Therapeutic Potential of Venetoclax and Selinexor in Targeting Hypoxia‐Induced Vulnerabilities in Multiple Myeloma

ABSTRACT Background Multiple myeloma (MM) is a blood cancer marked by the abnormal clonal growth of plasma cells. Hypoxia plays a critical role in the progression and treatment resistance of MM. Aims This study investigates the expression of B‐cell/CLL lymphoma 2 (BCL2) family genes. We also investi...

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Main Authors: Seiichi Okabe, Yuya Arai, Yuko Tanaka, Akihiko Gotoh
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Cancer Reports
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Online Access:https://doi.org/10.1002/cnr2.70249
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author Seiichi Okabe
Yuya Arai
Yuko Tanaka
Akihiko Gotoh
author_facet Seiichi Okabe
Yuya Arai
Yuko Tanaka
Akihiko Gotoh
author_sort Seiichi Okabe
collection DOAJ
description ABSTRACT Background Multiple myeloma (MM) is a blood cancer marked by the abnormal clonal growth of plasma cells. Hypoxia plays a critical role in the progression and treatment resistance of MM. Aims This study investigates the expression of B‐cell/CLL lymphoma 2 (BCL2) family genes. We also investigated the activity of BCL2 and exportin‐1 (XPO1) inhibitors and the potential therapeutic synergy of venetoclax and selinexor under hypoxic conditions. Methods and Results Analysis of publicly available datasets revealed hypoxia‐induced upregulation of BCL2 and BCL2‐like 11 (BCL2L11), while BCL2‐associated agonist of cell death (BAD) expression was suppressed. Venetoclax, a selective BCL2 inhibitor, demonstrated enhanced cytotoxicity and increased caspase‐3/7 activity under hypoxic conditions. Selinexor exhibited potent anti‐myeloma effects, including dose‐dependent reductions in cell viability and increased apoptotic activity. Combining selinexor with venetoclax under hypoxia produced anti‐myeloma effects, significantly reducing cell viability, increasing apoptosis, and disrupting the mitochondrial membrane potential. This combination effectively overcame resistance in bortezomib‐resistant MM cells and demonstrated efficacy in primary plasma cell leukemia (PCL) samples. Conclusion These findings highlight the potential of selinexor and venetoclax combination therapy to exploit hypoxia‐induced vulnerabilities in MM cells.
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spelling doaj-art-39ded456148740c79d87f3bbc2da36db2025-08-20T03:27:01ZengWileyCancer Reports2573-83482025-06-0186n/an/a10.1002/cnr2.70249Therapeutic Potential of Venetoclax and Selinexor in Targeting Hypoxia‐Induced Vulnerabilities in Multiple MyelomaSeiichi Okabe0Yuya Arai1Yuko Tanaka2Akihiko Gotoh3Department of Hematology Tokyo Medical University Tokyo JapanDepartment of Hematology Tokyo Medical University Tokyo JapanDepartment of Hematology Tokyo Medical University Tokyo JapanDepartment of Hematology Tokyo Medical University Tokyo JapanABSTRACT Background Multiple myeloma (MM) is a blood cancer marked by the abnormal clonal growth of plasma cells. Hypoxia plays a critical role in the progression and treatment resistance of MM. Aims This study investigates the expression of B‐cell/CLL lymphoma 2 (BCL2) family genes. We also investigated the activity of BCL2 and exportin‐1 (XPO1) inhibitors and the potential therapeutic synergy of venetoclax and selinexor under hypoxic conditions. Methods and Results Analysis of publicly available datasets revealed hypoxia‐induced upregulation of BCL2 and BCL2‐like 11 (BCL2L11), while BCL2‐associated agonist of cell death (BAD) expression was suppressed. Venetoclax, a selective BCL2 inhibitor, demonstrated enhanced cytotoxicity and increased caspase‐3/7 activity under hypoxic conditions. Selinexor exhibited potent anti‐myeloma effects, including dose‐dependent reductions in cell viability and increased apoptotic activity. Combining selinexor with venetoclax under hypoxia produced anti‐myeloma effects, significantly reducing cell viability, increasing apoptosis, and disrupting the mitochondrial membrane potential. This combination effectively overcame resistance in bortezomib‐resistant MM cells and demonstrated efficacy in primary plasma cell leukemia (PCL) samples. Conclusion These findings highlight the potential of selinexor and venetoclax combination therapy to exploit hypoxia‐induced vulnerabilities in MM cells.https://doi.org/10.1002/cnr2.70249BCL2hypoxiamyelomaselinexorvenetoclax
spellingShingle Seiichi Okabe
Yuya Arai
Yuko Tanaka
Akihiko Gotoh
Therapeutic Potential of Venetoclax and Selinexor in Targeting Hypoxia‐Induced Vulnerabilities in Multiple Myeloma
Cancer Reports
BCL2
hypoxia
myeloma
selinexor
venetoclax
title Therapeutic Potential of Venetoclax and Selinexor in Targeting Hypoxia‐Induced Vulnerabilities in Multiple Myeloma
title_full Therapeutic Potential of Venetoclax and Selinexor in Targeting Hypoxia‐Induced Vulnerabilities in Multiple Myeloma
title_fullStr Therapeutic Potential of Venetoclax and Selinexor in Targeting Hypoxia‐Induced Vulnerabilities in Multiple Myeloma
title_full_unstemmed Therapeutic Potential of Venetoclax and Selinexor in Targeting Hypoxia‐Induced Vulnerabilities in Multiple Myeloma
title_short Therapeutic Potential of Venetoclax and Selinexor in Targeting Hypoxia‐Induced Vulnerabilities in Multiple Myeloma
title_sort therapeutic potential of venetoclax and selinexor in targeting hypoxia induced vulnerabilities in multiple myeloma
topic BCL2
hypoxia
myeloma
selinexor
venetoclax
url https://doi.org/10.1002/cnr2.70249
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AT yukotanaka therapeuticpotentialofvenetoclaxandselinexorintargetinghypoxiainducedvulnerabilitiesinmultiplemyeloma
AT akihikogotoh therapeuticpotentialofvenetoclaxandselinexorintargetinghypoxiainducedvulnerabilitiesinmultiplemyeloma