Abstract
Inhibition of NOTCH1 signaling with gamma-secretase inhibitors (GSIs) has been proposed as a molecularly targeted therapy in T-cell acute lymphoblastic leukemia (T-ALL). However, GSIs seem to have limited antileukemic activity in human T-ALL and are associated with severe gastrointestinal toxicity resulting from inhibition of NOTCH signaling in the gut. Inhibition of NOTCH1 signaling in glucocorticoid-resistant T-ALL restored glucocorticoid sensitivity and co-treatment with glucocorticoids inhibited GSI-induced gut toxicity. Thus, combination therapies with GSIs plus glucocorticoids may offer a new opportunity for the use of anti-NOTCH1 therapies in human T-ALL.
Publication types
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Adult
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Amyloid Precursor Protein Secretases / antagonists & inhibitors*
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Animals
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Basic Helix-Loop-Helix Transcription Factors / physiology
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Child
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Drug Resistance, Neoplasm / drug effects
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Drug Synergism
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Enzyme Inhibitors / administration & dosage
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Enzyme Inhibitors / adverse effects
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Enzyme Inhibitors / pharmacology
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Gastrointestinal Diseases / chemically induced
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Gastrointestinal Diseases / prevention & control
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Gene Expression Regulation, Neoplastic / drug effects
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Glucocorticoids / administration & dosage
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Glucocorticoids / pharmacology*
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Homeodomain Proteins / physiology
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Humans
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Intestinal Mucosa / metabolism
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Intestines / drug effects
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Kruppel-Like Factor 4
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Kruppel-Like Transcription Factors / genetics
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Kruppel-Like Transcription Factors / physiology
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Mice
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Mice, Knockout
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Neoplasm Proteins / antagonists & inhibitors*
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Neoplasm Proteins / genetics
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Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
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Protein Processing, Post-Translational
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Receptor, Notch1 / antagonists & inhibitors*
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Receptor, Notch1 / genetics
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Transcription Factor HES-1
Substances
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Basic Helix-Loop-Helix Transcription Factors
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Enzyme Inhibitors
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Glucocorticoids
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Hes1 protein, mouse
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Homeodomain Proteins
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Kruppel-Like Factor 4
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Kruppel-Like Transcription Factors
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NOTCH1 protein, human
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Neoplasm Proteins
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Notch1 protein, mouse
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Receptor, Notch1
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Transcription Factor HES-1
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HES1 protein, human
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Amyloid Precursor Protein Secretases