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Blood, Vol. 95 No. 5 (March 1), 2000: pp. 1758-1766

Induction of resistance to the Abelson inhibitor STI571 in human leukemic cells through gene amplification

Philipp le Coutre, Elena Tassi, Marileila Varella-Garcia, Rossella Barni, Luca Mologni, Gonçalo Cabrita, Edoardo Marchesi, Rosanna Supino, and Carlo Gambacorti-Passerini

From the Department of Experimental Oncology, Istituto Nazionale Tumori, Milan; Cancer Center, University of Colorado Health Sciences Center, Denver, CO; Mario Negri Institute, Milan; and Section of Hematology, University of Milano Bicocca, S. Gerardo Hospital, Monza, Italy.

The 2-phenylaminopyrimidine derivative STI571 has been shown to selectively inhibit the tyrosine kinase domain of the oncogenic bcr/abl fusion protein. The activity of this inhibitor has been demonstrated so far both in vitro with bcr/abl expressing cells derived from leukemic patients, and in vivo on nude mice inoculated with bcr/abl positive cells. Yet, no information is available on whether leukemic cells can develop resistance to bcr/abl inhibition. The human bcr/abl expressing cell line LAMA84 was cultured with increasing concentrations of STI571. After approximately 6 months of culture, a new cell line was obtained and named LAMA84R. This newly selected cell line showed an IC50 for the STI571 (1.0 µM) 10-fold higher than the IC50 (0.1 µM) of the parental sensitive cell line. Treatment with STI571 was shown to increase both the early and late apoptotic fraction in LAMA84 but not in LAMA84R. The induction of apoptosis in LAMA84 was associated with the activation of caspase 3-like activity, which did not develop in the resistant LAMA84R cell line. LAMA84R cells showed increased levels of bcr/abl protein and mRNA when compared to LAMA84 cells. FISH analysis with BCR- and ABL-specific probes in LAMA84R cells revealed the presence of a marker chromosome containing approximately 13 to 14 copies of the BCR/ABL gene. Thus, overexpression of the Bcr/Abl protein mediated through gene amplification is associated with and probably determines resistance of human leukemic cells to STI571 in vitro.


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Another possible mechanism of resistance to STI571
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N. J. Donato, J. Y. Wu, J. Stapley, G. Gallick, H. Lin, R. Arlinghaus, and M. Talpaz
BCR-ABL independence and LYN kinase overexpression in chronic myelogenous leukemia cells selected for resistance to STI571
Blood, January 15, 2003; 101(2): 690 - 698.
[Abstract] [Full Text] [PDF]


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BloodHome page
H. M. Kantarjian, M. Talpaz, S. O'Brien, F. Giles, G. Garcia-Manero, S. Faderl, D. Thomas, J. Shan, M. B. Rios, and J. Cortes
Dose escalation of imatinib mesylate can overcome resistance to standard-dose therapy in patients with chronic myelogenous leukemia
Blood, January 15, 2003; 101(2): 473 - 475.
[Abstract] [Full Text] [PDF]


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ASH Education BookHome page
J. V. Melo, T. P. Hughes, and J. F. Apperley
Chronic Myeloid Leukemia
Hematology, January 1, 2003; 2003(1): 132 - 152.
[Abstract] [Full Text] [PDF]


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Mol Cancer ResHome page
J. M.L. Ebos, J. Tran, Z. Master, D. Dumont, J. V. Melo, E. Buchdunger, and R. S. Kerbel
Imatinib Mesylate (STI-571) Reduces Bcr-Abl-Mediated Vascular Endothelial Growth Factor Secretion in Chronic Myelogenous Leukemia
Mol. Cancer Res., December 1, 2002; 1(2): 89 - 95.
[Abstract] [Full Text] [PDF]


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Ann. Surg. Oncol.Home page
R. P. DeMatteo
The GIST of Targeted Cancer Therapy: A Tumor (Gastrointestinal Stromal Tumor), a Mutated Gene (c-kit), and a Molecular Inhibitor (STI571)
Ann. Surg. Oncol., November 1, 2002; 9(9): 831 - 839.
[Abstract] [Full Text] [PDF]


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Cancer Res.Home page
C. Ricci, B. Scappini, V. Divoky, S. Gatto, F. Onida, S. Verstovsek, H. M. Kantarjian, and M. Beran
Mutation in the ATP-binding Pocket of the ABL Kinase Domain in an STI571-resistant BCR/ABL-positive Cell Line
Cancer Res., November 1, 2002; 62(21): 5995 - 5998.
[Abstract] [Full Text] [PDF]


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Cancer Res.Home page
R. Nimmanapalli, E. O'Bryan, M. Huang, P. Bali, P. K. Burnette, T. Loughran, J. Tepperberg, R. Jove, and K. Bhalla
Molecular Characterization and Sensitivity of STI-571 (Imatinib Mesylate, Gleevec)-resistant, Bcr-Abl-positive, Human Acute Leukemia Cells to SRC Kinase Inhibitor PD180970 and 17-Allylamino-17-demethoxygeldanamycin
Cancer Res., October 15, 2002; 62(20): 5761 - 5769.
[Abstract] [Full Text] [PDF]


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Clin. Cancer Res.Home page
C. Yu, G. Krystal, P. Dent, and S. Grant
Flavopiridol Potentiates STI571-induced Mitochondrial Damage and Apoptosis in BCR-ABL-positive Human Leukemia Cells
Clin. Cancer Res., September 1, 2002; 8(9): 2976 - 2984.
[Abstract] [Full Text] [PDF]


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BloodHome page
O. G. Ottmann, B. J. Druker, C. L. Sawyers, J. M. Goldman, J. Reiffers, R. T. Silver, S. Tura, T. Fischer, M. W. Deininger, C. A. Schiffer, et al.
A phase 2 study of imatinib in patients with relapsed or refractory Philadelphia chromosome-positive acute lymphoid leukemias
Blood, August 28, 2002; 100(6): 1965 - 1971.
[Abstract] [Full Text] [PDF]


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NEJMHome page
G. D. Demetri, M. von Mehren, C. D. Blanke, A. D. Van den Abbeele, B. Eisenberg, P. J. Roberts, M. C. Heinrich, D. A. Tuveson, S. Singer, M. Janicek, et al.
Efficacy and Safety of Imatinib Mesylate in Advanced Gastrointestinal Stromal Tumors
N. Engl. J. Med., August 15, 2002; 347(7): 472 - 480.
[Abstract] [Full Text] [PDF]


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Cancer Res.Home page
D. Wisniewski, C. L. Lambek, C. Liu, A. Strife, D. R. Veach, B. Nagar, M. A. Young, T. Schindler, W. G. Bornmann, J. R. Bertino, et al.
Characterization of Potent Inhibitors of the Bcr-Abl and the c-Kit Receptor Tyrosine Kinases
Cancer Res., August 1, 2002; 62(15): 4244 - 4255.
[Abstract] [Full Text] [PDF]


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Molecular Cancer TherapeuticsHome page
S. M. Konstantinov, M. C. Georgieva, M. Topashka-Ancheva, H. Eibl, and M. R. Berger
Combination with an Antisense Oligonucleotide Synergistically Improves the Antileukemic Efficacy of Erucylphospho-N,N,N-trimethylpropylammonium in Chronic Myeloid Leukemia Cell Lines
Mol. Cancer Ther., August 1, 2002; 1(10): 877 - 884.
[Abstract] [Full Text] [PDF]


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BloodHome page
C. Roche-Lestienne, V. Soenen-Cornu, N. Grardel-Duflos, J.-L. Lai, N. Philippe, T. Facon, P. Fenaux, and C. Preudhomme
Several types of mutations of the Abl gene can be found in chronic myeloid leukemia patients resistant to STI571, and they can pre-exist to the onset of treatment
Blood, July 18, 2002; 100(3): 1014 - 1018.
[Abstract] [Full Text] [PDF]


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BloodHome page
R. R. Hoover, F.-X. Mahon, J. V. Melo, and G. Q. Daley
Overcoming STI571 resistance with the farnesyl transferase inhibitor SCH66336
Blood, July 18, 2002; 100(3): 1068 - 1071.
[Abstract] [Full Text] [PDF]


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BloodHome page
R. M. Braziel, T. M. Launder, B. J. Druker, S. B. Olson, R. E. Magenis, M. J. Mauro, C. L. Sawyers, R. L. Paquette, and M. E. O'Dwyer
Hematopathologic and cytogenetic findings in imatinib mesylate-treated chronic myelogenous leukemia patients: 14 months' experience
Blood, June 28, 2002; 100(2): 435 - 441.
[Abstract] [Full Text] [PDF]


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BloodHome page
C. L. Sawyers, A. Hochhaus, E. Feldman, J. M. Goldman, C. B. Miller, O. G. Ottmann, C. A. Schiffer, M. Talpaz, F. Guilhot, M. W. N. Deininger, et al.
Imatinib induces hematologic and cytogenetic responses in patients with chronic myelogenous leukemia in myeloid blast crisis: results of a phase II study
Blood, May 15, 2002; 99(10): 3530 - 3539.
[Abstract] [Full Text] [PDF]


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Stem CellsHome page
A. Countouriotis, T. B. Moore, and K. M. Sakamoto
Cell Surface Antigen and Molecular Targeting in the Treatment of Hematologic Malignancies
Stem Cells, May 1, 2002; 20(3): 215 - 229.
[Abstract] [Full Text] [PDF]


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BloodHome page
S. Branford, Z. Rudzki, S. Walsh, A. Grigg, C. Arthur, K. Taylor, R. Herrmann, K. P. Lynch, and T. P. Hughes
High frequency of point mutations clustered within the adenosine triphosphate-binding region of BCR/ABL in patients with chronic myeloid leukemia or Ph-positive acute lymphoblastic leukemia who develop imatinib (STI571) resistance
Blood, May 1, 2002; 99(9): 3472 - 3475.
[Abstract] [Full Text] [PDF]


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The OncologistHome page
M. O'Dwyer
Multifaceted Approach to the Treatment of Bcr-Abl-Positive Leukemias
Oncologist, April 1, 2002; 7(90001): 30 - 38.
[Abstract] [Full Text] [PDF]


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BloodHome page
M. Talpaz, R. T. Silver, B. J. Druker, J. M. Goldman, C. Gambacorti-Passerini, F. Guilhot, C. A. Schiffer, T. Fischer, M. W. N. Deininger, A. L. Lennard, et al.
Imatinib induces durable hematologic and cytogenetic responses in patients with accelerated phase chronic myeloid leukemia: results of a phase 2 study
Blood, March 15, 2002; 99(6): 1928 - 1937.
[Abstract] [Full Text] [PDF]


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BloodHome page
W.-K. Hofmann, L. C. Jones, N. A. Lemp, S. de Vos, H. Gschaidmeier, D. Hoelzer, O. G. Ottmann, and H. P. Koeffler
Ph+ acute lymphoblastic leukemia resistant to the tyrosine kinase inhibitor STI571 has a unique BCR-ABL gene mutation
Blood, March 1, 2002; 99(5): 1860 - 1862.
[Abstract] [Full Text] [PDF]


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NEJMHome page
D. G. Savage and K. H. Antman
Imatinib Mesylate -- A New Oral Targeted Therapy
N. Engl. J. Med., February 28, 2002; 346(9): 683 - 693.
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BloodHome page
B. M. F. Mow, J. Chandra, P. A. Svingen, C. G. Hallgren, E. Weisberg, T. J. Kottke, V. L. Narayanan, M. R. Litzow, J. D. Griffin, E. A. Sausville, et al.
Effects of the Bcr/abl kinase inhibitors STI571 and adaphostin (NSC 680410) on chronic myelogenous leukemia cells in vitro
Blood, January 15, 2002; 99(2): 664 - 671.
[Abstract] [Full Text] [PDF]


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BloodHome page
H. G. Jorgensen, M. A. Elliott, E. K. Allan, C. E. Carr, T. L. Holyoake, and K. D. Smith
alpha 1-Acid glycoprotein expressed in the plasma of chronic myeloid leukemia patients does not mediate significant in vitro resistance to STI571
Blood, January 15, 2002; 99(2): 713 - 715.
[Abstract] [Full Text] [PDF]


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JCOHome page
M. J. Mauro, M. O'Dwyer, M. C. Heinrich, and B. J. Druker
STI571: A Paradigm of New Agents for Cancer Therapeutics
J. Clin. Oncol., January 1, 2002; 20(1): 325 - 334.
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Cancer Res.Home page
C. Yu, G. Krystal, L. Varticovksi, R. McKinstry, M. Rahmani, P. Dent, and S. Grant
Pharmacologic Mitogen-activated Protein/Extracellular Signal-regulated Kinase Kinase/Mitogen-activated Protein Kinase Inhibitors Interact Synergistically with STI571 to Induce Apoptosis in Bcr/Abl-expressing Human Leukemia Cells
Cancer Res., January 1, 2002; 62(1): 188 - 199.
[Abstract] [Full Text] [PDF]


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Clin. Cancer Res.Home page
G. Klement, P. Huang, B. Mayer, S. K. Green, S. Man, P. Bohlen, D. Hicklin, and R. S. Kerbel
Differences in Therapeutic Indexes of Combination Metronomic Chemotherapy and an Anti-VEGFR-2 Antibody in Multidrug-resistant Human Breast Cancer Xenografts
Clin. Cancer Res., January 1, 2002; 8(1): 221 - 232.
[Abstract] [Full Text] [PDF]


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J. Immunol.Home page
Q. Zhang, P. N. Raghunath, L. Xue, M. Majewski, D. F. Carpentieri, N. Odum, S. Morris, T. Skorski, and M. A. Wasik
Multilevel Dysregulation of STAT3 Activation in Anaplastic Lymphoma Kinase-Positive T/Null-Cell Lymphoma
J. Immunol., January 1, 2002; 168(1): 466 - 474.
[Abstract] [Full Text] [PDF]


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BloodHome page
S. M. Graham, H. G. Jorgensen, E. Allan, C. Pearson, M. J. Alcorn, L. Richmond, and T. L. Holyoake
Primitive, quiescent, Philadelphia-positive stem cells from patients with chronic myeloid leukemia are insensitive to STI571 in vitro
Blood, January 1, 2002; 99(1): 319 - 325.
[Abstract] [Full Text] [PDF]


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BloodHome page
N. C. Wolff and R. L. Ilaria Jr
Establishment of a murine model for therapy-treated chronic myelogenous leukemia using the tyrosine kinase inhibitor STI571
Blood, November 1, 2001; 98(9): 2808 - 2816.
[Abstract] [Full Text] [PDF]


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ScienceHome page
C. Barthe, P. Cony-Makhoul, J. V. Melo, J. R. F.-X. Mahon, A. Hochhaus, S. Kreil, A. Corbin, P. La Rosee, T. Lahaye, U. Berger, et al.
Roots of Clinical Resistance to STI-571 Cancer Therapy
Science, September 21, 2001; 293(5538): 2163a - 2163.
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Cancer Res.Home page
A. Viloria-Petit, T. Crombet, S. Jothy, D. Hicklin, P. Bohlen, J. M. Schlaeppi, J. Rak, and R. S. Kerbel
Acquired Resistance to the Antitumor Effect of Epidermal Growth Factor Receptor-blocking Antibodies in Vivo: A Role for Altered Tumor Angiogenesis
Cancer Res., July 1, 2001; 61(13): 5090 - 5101.
[Abstract] [Full Text] [PDF]


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The OncologistHome page
M. J. Mauro and B. J. Druker
STI571: Targeting BCR-ABL as Therapy for CML
Oncologist, June 1, 2001; 6(3): 233 - 238.
[Abstract] [Full Text] [PDF]


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NEJMHome page
B. J. Druker, C. L. Sawyers, H. Kantarjian, D. J. Resta, S. F. Reese, J. M. Ford, R. Capdeville, and M. Talpaz
Activity of a Specific Inhibitor of the BCR-ABL Tyrosine Kinase in the Blast Crisis of Chronic Myeloid Leukemia and Acute Lymphoblastic Leukemia with the Philadelphia Chromosome
N. Engl. J. Med., April 5, 2001; 344(14): 1038 - 1042.
[Abstract] [Full Text] [PDF]


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NEJMHome page
J. M. Goldman and J. V. Melo
Targeting the BCR-ABL Tyrosine Kinase in Chronic Myeloid Leukemia
N. Engl. J. Med., April 5, 2001; 344(14): 1084 - 1086.
[Full Text] [PDF]


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BloodHome page
X. Sun, J. E. Layton, A. Elefanty, and G. J. Lieschke
Comparison of effects of the tyrosine kinase inhibitors AG957, AG490, and STI571 on BCR-ABL-expressing cells, demonstrating synergy between AG490 and STI571
Blood, April 1, 2001; 97(7): 2008 - 2015.
[Abstract] [Full Text] [PDF]


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BloodHome page
A. Reichert, N. Heisterkamp, G. Q. Daley, and J. Groffen
Treatment of Bcr/Abl-positive acute lymphoblastic leukemia in P190 transgenic mice with the farnesyl transferase inhibitor SCH66336
Blood, March 1, 2001; 97(5): 1399 - 1403.
[Abstract] [Full Text] [PDF]


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Clin. Cancer Res.Home page
R. Nimmanapalli, M. Porosnicu, D. Nguyen, E. Worthington, E. O’Bryan, C. Perkins, and K. Bhalla
Cotreatment with STI-571 Enhances Tumor Necrosis Factor {{alpha}}-related Apoptosis-inducing Ligand (TRAIL or Apo-2L)- induced Apoptosis of Bcr-Abl-positive Human Acute Leukemia Cells
Clin. Cancer Res., February 1, 2001; 7(2): 350 - 357.
[Abstract] [Full Text]


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ASH Education BookHome page
B. J. Druker, C. L. Sawyers, R. Capdeville, J. M. Ford, M. Baccarani, and J. M. Goldman
Chronic Myelogenous Leukemia
Hematology, January 1, 2001; 2001(1): 87 - 112.
[Abstract] [Full Text] [PDF]


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BloodHome page
Z. A. Knight;, C. Gambacorti-Passerini, P. le Coutre, E. Tassi, and H. Ruchatz
Another possible mechanism of resistance to STI571
Blood, December 1, 2000; 96(12): 4003 - 4005.
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JNCI J Natl Cancer InstHome page
C. Gambacorti-Passerini, R. Barni, P. le Coutre, M. Zucchetti, G. Cabrita, L. Cleris, F. Rossi, E. Gianazza, J. Brueggen, R. Cozens, et al.
Role of {alpha}1 Acid Glycoprotein in the In Vivo Resistance of Human BCR-ABL+ Leukemic Cells to the Abl Inhibitor STI571
J Natl Cancer Inst, October 18, 2000; 92(20): 1641 - 1650.
[Abstract] [Full Text] [PDF]


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ASH Education BookHome page
H. Kantarjian, J. V. Melo, S. Tura, S. Giralt, and M. Talpaz
Chronic Myelogenous Leukemia: Disease Biology and Current and Future Therapeutic Strategies
Hematology, January 1, 2000; 2000(1): 90 - 109.
[Abstract] [Full Text] [PDF]



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