Targeting survivin overcomes drug resistance in acute lymphoblastic leukemia

Blood. 2011 Aug 25;118(8):2191-9. doi: 10.1182/blood-2011-04-351239. Epub 2011 Jun 28.

Abstract

Relapse of drug-resistant acute lymphoblastic leukemia (ALL) has been associated with increased expression of survivin/BIRC5, an inhibitor of apoptosis protein, suggesting a survival advantage for ALL cells. In the present study, we report that inhibition of survivin in patient-derived ALL can eradicate leukemia. Targeting survivin with shRNA in combination with chemotherapy resulted in no detectable minimal residual disease in a xenograft model of primary ALL. Similarly, pharmacologic knock-down of survivin using EZN-3042, a novel locked nucleic acid antisense oligonucleotide, in combination with chemotherapy eliminated drug-resistant ALL cells. These findings show the importance of survivin expression in drug resistance and demonstrate that survivin inhibition may represent a powerful approach to overcoming drug resistance and preventing relapse in patients with ALL.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Combined Modality Therapy
  • Drug Resistance, Neoplasm / genetics
  • Gene Expression
  • Gene Targeting
  • Humans
  • Inhibitor of Apoptosis Proteins / antagonists & inhibitors*
  • Inhibitor of Apoptosis Proteins / deficiency
  • Inhibitor of Apoptosis Proteins / genetics*
  • Mice
  • Mice, Inbred NOD
  • Mice, Knockout
  • Neoplasm, Residual
  • Oligonucleotides / genetics
  • Oligonucleotides / therapeutic use
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • RNA, Small Interfering / genetics
  • Repressor Proteins / deficiency
  • Repressor Proteins / genetics
  • Survivin
  • Tumor Stem Cell Assay
  • Xenograft Model Antitumor Assays

Substances

  • BIRC5 protein, human
  • Birc5 protein, mouse
  • EZN 3042
  • Inhibitor of Apoptosis Proteins
  • Oligonucleotides
  • RNA, Small Interfering
  • Repressor Proteins
  • Survivin