Unravelling the suboptimal response of TP53-mutated chronic lymphocytic leukaemia to ibrutinib

Br J Haematol. 2019 Feb;184(3):392-396. doi: 10.1111/bjh.15613. Epub 2018 Oct 18.

Abstract

TP53-disrupted chronic lymphocytic leukaemia (CLL) patients show a suboptimal long-term response to ibrutinib. We hereby report that ibrutinib-induced in vitro apoptosis and proliferation inhibition were significantly lower in TP53-mutated (TP53-M) CLL cells compared to TP53 wild-type cells. Contrariwise, venetoclax effectively killed TP53-M cells. Gene expression profile analysis of TP53-M cells revealed a downmodulation of B-cell receptor (BCR)-related genes and an upmodulation of genes with anti-apoptotic/pro-survival activity, suggesting that the survival and proliferation of TP53-M cells are less dependent on the BCR pathway. These observations further support the use of drug combinations for the optimal management of TP53-M CLL patients.

Keywords: CLL; BCL2 inhibitor; BCR activity; BTK inhibitor; TP53 mutation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenine / analogs & derivatives
  • Adult
  • Aged
  • Aged, 80 and over
  • Apoptosis / drug effects
  • Bridged Bicyclo Compounds, Heterocyclic / pharmacology
  • Cell Proliferation / drug effects
  • Cell Survival / drug effects
  • Down-Regulation / drug effects*
  • Female
  • Gene Expression Regulation, Neoplastic / drug effects*
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
  • Leukemia, Lymphocytic, Chronic, B-Cell / genetics
  • Leukemia, Lymphocytic, Chronic, B-Cell / metabolism
  • Leukemia, Lymphocytic, Chronic, B-Cell / pathology
  • Male
  • Middle Aged
  • Mutation*
  • Piperidines
  • Pyrazoles / pharmacology*
  • Pyrimidines / pharmacology*
  • Receptors, Antigen, B-Cell / biosynthesis*
  • Sulfonamides / pharmacology
  • Tumor Suppressor Protein p53 / genetics
  • Tumor Suppressor Protein p53 / metabolism*

Substances

  • Bridged Bicyclo Compounds, Heterocyclic
  • Piperidines
  • Pyrazoles
  • Pyrimidines
  • Receptors, Antigen, B-Cell
  • Sulfonamides
  • TP53 protein, human
  • Tumor Suppressor Protein p53
  • ibrutinib
  • Adenine
  • venetoclax