Combination of the mTOR inhibitor rapamycin and CC-5013 has synergistic activity in multiple myeloma

Noopur Raje, Shaji K Kumar, Teru Hideshima, Kenji Ishitsuka, Dharminder Chauhan, Constantine Mitsiades, Klaus Podar, Steven Le Gouill, Paul Richardson, Nikhil C. Munshi, David I. Stirling, Joseph H. Antin, Kenneth C. Anderson

Research output: Contribution to journalArticle

172 Citations (Scopus)

Abstract

Previous studies have demonstrated the in vitro and in vivo activity of CC-5013 (Revlimid), an immunomodulatory analog (IMiD) of thalidomide, in multiple myeloma (MM). In the present study, we have examined the anti-MM activity of rapamycin (Rapamune), a specific mTOR inhibitor, combined with CC-5013. Based on the Chou-Talalay method, combination indices of less than 1 were obtained for all dose ranges of CC-5013 when combined with rapamycin, suggesting strong synergism. Importantly, this combination was able to overcome drug resistance when tested against MM cell lines resistant to conventional chemotherapy. Moreover, the combination, but not rapamycin alone, was able to overcome the growth advantage conferred on MM cells by interleukin-6 (IL-6), insulin-like growth factor-1 (IGF-1), or adherence to bone marrow stromal cells (BMSCs). Combining rapamycin and CC-5013 induced apoptosis of MM cells. Differential signaling cascades, including the mitogen-activated protein kinase (MAPK) and the phosphatidylinositol 3′-kinass/Akt kinase (PI3K/Akt) pathways, were targeted by these drugs individually and in combination, suggesting the molecular mechanism by which they interfere with MM growth and survival. These studies, therefore, provide the framework for clinical evaluation of mTOR inhibitors combined with IMiDs to improve patient outcome in MM.

Original languageEnglish (US)
Pages (from-to)4188-4193
Number of pages6
JournalBlood
Volume104
Issue number13
DOIs
StatePublished - Dec 15 2004
Externally publishedYes

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Sirolimus
Multiple Myeloma
Thalidomide
Chemotherapy
Somatomedins
Phosphatidylinositols
Mitogen-Activated Protein Kinases
Pharmaceutical Preparations
Mitogen-Activated Protein Kinase 3
Interleukin-6
Bone
Phosphotransferases
Growth
Cells
lenalidomide
Mesenchymal Stromal Cells
Drug Resistance
Apoptosis
Drug Therapy
Cell Line

ASJC Scopus subject areas

  • Hematology

Cite this

Raje, N., Kumar, S. K., Hideshima, T., Ishitsuka, K., Chauhan, D., Mitsiades, C., ... Anderson, K. C. (2004). Combination of the mTOR inhibitor rapamycin and CC-5013 has synergistic activity in multiple myeloma. Blood, 104(13), 4188-4193. https://doi.org/10.1182/blood-2004-06-2281

Combination of the mTOR inhibitor rapamycin and CC-5013 has synergistic activity in multiple myeloma. / Raje, Noopur; Kumar, Shaji K; Hideshima, Teru; Ishitsuka, Kenji; Chauhan, Dharminder; Mitsiades, Constantine; Podar, Klaus; Le Gouill, Steven; Richardson, Paul; Munshi, Nikhil C.; Stirling, David I.; Antin, Joseph H.; Anderson, Kenneth C.

In: Blood, Vol. 104, No. 13, 15.12.2004, p. 4188-4193.

Research output: Contribution to journalArticle

Raje, N, Kumar, SK, Hideshima, T, Ishitsuka, K, Chauhan, D, Mitsiades, C, Podar, K, Le Gouill, S, Richardson, P, Munshi, NC, Stirling, DI, Antin, JH & Anderson, KC 2004, 'Combination of the mTOR inhibitor rapamycin and CC-5013 has synergistic activity in multiple myeloma', Blood, vol. 104, no. 13, pp. 4188-4193. https://doi.org/10.1182/blood-2004-06-2281
Raje, Noopur ; Kumar, Shaji K ; Hideshima, Teru ; Ishitsuka, Kenji ; Chauhan, Dharminder ; Mitsiades, Constantine ; Podar, Klaus ; Le Gouill, Steven ; Richardson, Paul ; Munshi, Nikhil C. ; Stirling, David I. ; Antin, Joseph H. ; Anderson, Kenneth C. / Combination of the mTOR inhibitor rapamycin and CC-5013 has synergistic activity in multiple myeloma. In: Blood. 2004 ; Vol. 104, No. 13. pp. 4188-4193.
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