Gemcitabine and APG-1252, a novel small molecule inhibitor of BCL-2/BCL-XL, display a synergistic antitumor effect in nasopharyngeal carcinoma through the JAK-2/STAT3/MCL-1 signaling pathway

• DOI: 10.1038/s41419-021-04042-7
• Publication Date: 2021-08-05T07:02:58Z
• Authors: Fan Luo; Fei-Teng Lu; Miao-Zhen Qiu; Ting Zhou; Wen-Juan Ma; Min Luo; Kang-Mei Zeng; Qiu-Yun Luo; Wen-Tao Pan; Lin Zhang; Zeng-Fei Xia; Zhong-Han Zhang; Jia-Xin Cao; Hong-Yun Zhao; Li Zhang; Da-Jun Yang
• Keywords: STAT3 Transcription Factor; 0301 basic medicine; Epithelial-Mesenchymal Transition; Antineoplastic Agents; Apoptosis; Deoxycytidine; Models, Biological; Article; 03 medical and health sciences; Piperidines; Cell Movement; Cell Line, Tumor; Humans; Neoplasm Invasiveness; Cell Proliferation; Aniline Compounds; Nasopharyngeal Carcinoma; QH573-671; Drug Synergism; Nasopharyngeal Neoplasms; Janus Kinase 2; 3. Good health; Caspases; Myeloid Cell Leukemia Sequence 1 Protein; Cytology; Signal Transduction

AbstractAdvanced nasopharyngeal carcinoma (NPC) has a poor prognosis, with an unfavorable response to palliative chemotherapy. Unfortunately, there are few effective therapeutic regimens. Therefore, we require novel treatment strategies with enhanced efficacy. The present study aimed to investigate the antitumor efficacy of APG-1252-M1, a dual inhibitor of BCL-2/BCL-XL, as a single agent and combined with gemcitabine. We applied various apoptotic assays and used subcutaneous transplanted NPC model to assess the in vitro and in vivo antitumor activity. Moreover, phospho-tyrosine kinase array was used to investigate the combined therapy’s potential synergistic mechanism. In addition, further validation was performed using immunohistochemistry and western blotting. In vitro, we observed that APG-1252-M1 had moderate antitumor activity toward NPC cells; however, it markedly improved gemcitabine’s ability to promote NPC cell apoptosis and suppress invasion, migration, and proliferation. Specifically, APG-1252 plus gemcitabine exhibited even remarkable antitumor activity in vivo. Mechanistically, the drug combination synergistically suppressed NPC by activating caspase-dependent pathways, blocking the phospho (p)-JAK-2/STAT3/MCL-1 signaling pathway, and inhibiting epithelial-mesenchymal transition. In conclusion, the results indicated that the combination of APG-1252 and gemcitabine has synergistic anticancer activities against NPC, providing a promising treatment modality for patients with NPC.