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Blood, 1 February 2006, Vol. 107, No. 3, pp. 1092-1100.
Prepublished online as a Blood First Edition Paper on October 18, 2005; DOI 10.1182/blood-2005-03-1158.
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NEOPLASIA
Antimyeloma activity of heat shock protein-90 inhibition
Constantine S. Mitsiades,
Nicholas S. Mitsiades,
Ciaran J. McMullan,
Vassiliki Poulaki,
Andrew L. Kung,
Faith E. Davies,
Gareth Morgan,
Masaharu Akiyama,
Reshma Shringarpure,
Nikhil C. Munshi,
Paul G. Richardson,
Teru Hideshima,
Dharminder Chauhan,
Xuesong Gu,
Charles Bailey,
Marie Joseph,
Towia A. Libermann,
Neal S. Rosen, and
Kenneth C. Anderson
From the Department of Medical Oncology, Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA; Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA; Departments of Cell Biology and Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA; Royal Marsden Hospital and Institute of Cancer Research, Sutton, Surrey, United Kingdom; Genomics Center, Beth Israel Deaconess Medical Center, Harvard Institutes of Medicine, Boston, MA; and Memorial Sloan-Kettering Cancer Center, New York, NY.
We show that multiple myeloma (MM), the second most commonly diagnosed hematologic malignancy, is responsive to hsp90 inhibitors in vitro and in a clinically relevant orthotopic in vivo model, even though this disease does not depend on HER2/neu, bcr/abl, androgen or estrogen receptors, or other hsp90 chaperoning clients which are hallmarks of tumor types traditionally viewed as attractive clinical settings for use of hsp90 inhibitors, such as the geldanamycin analog 17-AAG. This class of agents simultaneously suppresses in MM cells the expression and/or function of multiple levels of insulin-like growth factor receptor (IGF-1R) and interleukin-6 receptor (IL-6R) signaling (eg, IKK/NF- B, PI-3K/Akt, and Raf/MAPK) and downstream effectors (eg, proteasome, telomerase, and HIF-1 activities). These pleiotropic proapoptotic effects allow hsp90 inhibitors to abrogate bone marrow stromal cell-derived protection on MM tumor cells, and sensitize them to other anticancer agents, including cytotoxic chemotherapy and the proteasome inhibitor bortezomib. These results indicate that hsp90 can be targeted therapeutically in neoplasias that may not express or depend on molecules previously considered to be the main hsp90 client proteins. This suggests a more general role for hsp90 in chaperoning tumor- or tissue-type-specific constellations of client proteins with critical involvement in proliferative and antiapoptotic cellular responses, and paves the way for more extensive future therapeutic applications of hsp90 inhibition in diverse neoplasias, including MM.
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