Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Lymphoma

Antiproliferative activity of RAD001 (everolimus) as a single agent and combined with other agents in mantle cell lymphoma

Abstract

Mantle cell lymphoma (MCL) is an aggressive form of B-cell non-Hodgkin's lymphoma, with a mean survival of only 3–5 years and suboptimal therapeutic options. MCL is characterized by a balanced translocation t(11;14)(q13;q32), resulting in overexpression of cyclin D1, a G1 cyclin regulated by the PI3K/Akt/mammalian target of rapamycin (mTOR) signaling pathway. As improved therapy for MCL is required and the mTOR pathway may be involved in its pathophysiology, the antiproliferative effects of RAD001 (everolimus), an mTOR inhibitor, against three MCL cell lines were investigated. As a single agent, RAD001 inhibited proliferation in MCL cell lines (Jeko1, SP49 and NCEB1) approximately 40–65% compared to diluent control cells. This was associated with G1 cell-cycle arrest and reduced phosphorylation of the mTOR downstream target, 4E-BP1. Furthermore, combination drug studies revealed predominantly synergistic cytotoxicity with RAD001 and several secondary agents, including doxorubicin, vincristine or rituximab (components of the standard MCL regimen), as well as paclitaxel, vorinostat and bortezomib. These data indicate that single agent RAD001 is effective in inhibiting growth of MCL cells in vitro and combination studies with secondary agents further demonstrate synergistic cytotoxicity. Thus, these findings support future clinical studies of RAD001 in the treatment of MCL.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Weisenburger DD, Armitage JO . Mantle cell lymphoma – an entity comes of age. Blood 1996; 87: 4483–4494.

    CAS  PubMed  Google Scholar 

  2. Tsujimoto Y, Jaffe E, Cossman J, Gorham J, Nowell PC, Croce CM . Clustering of breakpoints on chromosome 11 in human B-cell neoplasms with the t(11;14) chromosome translocation. Nature 1985; 315: 340–343.

    Article  CAS  PubMed  Google Scholar 

  3. Lukas J, Jadayel D, Bartkova J, Nacheva E, Dyer MJ, Strauss M et al. BCL-1/cyclin D1 oncoprotein oscillates and subverts the G1 phase control in B-cell neoplasms carrying the t(11;14) translocation. Oncogene 1994; 9: 2159–2167.

    CAS  PubMed  Google Scholar 

  4. Bosch F, Jares P, Campo E, Lopez-Guillermo A, Piris MA, Villamor N et al. PRAD-1/cyclin D1 gene overexpression in chronic lymphoproliferative disorders: a highly specific marker of mantle cell lymphoma. Blood 1994; 84: 2726–2732.

    CAS  PubMed  Google Scholar 

  5. Kato J, Matsushime H, Hiebert SW, Ewen ME, Sherr CJ . Direct binding of cyclin D to the retinoblastoma gene product (pRb) and pRb phosphorylation by the cyclin D-dependent kinase CDK4. Genes Dev 1993; 7: 331–342.

    Article  CAS  PubMed  Google Scholar 

  6. Sherr CJ . G1 phase progression: cycling on cue. Cell 1994; 79: 551–555.

    Article  CAS  PubMed  Google Scholar 

  7. Xu RH, Pelicano H, Zhang H, Giles FJ, Keating MJ, Huang P . Synergistic effect of targeting mTOR by rapamycin and depleting ATP by inhibition of glycolysis in lymphoma and leukemia cells. Leukemia 2005; 19: 2153–2158.

    Article  CAS  PubMed  Google Scholar 

  8. Gingras AC, Raught B, Sonenberg N . Regulation of translation initiation by FRAP/mTOR. Genes Dev 2001; 15: 807–826.

    Article  CAS  PubMed  Google Scholar 

  9. Hay N . The Akt-mTOR tango and its relevance to cancer. Cancer Cell 2005; 8: 179–183.

    Article  CAS  PubMed  Google Scholar 

  10. Jacinto E, Hall MN . Tor signalling in bugs, brain and brawn. Nat Rev Mol Cell Biol 2003; 4: 117–126.

    Article  CAS  PubMed  Google Scholar 

  11. Geoerger B, Kerr K, Tang CB, Fung KM, Powell B, Sutton LN et al. Antitumor activity of the rapamycin analog CCI-779 in human primitive neuroectodermal tumor/medulloblastoma models as single agent and in combination chemotherapy. Cancer Res 2001; 61: 1527–1532.

    CAS  PubMed  Google Scholar 

  12. Wu L, Birle DC, Tannock IF . Effects of the mammalian target of rapamycin inhibitor CCI-779 used alone or with chemotherapy on human prostate cancer cells and xenografts. Cancer Res 2005; 65: 2825–2831.

    Article  CAS  PubMed  Google Scholar 

  13. Recher C, Beyne-Rauzy O, Demur C, Chicanne G, Dos Santos C, Mas VM et al. Antileukemic activity of rapamycin in acute myeloid leukemia. Blood 2005; 105: 2527–2534.

    Article  CAS  PubMed  Google Scholar 

  14. Boulay A, Zumstein-Mecker S, Stephan C, Beuvink I, Zilbermann F, Haller R et al. Antitumor efficacy of intermittent treatment schedules with the rapamycin derivative RAD001 correlates with prolonged inactivation of ribosomal protein S6 kinase 1 in peripheral blood mononuclear cells. Cancer Res 2004; 64: 252–261.

    Article  CAS  PubMed  Google Scholar 

  15. Treeck O, Wackwitz B, Haus U, Ortmann O . Effects of a combined treatment with mTOR inhibitor RAD001 and tamoxifen in vitro on growth and apoptosis of human cancer cells. Gynecol Oncol 2006; 102: 292–299.

    Article  CAS  PubMed  Google Scholar 

  16. Kumagai T, O'Kelly J, Said JW, Koeffler HP . Vitamin D2 analog 19-nor-1,25-dihydroxyvitamin D2: antitumor activity against leukemia, myeloma and colon cancer cells. J Natl Cancer Inst 2003; 95: 896–905.

    Article  CAS  PubMed  Google Scholar 

  17. Yee KW, Zeng Z, Konopleva M, Verstovsek S, Ravandi F, Ferrajoli A et al. Phase I/II study of the mammalian target of rapamycin inhibitor everolimus (RAD001) in patients with relapsed or refractory hematologic malignancies. Clin Cancer Res 2006; 12: 5165–5173.

    Article  CAS  PubMed  Google Scholar 

  18. Yan H, Frost P, Shi Y, Hoang B, Sharma S, Fisher M et al. Mechanism by which mammalian target of rapamycin inhibitors sensitize multiple myeloma cells to dexamethasone-induced apoptosis. Cancer Res 2006; 66: 2305–2313.

    Article  CAS  PubMed  Google Scholar 

  19. Dengler J, von Bubnoff N, Decker T, Peschel C, Duyster J . Combination of imatinib with rapamycin or RAD001 acts synergistically only in Bcr-Abl-positive cells with moderate resistance to imatinib. Leukemia 2005; 19: 1835–1838.

    Article  CAS  PubMed  Google Scholar 

  20. Witzig TE . Current treatment approaches for mantle-cell lymphoma. J Clin Oncol 2005; 23: 6409–6414.

    Article  CAS  PubMed  Google Scholar 

  21. Thieblemont C, Antal D, Lacotte-Thierry L, Delwail V, Espinouse D, Michallet AS et al. Chemotherapy with rituximab followed by high-dose therapy and autologous stem cell transplantation in patients with mantle cell lymphoma. Cancer 2005; 104: 1434–1441.

    Article  CAS  PubMed  Google Scholar 

  22. Lenz G, Dreyling M, Hoster E, Wormann B, Duhrsen U, Metzner B et al. Immunochemotherapy with rituximab and cyclophosphamide, doxorubicin, vincristine and prednisone significantly improves response and time to treatment failure, but not long-term outcome in patients with previously untreated mantle cell lymphoma: results of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG). J Clin Oncol 2005; 23: 1984–1992.

    Article  CAS  PubMed  Google Scholar 

  23. Samaha H, Dumontet C, Ketterer N, Moullet I, Thieblemont C, Bouafia F et al. Mantle cell lymphoma: a retrospective study of 121 cases. Leukemia 1998; 12: 1281–1287.

    Article  CAS  PubMed  Google Scholar 

  24. Leonard JP, Schattner EJ, Coleman M . Biology and management of mantle cell lymphoma. Curr Opin Oncol 2001; 13: 342–347.

    Article  CAS  PubMed  Google Scholar 

  25. Vivanco I, Sawyers CL . The phosphatidylinositol 3-Kinase AKT pathway in human cancer. Nat Rev Cancer 2002; 2: 489–501.

    Article  CAS  PubMed  Google Scholar 

  26. Vignot S, Faivre S, Aguirre D, Raymond E . mTOR-targeted therapy of cancer with rapamycin derivatives. Ann Oncol 2005; 16: 525–537.

    Article  CAS  PubMed  Google Scholar 

  27. Lenz G, Dreyling M, Hiddemann W . Mantle cell lymphoma: established therapeutic options and future directions. Ann Hematol 2004; 83: 71–77.

    Article  CAS  PubMed  Google Scholar 

  28. Ladetto M, Zallio F, Vallet S, Ricca I, Cuttica A, Caracciolo D et al. Concurrent administration of high-dose chemotherapy and rituximab is a feasible and effective chemo/immunotherapy for patients with high-risk non-Hodgkin's lymphoma. Leukemia 2001; 15: 1941–1949.

    Article  CAS  PubMed  Google Scholar 

  29. Howard OM, Gribben JG, Neuberg DS, Grossbard M, Poor C, Janicek MJ et al. Rituximab and CHOP induction therapy for newly diagnosed mantle-cell lymphoma: molecular complete responses are not predictive of progression-free survival. J Clin Oncol 2002; 20: 1288–1294.

    Article  CAS  PubMed  Google Scholar 

  30. Lefrere F, Delmer A, Suzan F, Levy V, Belanger C, Djabarri M et al. Sequential chemotherapy by CHOP and DHAP regimens followed by high-dose therapy with stem cell transplantation induces a high rate of complete response and improves event-free survival in mantle cell lymphoma: a prospective study. Leukemia 2002; 16: 587–593.

    Article  CAS  PubMed  Google Scholar 

  31. Gera JF, Mellinghoff IK, Shi Y, Rettig MB, Tran C, Hsu JH et al. AKT activity determines sensitivity to mammalian target of rapamycin (mTOR) inhibitors by regulating cyclin D1 and c-myc expression. J Biol Chem 2004; 279: 2737–2746.

    Article  CAS  PubMed  Google Scholar 

  32. Avellino R, Romano S, Parasole R, Bisogni R, Lamberti A, Poggi V et al. Rapamycin stimulates apoptosis of childhood acute lymphoblastic leukemia cells. Blood 2005; 106: 1400–1406.

    Article  CAS  PubMed  Google Scholar 

  33. Witzig TE, Geyer SM, Ghobrial I, Inwards DJ, Fonseca R, Kurtin P et al. Phase II trial of single agent temsirolimus (CCI-779) for relapsed mantle cell lymphoma. J Clin Oncol 2005; 23: 5347–5356.

    Article  CAS  PubMed  Google Scholar 

  34. Jundt F, Raetzel N, Muller C, Calkhoven CF, Kley K, Mathas S et al. A rapamycin derivative (everolimus) controls proliferation through down-regulation of truncated CCAAT enhancer binding protein {beta} and NF-{kappa}B activity in Hodgkin and anaplastic large cell lymphomas. Blood 2005; 106: 1801–1807.

    Article  CAS  PubMed  Google Scholar 

  35. Hipp S, Ringshausen I, Oelsner M, Bogner C, Peschel C, Decker T . Inhibition of the mammalian target of rapamycin and the induction of cell-cycle arrest in mantle cell lymphoma cells. Haematologica 2005; 90: 1433–1434.

    CAS  PubMed  Google Scholar 

  36. Sun SY, Rosenberg LM, Wang X, Zhou Z, Yue P, Fu H et al. Activation of Akt and eIF4E survival pathways by rapamycin-mediated mammalian target of rapamycin inhibition. Cancer Res 2005; 65: 7052–7058.

    Article  CAS  PubMed  Google Scholar 

  37. Dudkin L, Dilling MB, Cheshire PJ, Harwood FC, Hollingshead M, Arbuck SG et al. Biochemical correlates of mTOR inhibition by the rapamycin ester CCI-779 and tumor growth inhibition. Clin Cancer Res 2001; 7: 1758–1764.

    CAS  PubMed  Google Scholar 

  38. Dilling MB, Germain GS, Dudkin L, Jayaraman AL, Zhang X, Harwood FC et al. 4E-binding proteins, the suppressors of eukaryotic initiation factor 4E, are down-regulated in cells with acquired or intrinsic resistance to rapamycin. J Biol Chem 2002; 277: 13907–13917.

    Article  CAS  PubMed  Google Scholar 

  39. Rizzieri DA, Sand GJ, McGaughey D, Moore JO, DeCastro C, Chao NJ et al. Low-dose weekly paclitaxel for recurrent or refractory aggressive non-Hodgkin lymphoma. Cancer 2004; 100: 2408–2414.

    Article  CAS  PubMed  Google Scholar 

  40. Kosmas C, Stamatopoulos K, Stavroyianni N, Tsavaris N, Papadaki T . Anti-CD20-based therapy of B cell lymphoma: state of the art. Leukemia 2002; 16: 2004–2015.

    Article  CAS  PubMed  Google Scholar 

  41. Ghielmini M, Schmitz SF, Cogliatti S, Bertoni F, Waltzer U, Fey MF et al. Effect of single agent rituximab given at the standard schedule or as prolonged treatment in patients with mantle cell lymphoma: a study of the Swiss Group for Clinical Cancer Research (SAKK). J Clin Oncol 2005; 23: 705–711.

    Article  CAS  PubMed  Google Scholar 

  42. Sakajiri S, Kumagai T, Kawamata N, Saitoh T, Said JW, Koeffler HP . Histone deacetylase inhibitors profoundly decrease proliferation of human lymphoid cancer cell lines. Exp Hematol 2005; 33: 53–61.

    Article  CAS  PubMed  Google Scholar 

  43. Pham LV, Tamayo AT, Yoshimura LC, Lo P, Ford RJ . Inhibition of constitutive NF-kappa B activation in mantle cell lymphoma B cells leads to induction of cell-cycle arrest and apoptosis. J Immunol 2003; 171: 88–95.

    Article  CAS  PubMed  Google Scholar 

  44. Dolcet X, Llobet D, Pallares J, Matias-Guiu X . NF-κB in development and progression of human cancer. Virchows Arch 2005; 446: 475–482.

    Article  CAS  PubMed  Google Scholar 

  45. O'Connor OA, Wright J, Moskowitz C, Muzzy J, MacGregor-Cortelli B, Stubblefield M et al. Phase II clinical experience with the novel proteasome inhibitor bortezomib in patients with indolent non-Hodgkin's lymphoma and mantle cell lymphoma. J Clin Oncol 2005; 23: 676–684.

    Article  CAS  PubMed  Google Scholar 

  46. Goy A, Younes A, McLaughlin P, Pro B, Romaguera JE, Hagemeister F et al. Phase II study of proteasome inhibitor bortezomib in relapsed or refractory B-cell non-Hodgkin's lymphoma. J Clin Oncol 2005; 23: 667–675.

    Article  CAS  PubMed  Google Scholar 

  47. Orlowski RZ, Stinchcombe TE, Mitchell BS, Shea TC, Baldwin AS, Stahl S et al. Phase I trial of the proteasome inhibitor PS-341 in patients with refractory hematologic malignancies. J Clin Oncol 2002; 20: 4420–4427.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Dr Norihiko Kawamata for helpful insights and discussions. This work was supported in part by the Lymphoma Foundation (HPK), the Tower Cancer Research Foundation Fellowship (TH) and a gift from The Novartis Institutes for BioMedical Research.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to T Haritunians.

Additional information

HPK holds the Mark Goodson Chair of Oncology Research at Cedars-Sinai Medical Center and is a member of the Molecular Biology Institute and Jonsson Comprehensive Cancer Center at UCLA.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Haritunians, T., Mori, A., O'Kelly, J. et al. Antiproliferative activity of RAD001 (everolimus) as a single agent and combined with other agents in mantle cell lymphoma. Leukemia 21, 333–339 (2007). https://doi.org/10.1038/sj.leu.2404471

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.leu.2404471

Keywords

This article is cited by

Search

Quick links