A FLT3-targeted tyrosine kinase inhibitor is cytotoxic to leukemia cells in vitro and in vivo

M Levis, J Allebach, KF Tse, R Zheng… - Blood, The Journal …, 2002 - ashpublications.org
M Levis, J Allebach, KF Tse, R Zheng, BR Baldwin, BD Smith, S Jones-Bolin, B Ruggeri…
Blood, The Journal of the American Society of Hematology, 2002ashpublications.org
Constitutively activating internal tandem duplication (ITD) and point mutations of the receptor
tyrosine kinase FLT3 are present in up to 41% of patients with acute myeloid leukemia
(AML). These FLT3/ITD mutations are likely to be important because their presence is
associated with a poor prognosis. Both types of mutations appear to activate the tyrosine
kinase activity of FLT3. We describe here the identification and characterization of the
indolocarbazole derivative CEP-701 as a FLT3 inhibitor. This drug potently and selectively …
Constitutively activating internal tandem duplication (ITD) and point mutations of the receptor tyrosine kinase FLT3 are present in up to 41% of patients with acute myeloid leukemia (AML). These FLT3/ITD mutations are likely to be important because their presence is associated with a poor prognosis. Both types of mutations appear to activate the tyrosine kinase activity of FLT3. We describe here the identification and characterization of the indolocarbazole derivative CEP-701 as a FLT3 inhibitor. This drug potently and selectively inhibits autophosphorylation of wild-type and constitutively activated mutant FLT3 in vitro in FLT3/ITD-transfected cells and in human FLT3-expressing myeloid leukemia–derived cell lines. We demonstrate that CEP-701 induces a cytotoxic effect on cells in a dose-responsive fashion that parallels the inhibition of FLT3. STAT5 and ERK1/2, downstream targets of FLT3 in the signaling pathway, are inhibited in response to FLT3 inhibition. In primary leukemia blasts from AML patients harboring FLT3/ITD mutations, FLT3 is also inhibited, with an associated cytotoxic response. Finally, using a mouse model of FLT3/ITD leukemia, we demonstrate that the drug inhibits FLT3 phosphorylation in vivo and prolongs survival. These findings form the basis for a planned clinical trial of CEP-701 in patients with AML harboring FLT3- activating mutations.
ashpublications.org