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@ARTICLE{Jebaraj:177081,
author = {B. M. C. Jebaraj and A. Müller and R. P. Dheenadayalan and
S. Endres and P. M. Roessner$^*$ and F. Seyfried and C.
Walliser and M. Wist and J. Qi and E. Tausch and D.
Mertens$^*$ and J. A. Fox and K.-M. Debatin and L. H. Meyer
and P. Taverna and M. Seiffert$^*$ and P. Gierschik and S.
Stilgenbauer},
title = {{E}valuation of vecabrutinib as a model for non-covalent
{BTK}/{ITK} inhibition for treatment of chronic lymphocytic
leukemia.},
journal = {Blood},
volume = {139},
number = {6},
issn = {0006-4971},
address = {Washington, DC},
publisher = {American Society of Hematology},
reportid = {DKFZ-2021-02287},
pages = {859-875},
year = {2022},
note = {2022 Feb 10;139(6):859-875},
abstract = {Covalent Bruton tyrosine kinase (BTK) inhibitors such as
ibrutinib have proven to be highly beneficial in the
treatment of chronic lymphocytic leukemia (CLL).
Interestingly, the off-target inhibition of IL-2-inducible
T-cell kinase (ITK) by ibrutinib may also play a role in
modulating the tumor microenvironment, potentially enhancing
the treatment benefit. However, resistance to covalently
binding BTK inhibitors can develop by a mutation in cysteine
481 of BTK (C481S), which prevents the irreversible binding
of the drugs. In the present study we performed pre-clinical
characterization of vecabrutinib, a next generation
non-covalent BTK inhibitor, with ITK inhibitory properties
similar to those of ibrutinib. Unlike ibrutinib and other
covalent BTK inhibitors, vecabrutinib showed retention of
the inhibitory effect on C481S BTK mutants in vitro, similar
to that of wildtype BTK. In the murine Eµ-TCL1 adoptive
transfer model, vecabrutinib reduced tumor burden and
significantly improved survival. Vecabrutinib treatment led
to a decrease in CD8+ effector and memory T-cell
populations, while the naïve populations were increased. Of
importance, vecabrutinib treatment significantly reduced
frequency of regulatory CD4+ T-cells (Tregs) in vivo. Unlike
ibrutinib, vecabrutinib treatment showed minimal adverse
impact on activation and proliferation of isolated T-cells.
Lastly, combination treatment of vecabrutinib with
venetoclax was found to augment treatment efficacy,
significantly improve survival and lead to favourable
reprogramming of the microenvironment in the murine Eµ-TCL1
model. Thus, non-covalent BTK/ITK inhibitors such as
vecabrutinib may be efficacious in C481S BTK mutant CLL,
while preserving the T-cell immunomodulatory function of
ibrutinib.},
cin = {B060 / B061},
ddc = {610},
cid = {I:(DE-He78)B060-20160331 / I:(DE-He78)B061-20160331},
pnm = {312 - Funktionelle und strukturelle Genomforschung
(POF4-312)},
pid = {G:(DE-HGF)POF4-312},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:34662393},
doi = {10.1182/blood.2021011516},
url = {https://inrepo02.dkfz.de/record/177081},
}