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Alkynyl nicotinamides show antileukemic activity in drug-resistant acute myeloid leukemia
Baskar Ramdas, … , Herman O. Sintim, Reuben Kapur
Baskar Ramdas, … , Herman O. Sintim, Reuben Kapur
Published June 17, 2024
Citation Information: J Clin Invest. 2024;134(12):e169245. https://doi.org/10.1172/JCI169245.
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Research Article Hematology Article has an altmetric score of 221

Alkynyl nicotinamides show antileukemic activity in drug-resistant acute myeloid leukemia

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Abstract

Activating mutations of FLT3 contribute to deregulated hematopoietic stem and progenitor cell (HSC/Ps) growth and survival in patients with acute myeloid leukemia (AML), leading to poor overall survival. AML patients treated with investigational drugs targeting mutant FLT3, including Quizartinib and Crenolanib, develop resistance to these drugs. Development of resistance is largely due to acquisition of cooccurring mutations and activation of additional survival pathways, as well as emergence of additional FLT3 mutations. Despite the high prevalence of FLT3 mutations and their clinical significance in AML, there are few targeted therapeutic options available. We have identified 2 novel nicotinamide-based FLT3 inhibitors (HSN608 and HSN748) that target FLT3 mutations at subnanomolar concentrations and are potently effective against drug-resistant secondary mutations of FLT3. These compounds show antileukemic activity against FLT3ITD in drug-resistant AML, relapsed/refractory AML, and in AML bearing a combination of epigenetic mutations of TET2 along with FLT3ITD. We demonstrate that HSN748 outperformed the FDA-approved FLT3 inhibitor Gilteritinib in terms of inhibitory activity against FLT3ITD in vivo.

Authors

Baskar Ramdas, Neetu Dayal, Ruchi Pandey, Elizabeth Larocque, Rahul Kanumuri, Santhosh Kumar Pasupuleti, Sheng Liu, Chrysi Kanellopoulou, Elizabeth Fei Yin Chu, Rodrigo Mohallem, Saniya Virani, Gaurav Chopra, Uma K. Aryal, Rena Lapidus, Jun Wan, Ashkan Emadi, Laura S. Haneline, Frederick W. Holtsberg, M. Javad Aman, Herman O. Sintim, Reuben Kapur

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Figure 6

Therapeutic efficacy of HSN748 in a genetic mouse model of AML bearing a combination of epigenetic (Tet2) and genetic (Flt3ITD/ITD) mutation.

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Therapeutic efficacy of HSN748 in a genetic mouse model of AML bearing a...
Equal number of bone marrow mononuclear cells from CD45.1-expressing BoyJ mice and CD45.2 expressing Tet2–/–:Flt3ITD/ITD AML mice were mixed and transplanted to lethally irradiated F1 recipients that expresses both CD45.1 and CD45.2. 6 weeks after transplant peripheral blood engraftment was analyzed. Mice were treated orally with either vehicle or HSN748 at 20 mg/kg 5 times a week. HSN748 treatment of these mice reduces peripheral leukemic burden. (A) WBC, neutrophil,and monocyte counts. HSN748 treatment reduces splenomegaly. (B) Spleen pictures, quantification data for spleen weight in the middle panel and reduction of leukemic cells (CD45.1) with significant increase in normal cells (CD45.1+) in the right-side panel. (C) the representative flow profiles of erythroid differentiation in bone marrow from vehicle and HSN748-treated groups. HSN748 treatment induces differentiation of erythroid cells in bone marrow as demonstrated by increase in mature Ter119+ single-positive cells in the bone marrow of HSN748-treated mice compared with vehicle-treated group (right side panel). (D) shows the representative flow profiles of CD11b/Gr1 cells. HSN748 treatment induces differentiation of myeloid cells in the bone marrow as shown by increase in the frequency of mature CD11b/Gr1 double-positive cells and a decrease in the frequency of immature CD11b–/Gr1+ single-positive population compared with vehicle-treated group (middle panel) and a reduction in the frequency of immature CD11b–/Kit+ leukemic cells (right side panel). (E) The representative flow profiles of Lin– Sca1+Kit+ (LSK) cells. (F) shows the quantification data of frequency of lineage negative cells (left side panel) and total frequency of lin– Kit+ myeloid progenitors (right side panel) with insignificant effect on LSK total frequency (middle panel) on HSN748 treatment. Data represents median with interquartile range by 2-tailed Welch’s t test (n = 6 in each group ***P < 0.001, *P < 0.05).

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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