BH3 mimetics targeting BCL-XL have efficacy in solid tumors with RB1 loss and replication stress

Abstract BH3 mimetic drugs that inhibit BCL-2, BCL-XL, or MCL-1 have limited activity in solid tumors. Through assessment of xenograft-derived 3D prostate cancer models and cell lines we find that tumors with RB1 loss are sensitive to BCL-XL inhibition. In parallel, drug screening demonstrates that...

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Main Authors: Andreas Varkaris, Keshan Wang, Mannan Nouri, Nina Kozlova, Daniel R. Schmidt, Anastasia Stavridi, Seiji Arai, Nicholas Ambrosio, Larysa Poluben, Juan M. Jimenez-Vacas, Daniel Westaby, Juliet Carmichael, Fang Xie, Ines Figueiredo, Lorenzo Buroni, Antje Neeb, Bora Gurel, Nicholas Chevalier, Lisha Brown, Olga Voznesensky, Shao-Yong Chen, Joshua W. Russo, Xin Yuan, Dejan Juric, Himisha Beltran, Johann S. De Bono, Matthew G. Vander Heiden, David J. Einstein, Taru Muranen, Eva Corey, Adam Sharp, Steven P. Balk
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-60238-x
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author Andreas Varkaris
Keshan Wang
Mannan Nouri
Nina Kozlova
Daniel R. Schmidt
Anastasia Stavridi
Seiji Arai
Nicholas Ambrosio
Larysa Poluben
Juan M. Jimenez-Vacas
Daniel Westaby
Juliet Carmichael
Fang Xie
Ines Figueiredo
Lorenzo Buroni
Antje Neeb
Bora Gurel
Nicholas Chevalier
Lisha Brown
Olga Voznesensky
Shao-Yong Chen
Joshua W. Russo
Xin Yuan
Dejan Juric
Himisha Beltran
Johann S. De Bono
Matthew G. Vander Heiden
David J. Einstein
Taru Muranen
Eva Corey
Adam Sharp
Steven P. Balk
author_facet Andreas Varkaris
Keshan Wang
Mannan Nouri
Nina Kozlova
Daniel R. Schmidt
Anastasia Stavridi
Seiji Arai
Nicholas Ambrosio
Larysa Poluben
Juan M. Jimenez-Vacas
Daniel Westaby
Juliet Carmichael
Fang Xie
Ines Figueiredo
Lorenzo Buroni
Antje Neeb
Bora Gurel
Nicholas Chevalier
Lisha Brown
Olga Voznesensky
Shao-Yong Chen
Joshua W. Russo
Xin Yuan
Dejan Juric
Himisha Beltran
Johann S. De Bono
Matthew G. Vander Heiden
David J. Einstein
Taru Muranen
Eva Corey
Adam Sharp
Steven P. Balk
author_sort Andreas Varkaris
collection DOAJ
description Abstract BH3 mimetic drugs that inhibit BCL-2, BCL-XL, or MCL-1 have limited activity in solid tumors. Through assessment of xenograft-derived 3D prostate cancer models and cell lines we find that tumors with RB1 loss are sensitive to BCL-XL inhibition. In parallel, drug screening demonstrates that disruption of nucleotide pools by agents including thymidylate synthase inhibitors sensitizes to BCL-XL inhibition, together indicating that replication stress increases dependence on BCL-XL. Mechanistically we establish that replication stress sensitizes to BCL-XL inhibition through TP53/CDKN1A-dependent suppression of BIRC5 expression. Therapy with a BCL-2/BCL-XL inhibitor (navitoclax) in combination with thymidylate synthase inhibitors (raltitrexed or capecitabine) causes marked and prolonged tumor regression in prostate and breast cancer xenograft models. These findings indicate that BCL-XL inhibitors may be effective as single agents in a subset of solid tumors with RB1 loss, and that pharmacological induction of replication stress may be a broadly applicable approach for sensitizing to BCL-XL inhibitors.
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spelling doaj-art-b409d7dee3f54934896600988205eff52025-08-20T03:16:51ZengNature PortfolioNature Communications2041-17232025-05-0116111710.1038/s41467-025-60238-xBH3 mimetics targeting BCL-XL have efficacy in solid tumors with RB1 loss and replication stressAndreas Varkaris0Keshan Wang1Mannan Nouri2Nina Kozlova3Daniel R. Schmidt4Anastasia Stavridi5Seiji Arai6Nicholas Ambrosio7Larysa Poluben8Juan M. Jimenez-Vacas9Daniel Westaby10Juliet Carmichael11Fang Xie12Ines Figueiredo13Lorenzo Buroni14Antje Neeb15Bora Gurel16Nicholas Chevalier17Lisha Brown18Olga Voznesensky19Shao-Yong Chen20Joshua W. Russo21Xin Yuan22Dejan Juric23Himisha Beltran24Johann S. De Bono25Matthew G. Vander Heiden26David J. Einstein27Taru Muranen28Eva Corey29Adam Sharp30Steven P. Balk31Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolInstitute of Cancer Research, Royal Marsden NHS Foundation TrustInstitute of Cancer Research, Royal Marsden NHS Foundation TrustInstitute of Cancer Research, Royal Marsden NHS Foundation TrustDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolInstitute of Cancer Research, Royal Marsden NHS Foundation TrustInstitute of Cancer Research, Royal Marsden NHS Foundation TrustInstitute of Cancer Research, Royal Marsden NHS Foundation TrustInstitute of Cancer Research, Royal Marsden NHS Foundation TrustMassachusetts General Cancer Center and Department of Medicine, Harvard Medical SchoolDepartment of Urology, University of WashingtonDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolMassachusetts General Cancer Center and Department of Medicine, Harvard Medical SchoolDana-Farber Cancer InstituteInstitute of Cancer Research, Royal Marsden NHS Foundation TrustKoch Institute for Integrative Cancer Research, Massachusetts Institute of TechnologyDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Urology, University of WashingtonInstitute of Cancer Research, Royal Marsden NHS Foundation TrustDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolAbstract BH3 mimetic drugs that inhibit BCL-2, BCL-XL, or MCL-1 have limited activity in solid tumors. Through assessment of xenograft-derived 3D prostate cancer models and cell lines we find that tumors with RB1 loss are sensitive to BCL-XL inhibition. In parallel, drug screening demonstrates that disruption of nucleotide pools by agents including thymidylate synthase inhibitors sensitizes to BCL-XL inhibition, together indicating that replication stress increases dependence on BCL-XL. Mechanistically we establish that replication stress sensitizes to BCL-XL inhibition through TP53/CDKN1A-dependent suppression of BIRC5 expression. Therapy with a BCL-2/BCL-XL inhibitor (navitoclax) in combination with thymidylate synthase inhibitors (raltitrexed or capecitabine) causes marked and prolonged tumor regression in prostate and breast cancer xenograft models. These findings indicate that BCL-XL inhibitors may be effective as single agents in a subset of solid tumors with RB1 loss, and that pharmacological induction of replication stress may be a broadly applicable approach for sensitizing to BCL-XL inhibitors.https://doi.org/10.1038/s41467-025-60238-x
spellingShingle Andreas Varkaris
Keshan Wang
Mannan Nouri
Nina Kozlova
Daniel R. Schmidt
Anastasia Stavridi
Seiji Arai
Nicholas Ambrosio
Larysa Poluben
Juan M. Jimenez-Vacas
Daniel Westaby
Juliet Carmichael
Fang Xie
Ines Figueiredo
Lorenzo Buroni
Antje Neeb
Bora Gurel
Nicholas Chevalier
Lisha Brown
Olga Voznesensky
Shao-Yong Chen
Joshua W. Russo
Xin Yuan
Dejan Juric
Himisha Beltran
Johann S. De Bono
Matthew G. Vander Heiden
David J. Einstein
Taru Muranen
Eva Corey
Adam Sharp
Steven P. Balk
BH3 mimetics targeting BCL-XL have efficacy in solid tumors with RB1 loss and replication stress
Nature Communications
title BH3 mimetics targeting BCL-XL have efficacy in solid tumors with RB1 loss and replication stress
title_full BH3 mimetics targeting BCL-XL have efficacy in solid tumors with RB1 loss and replication stress
title_fullStr BH3 mimetics targeting BCL-XL have efficacy in solid tumors with RB1 loss and replication stress
title_full_unstemmed BH3 mimetics targeting BCL-XL have efficacy in solid tumors with RB1 loss and replication stress
title_short BH3 mimetics targeting BCL-XL have efficacy in solid tumors with RB1 loss and replication stress
title_sort bh3 mimetics targeting bcl xl have efficacy in solid tumors with rb1 loss and replication stress
url https://doi.org/10.1038/s41467-025-60238-x
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