Targeting White Blood Cells Synergizes with Waldenstrom Macroglobulinemia Treatments

Key Findings

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Researchers have developed a novel approach for treatment of Waldenström macroglobulinemia, a rare form of lymphoma. By targeting specific cell proteins that control DNA with inhibitors, researchers successfully reduced the growth of cancer cells. Combining multiple drugs showed even stronger killing effects against cancer cells, a promising new therapeutic approach.

About the Co-Author

Sherine Elsawa

Sherine Elsawa, Associate Professor of Molecular, Cellular, and Biomedical Sciences

Contact information: Sherine.Elsawa@unh.edu, 603-862-5359, Elsawa Lab website

This research first published in the journal Epigenomics.

Researchers: S. Matissek, W. Han, M. Karbalivand, M. Sayed, B. Reilly, S. Mallat, S. Ghazal, M. Munshi, G. Yang, S. Treon, S. Walker, and S. Elsawa.
Waldenström macroglobulinemia (WM), a rare form of lymphoma, does not have any known cure and only one FDA-approved treatment, making it challenging to treat patients. But with the work being done at UNH, that may one day change. 

Researchers at UNH have taken the approach of targeting specific cell proteins that control DNA information using inhibitors, or drugs, that were effective in reducing the growth of the cancer cells and when combined with a third drug were even more successful in killing the WM cancer cells, which could lead to more treatment options.

“This is the first study to report the promising results of inhibitors in Waldenström macroglobulinemia which could open the door to new clinical possibilities,” said Sherine Elsawa, associate professor of molecular, cellular and biomedical sciences. “We know that targeting these types of proteins with inhibitors can increase high therapeutic results in many other kinds of cancer but desired results in WM cells has been lacking.”

“We know that targeting these types of proteins with inhibitors can increase high therapeutic results in many other kinds of cancer but desired results in WM cells has been lacking.”

In their study, published in the journal Epigenomics, Elsawa and her team focused on the epigenetic regulation of WM cancer cells. Epigenetics is the study of how DNA is opened and closed to allow certain genes to be expressed or encoded. Each protein has a different function—some write the genetic code, some read or interpret it and others can erase the code. The researchers focused on two proteins, bromodomain and extraterminal (BET), which are epigenetic readers. BET proteins have been shown to be involved in pathological conditions including cancer. Drugs that inhibit these proteins can block gene expression that regulate cancer cells by slowing and stopping their growth.

The WM cancer cells were treated with the BET inhibitors JQ-1 and I-BET-762 which reduced the growth of the WM cells in the lab, with JQ-1 showing the strongest inhibitory effect. However, neither inhibitor was effective in inducing cell death. Researchers next tried adding three different drugs, one at a time, in combination with the BET inhibitors (JQ-1 and I-BET-762). After studying each separate drug combination, they found that adding panabinostat, a known cancer drug, to the inhibitors offered the greatest combination therapy. The study suggests epigenetic targeting is likely to provide a better therapeutic outcome.

This research was supported by a grant from the International Waldenström Macroglobulinemia Foundation and the Leukemia & Lymphoma Society (IWMF-LLS), an award from the National Institutes of Health Centers of Biomedical Research Excellence (COBRE) (CIBBR, P20GM113131), and an Institutional Development Award (IDeA) from the National Institute of General Medical Sciences.

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