het/?.sup.ko mice did not exhibit as significant a reduction in the number of circulating T cells as their ?.sup.ko/?.sup.het counterpart. Blood and tissues from animals with 50% activity in both p110 isoforms showed no major changes as compared to WT. Therefore, the order of genotypes displaying the least effect to most effect on T cells is as follows: WT<?.sup.het/?.sup.het<?.sup.het/?.sup.ko<?.sup.ko/?.sup.het<?.sup.ko/?.sup.ko. Based on these findings, it can be concluded that a drug that inhibits 50% of p110? and 100% of p110? would result in the least consequential impact on the immune system. Determining the exact amount of PI3K activity necessary to maintain the immune system could culminate in safer and more effective treatment of inflammatory diseases and blood cancers.
Example 9
PI3K? or PI3K? can Support Malignant Transformation of T Cells
[0166] Deletion of the tumor suppressor gene PTEN in T cell progenitors drives the malignant transformation of these cells within the thymus of mice (Suzuki et al., 2001; Hagenbeek and Spits, 2008; Liu et al., 2010). Moreover, the resulting tumors possess similar genetic and biochemical aberrations associated with a subset of patients with T-ALL including hyperactivation of the PI3K/Akt signaling pathway (Maser et al., 2007; Guo et al., 2008). Because PI3K? and PI3K? play a role in T cell development, their contribution to tumor formation was assessed by crossing mice containing PTEN alleles floxed by the loxP Cre excision sites with Lck-cre transgenic animals (Lck/Pten.sup.fl/fl) alone or together with those lacking p110? (encoded by Pik3cg) and/or p110? (encoded by Pik3cd) catalytic subunits. Consistent with previous studies, >85% of Lck/Pten.sup.fl/fl mice develop T-ALL and eventually succumb to the disease (median survival of 140 days), which was confirmed by flow cytometric analysis (
[0167] However, the activity of either isoform alone was sufficient to promote tumor formation, yielding similar median survival times for Lck/Pten.sup.fl/fl; Pik3cg.sup.?/? and Lck/Pten.sup.fl/fl; Pik3cd.sup.?/? mice (175 days versus 178 days, respectively). Comparable percentages of these animals developed and died of T-ALL (65% versus 64%, respectively) and tumors had evidence of activation of the PI3K/Akt signaling pathway, albeit much reduced as compared to those from Lck/Pten.sup.fl/fl animals (
[0168] Further evidence demonstrating that it is the unleashed activities of PI3K? and PI3K? that provide the signals necessary for the development of T-ALL is suggested by the continued reduction in thymus size and cellularity in 6 week old TKO mice (
Example 10
Effect of PI3K?/PI3K? Dual Inhibition on Thymocyte Signaling and Development
[0169] In order to ascertain whether PI3K? and PI3K? are also required for tumor maintenance and can be targeted therapeutically in T-ALL, a small molecule that preferentially inhibits the function of both p110? and p110? catalytic domains was generated. This small molecule was designated CAL-130 (
[0170] Importantly, this small molecule does not inhibit additional intracellular signaling pathways (i.e. p38 mitogen-activated protein kinase or insulin receptor tyrosine kinase) that are critical for general cell function and survival (Tables 1 and 2). To demonstrate that CAL-130 can block the activities of both PI3K? and PI3K? in thymocytes, its ability to prevent phosphorylation of Akt (Ser473) and calcium flux in response to TCR-cross-linking were evaluated. As set forth above, the combined activities of these two class I PI3K isoforms are necessary for phosphorylation of this protein kinase in this cell population (Swat et al., 2006). Consistent with these results, CAL-130 treatment of thymocytes harvested from 6 week old wild type animals prevented TCR induced Akt phosphorylation and attenuated calcium flux to levels observed for their Pik3cg.sup.?/?; pik3cd.sup.?/? counterparts (
[0171] To assess the in vivo efficacy of the inhibitor, its effects on thymi of 6 week old mice were determined, specifically for its ability to recapitulate the phenotype observed when both p110? and p110? are deficient. Animals received 10 mg kg.sup.?1 of the inhibitor orally, which was sufficient to maintain plasma concentrations of 0.33?0.18 ?M at the end of 8 hours (
Example 11
Antileukemic Effects of Pharmacological Inhibition of PI3K? and PI3K? in PTEN Null T-ALL Tumors in Mice
[0172] The clinical significance of interfering with the combined activities of PI3K? and PI3K? was determined by administering CAL-130 to Lck/Pten.sup.fl/fl mice with established T-ALL. Candidate animals for survival studies were ill-appearing, had a WBC above 45K ?l.sup.?1, evidence of blasts on peripheral smear, and a majority of circulation cells (>75%) staining double positive for Thy1.2 and Ki-67. Mice received an oral dose (10 mg kg.sup.?1) of the inhibitor every 8 hours for a period of 7 days and were then followed until moribund. Despite the limited duration of therapy, CAL-130 was highly effective in extending the median survival for treated animals to 45 days as compared 7.5 days for the control group (
[0173] To determine the effect of CAL-130 on disease burden, sequential blood counts and peripheral smears as well as flow cytometric analyses were performed on Lck/Pten.sup.fl/fl mice pre- and post-administration of the inhibitor (
[0174] Further evidence to support the ability of CAL-130 to reduce tumor burden was obtained by bioluminescent imaging. Pten.sup.fl/fl mice were crossed with a strain in which a luciferase cDNA, preceded by a LoxP-stop-LoxP cassette, was introduced into the ubiquitously expressed ROSA26 locus (Safran et al., 2003). Progeny were then crossed with Lck-cre transgenics to delete Pten in T cell progenitors and induce expression of luciferase (Lck/Pten.sup.fl/fl; Gt(ROSA)26Sor.sup.tm1(Luc)Kael/J). Imaging on T-ALL tumor bearing animals was performed just prior to and after 4 days of treatment with CAL-130. Signals at day 4 were dramatically lower in treated animals, consistent with the reduction in the WBC count and the CD4 single positive population of tumor cells (
Example 12
Reliance of PTEN Null Human T-ALL on PI3K? and PI3K?
[0175] To test whether CAL-130 may have similar effects on human tumors, the response of T-ALL cell lines to the compound were first analyzed. A human T-ALL cell line, CCRF-CEM, was used. T-ALL cell lines typically have multiple mutations including but not limited to Notchi and PTEN (Palomero et al., 2007). Moreover, this particular cell line also has reduced sensitivity to conventional chemotherapies used in the treatment of T-ALL such as dexamethasone. Incubation of cultured cells with CAL-130, but not inhibitors of either PI3K? or PI3K?, prevented proliferation and promoted apoptosis within 24 hours, which persisted over 4 days of treatment (
[0176] The PI3K/Akt signaling pathway can play a major role in cell cycle progression and growth of tumors by regulating the activation state of the downstream targets such as glycogen synthase kinase-3? (GSK3?) and mTOR (Schmelzle and Hall, 2000; Cohen and Frame, 2001). PI3K/Akt mediated phosphorylation suppresses the function of the former and promotes the activity of the latter. Tumor cell survival, on the other hand, is largely mediated by the ability of this pathway to inactivate proapoptotic effectors such as the BH3-only pro-apoptotic protein BAD and to repress the expression of BIM, both of which participate in the mitochondria-dependent cell death pathway (Strasser et al., 2000; Duronio, 2008). Therefore, the ability of CAL-130 treatment to interfere with such events was examined. Indeed, CCRF-CEM cells exposed to increasing concentration of drug exhibited a corresponding reduction and complete abrogation of Akt (Ser473) phosphorylation at 2.5 ?M (
[0177] To assess the in vivo relevance of these observations, the ability of CAL-130 to prevent the proliferation of CCRF-CEM cells implanted subcutaneously or to prolong the survival of NOD.Cg-Prkdc.sup.scid Il2rg.sup.tm1Wjl/Sz that received these cells intravenously was evaluated. In the former, luciferase expressing CCRF-CEM cells were injected into the flanks of immunodeficient mice and allowed to grow for 1 week before administering vehicle control or inhibitor (10 mg kg.sup.?1 every 8 hours) for a total of 4 days. In the latter, treatment commenced 3 days post-injection of tumor cells for a total of 7 days. Bioimaging of subcutaneous tumors revealed a 5-fold difference in luminescence in CAL-130 treated versus vehicle control treated animals (
[0178] As the continued passage of rapidly growing tumor lines can result in genetic alterations distinct from the cell from which it was originally derived, the effect of CAL-130 on primary T-ALL samples isolated from patients with active disease was also evaluated. Consistent with the animal studies, human tumor cells devoid of PTEN were exquisitely sensitive to dual inhibition of PI3K?/?, but not single inhibition of PI3K?, which resulted in a reduction in tumor cell viability as well as in Akt phosphorylation in response to treatment (
[0179] Oncogenesis is a complex and multigenic process that often involves constitutive activation of the PI3K signaling pathway. Most notably are the gain-of-function mutations frequently found in PIK3CA, the gene that encodes for the p110? catalytic subunit, and genetic alterations that lead to the inactivation of the tumor suppressor gene Pten (Samuels et al., 2004; Zunder et al., 2008; Sulis and Parsons, 2003; Salmena et al., 2008). In the latter scenario, the possibility exists that the unregulated activity of any of the four class I PI3K isoforms could drive tumor development. For instance, previous reports demonstrate that PI3K? is essential for the induction, growth, and survival of PTEN-deficient tumors of epithelial cell origin (Jia et al., 2008; Wee et al., 2008). Moreover, it has been suggested that all class I PI3K isoforms are capable of coupling to upstream signaling pathways in which they are not normally engaged, thus compensating for inhibition/genetic deletion of a particular isoform (Foukas et al., 2010). To date, no conclusive evidence exists to implicate PI3K? or any other class I PI3K in the genesis of hematological malignancies such as T-ALL.
[0180] These results demonstrate that in the absence of physiological regulation, the activity of either PI3K? or PI3K? is sufficient for the malignant transformation of T cell progenitors in a living animal. This is exemplified by the similar onset of disease and percent survival of mice lacking either p110? or p110?, and the rare incidence of tumor development in their combined absence. Moreover, pharmacological blockade of both p110?/? dramatically impacted on tumor cell proliferation and survival as demonstrated in CAL-130 treatment of diseased Lck/Pten.sup.fl/fl mice, IC87114 treatment of diseased Lck/Pten.sup.fl/fl Pik3cg.sup.?/? mice as well as CAL-130 treatment of PTEN null human T-ALL primary tumors or tumor cell lines; no such effects were observed with siRNA knockdown of either p110? or p110?, and selective blockade of PI3K? with IC87114 was ineffective in reducing the viability of primary human T-ALL samples. These results would suggest that propagation of upstream signaling pathways critical for the development and/or survival of PTEN null T-ALL tumors rely on PI3K? and PI3K? and that the remaining isoforms (i.e. alpha and beta) cannot adequately compensate for their inactivity. Clearly, the same PI3K isoforms can participate in both tumorigenesis and tumor maintenance.
[0181] It has previously been established that PTEN loss is necessary but not sufficient to cause the malignant transformation of T cell progenitors (Liu et al., 2010; Guo et al., 2011). This typically requires additional genetic events such as chromosomal translocations involving the T cell receptor ?/? locus and c-myc oncogene (Bernard et al., 1988; Finger et al., 1986), which are acquired during the transition from CD4.sup.?CD8.sup.? DN to CD4.sup.+CD8.sup.+ DP development stage. Despite the presence of these strong oncogenic signals, the combined absence of PI3K? and PI3K? significantly impaired leukemogenesis suggesting that loss of these isoforms can act as a tumorigenic bottleneck. Although it is possible that the overall reduction in CD4.sup.+CD8.sup.+ DP thymocyte numbers can partially account for the lower tumor incidence, it is unlikely because the transition from DN to DP thymocyte population in the double knockout mice is relatively normal (Swat et al., 2005). That is to say, there is no major deficiency in the number of early T cell progenitors that could undergo malignant transformation in the absence of PTEN activity. Yet, not only is tumorigenesis disrupted in TKO mice but the abnormality observed in T cell development persisted as well. This is in contrast to the severe defect in thymocyte development associated with a genetic deletion of phosphoinositide-dependent kinase 1 (PDK1) (Hinton et al., 2004), a direct downstream target of class I PI3K, which can be overcome by the loss of PTEN resulting in near normal numbers of thymocytes and peripheral T cells (Finlay et al., 2009). Similarly, PTEN deficiency can bypass a defect in either IL-7R or pre-TCR signaling, which are critical for the normal development and survival of T cells (Hagenbeek et al., 2004). In stark contrast to these studies is the inability of a PTEN deficient state to promote thymocyte proliferation and development in triple mutant Lck/Pten.sup.fl/fl; Pik3cg.sup.?/?; pik3cd.sup.?/? mice.
[0182] Thus, developmental and genomic events responsible for the generation as well as the malignant transformation of T cells in the context of a PTEN deficient state are critically reliant on proliferation and survival signals provided by PI3K? and PI3K?. It is interesting to note that although PTEN appears to play a key role in regulating the activities of class I PI3K, it is not the only phosphatase in T cells. SHIP1 (SH2-containing inositol-5-phosphatase) is also capable of hydrolyzing PIP3 and has been shown to play an important role in the immunoregulatory capacity and development of specific subsets of T cells (Tarasenko et al., 2007; Collazo et al., 2009). Although deletion of SHIP1 alone in T cell progenitors is not sufficient to induce leukemogenesis, low levels of this phosphatase in conjunction with PTEN inactivation have been reported in human T-ALL tumors suggesting that inactivation of both phosphatases contribute to the hyperactivation of the PI3K/Akt signaling pathway (Lo et al., 2009). The discovery that both PI3K? and PI3K? are the engines that help drive the oncogenic process in T cell progenitors in the absence of appropriate regulation and can provide sufficient growth and survival signals necessary for tumor cell maintenance makes them attractive targets for therapy in such clinical cases. Moreover, dual inhibition of PI3K? and PI3K? in combination with conventional chemotherapies such as glucocorticoids may be of particular clinical utility in such individuals as they are more likely to fail induction chemotherapy and relapse (Gutierrez et al., 2009; Jotta et al., 2010).
[0183] It has been suggested that a complex signaling network involving PI3K exists between leukemic and supporting cells in the tissue microenvironment that may contribute to disease progression and drug resistance (Ayala et al., 2009; Konopleva et al., 2009; Burger et al., 2009). This is exemplified by the recent observations that the PI3K? specific inhibitor CAL-101 reduces levels of circulating chemokines known to contribute to tissue localization of chronic lymphocytic leukemic cells (Hoellenriegel et al., 2011). Consequently, this results in a generalized lymphocytosis during treatment of patients with this hematological malignancy. In contrast, a dramatic and sustained reduction in peripheral blood T-ALL cells within hours of CAL-130 treatment of diseased Lck/Pten.sup.fl/fl mice (data not shown) was observed. That said, it is possible that paracrine and/or autocrine signaling responsible for T-ALL survival in tissues may be disrupted by simultaneously blocking the activities of PI3K? and PI3K?. Further work will be required to establish the role of these PI3K isoforms in supporting microenvironmental interactions in T-ALL.
[0184] In the broader perspective, the results indicate that in the absence of PTEN mediated regulation, distinct class I PI3Ks can predominate in the development and survival of tumors in a manner that is most likely to involve isoforms that normally play a critical role in the function of that particular cell type. Furthermore, it is possible to target cancer cells by exploiting their addiction to the activity of distinct PI3K isoforms that are not themselves classical oncogenes. More generally, by identifying PI3K? and PI3K? as key therapeutic targets, it may be possible to limit toxicities that would be associated with the administration of pan-PI3K or Akt inhibitors including perturbations in insulin signaling and glucose metabolism (Crouthamel et al., 2009).
DOCUMENTS
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[0287] All documents cited in this application are hereby incorporated by reference as if recited in full herein.
[0288] Although illustrative embodiments of the present invention have been described herein, it should be understood that the invention is not limited to those described, and that various other changes or modifications may be made by one skilled in the art without departing from the scope or spirit of the invention.