Preventing chemotherapy-induced myelosuppression by repurposing the FLT3 inhibitor quizartinib

Sci Transl Med. 2017 Aug 9;9(402):eaam8060. doi: 10.1126/scitranslmed.aam8060.

Abstract

We describe an approach to inhibit chemotherapy-induced myelosuppression. We found that short-term exposure of mice to the FLT3 inhibitor quizartinib induced the transient quiescence of multipotent progenitors (MPPs). This property of quizartinib conferred marked protection to MPPs in mice receiving fluorouracil or gemcitabine. The protection resulted in the rapid recovery of bone marrow and blood cellularity, thus preventing otherwise lethal myelosuppression. A treatment strategy involving quizartinib priming that protected wild-type bone marrow progenitors, but not leukemic cells, from fluorouracil provided a more effective treatment than conventional induction therapy in mouse models of acute myeloid leukemia. This strategy has the potential to be extended for use in other cancers where FLT3 inhibition does not adversely affect the effectiveness of chemotherapy. Thus, the addition of quizartinib to cancer treatment regimens could markedly improve cancer patient survival and quality of life.

MeSH terms

  • Animals
  • Antineoplastic Agents / therapeutic use
  • Benzothiazoles / therapeutic use*
  • Cell Proliferation / drug effects
  • Fluorouracil / therapeutic use
  • Hematopoietic Stem Cells / drug effects
  • Hematopoietic Stem Cells / metabolism
  • Leukemia, Myeloid, Acute / drug therapy
  • Leukemia, Myeloid, Acute / metabolism
  • Mice
  • Mice, Inbred C57BL
  • Phenylurea Compounds / therapeutic use*
  • Quality of Life
  • fms-Like Tyrosine Kinase 3 / antagonists & inhibitors
  • fms-Like Tyrosine Kinase 3 / metabolism*

Substances

  • Antineoplastic Agents
  • Benzothiazoles
  • Phenylurea Compounds
  • quizartinib
  • fms-Like Tyrosine Kinase 3
  • Fluorouracil