[PDF][PDF] Proteasome inhibition in multiple myeloma: head-to-head comparison of currently available proteasome inhibitors

A Besse, L Besse, M Kraus, M Mendez-Lopez… - Cell chemical …, 2019 - cell.com
A Besse, L Besse, M Kraus, M Mendez-Lopez, J Bader, BT Xin, G de Bruin, E Maurits
Cell chemical biology, 2019cell.com
Proteasome inhibitors (PIs) are a backbone of multiple myeloma (MM) therapy. The
proteasome harbors six proteolytically active subunits (β1, β2, β5), while β5 was identified
as rate-limiting and is a primary target of clinically available PIs. The most effective pattern of
subunit inhibition provided by these PIs for cytotoxic activity in MM is unknown. A head-to-
head comparison of clinically available PIs shows that in the clinically relevant setting only
the co-inhibition of β1 or β2 with β5 activity achieves meaningful functional proteasome …
Summary
Proteasome inhibitors (PIs) are a backbone of multiple myeloma (MM) therapy. The proteasome harbors six proteolytically active subunits (β1, β2, β5), while β5 was identified as rate-limiting and is a primary target of clinically available PIs. The most effective pattern of subunit inhibition provided by these PIs for cytotoxic activity in MM is unknown. A head-to-head comparison of clinically available PIs shows that in the clinically relevant setting only the co-inhibition of β1 or β2 with β5 activity achieves meaningful functional proteasome inhibition and cytotoxicity, while the selective β2/β5 inhibition of both constitutive and immunoproteasome is the most cytotoxic. In the long-term setting, selective inhibition of β5 subunit is sufficient to induce cytotoxicity in PI-sensitive, but not in PI-resistant MM, and the β5/β2 co-inhibition is the most cytotoxic in PI-resistant MM. These results give a rational basis for selecting individual PIs for the treatment of MM.
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