Combined DNA methyltransferase and histone deacetylase inhibition in the treatment of myeloid neoplasms

Steven D. Gore, Stephen B Baylin, Elizabeth Sugar, Hetty Carraway, Carole B. Miller, Michael A Carducci, Michael Grever, Oliver Galm, Tianna Dauses, Judith Karp, Michelle Rudek-Renaut, Ming Zhao, B Douglas Smith, Jasper Manning, Anchalee Jiemjit, George J Dover, Abbie Mays, James Zwiebel, Anthony Murgo, Li Jun Weng & 1 others James G. Herman

Research output: Contribution to journalArticle

Abstract

Optimal reexpression of most genes silenced through promoter methylation requires the sequential application of DNA methyltransferase inhibitors followed by histone deacetylase inhibitors in tumor cell cultures. Patients with myelodysplastic syndrome or acute myeloid leukemia (AML) were treated with the methyltransferase inhibitor 5-azacitidine (aza-CR) followed by the histone deacetylase inhibitor sodium phenylbutyrate. Major responses associated with cytogenetic complete response developed in patients receiving prolonged dosing schedules of aza-CR. Bisulfite sequencing of the p15 promoter in marrow DNA during the first cycle of treatment showed heterogeneous allelic demethylation in three responding patients, suggesting ongoing demethylation within the tumor clone, but no demethylation in two nonresponders. Six of six responding patients with pretreatment methylation of p15 or CDH-1 promoters reversed methylation during the first cycle of therapy (methylation-specific PCR), whereas none of six nonresponders showed any demethylation. Gene demethylation correlated with the area under the aza-CR plasma concentration-time curve. Administration of both drugs was associated with induction of acetylation of histones H3 and H4. This study provides the first demonstration that molecular mechanisms responsible for responses to DNA methyltransferase/histone deacetylase inhibitor combinations may include reversal of aberrant epigenetic gene silencing. The promising percentage of major hematologic responses justifies the testing of such combinations in prospective randomized trials.

Original languageEnglish (US)
Pages (from-to)6361-6369
Number of pages9
JournalCancer Research
Volume66
Issue number12
DOIs
StatePublished - Jun 15 2006

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Histone Deacetylases
Methyltransferases
Methylation
Histone Deacetylase Inhibitors
DNA
Histones
Neoplasms
Azacitidine
Myelodysplastic Syndromes
Gene Silencing
Therapeutics
Acetylation
Acute Myeloid Leukemia
Epigenomics
Cytogenetics
Genes
Appointments and Schedules
Clone Cells
Cell Culture Techniques
Bone Marrow

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Combined DNA methyltransferase and histone deacetylase inhibition in the treatment of myeloid neoplasms. / Gore, Steven D.; Baylin, Stephen B; Sugar, Elizabeth; Carraway, Hetty; Miller, Carole B.; Carducci, Michael A; Grever, Michael; Galm, Oliver; Dauses, Tianna; Karp, Judith; Rudek-Renaut, Michelle; Zhao, Ming; Smith, B Douglas; Manning, Jasper; Jiemjit, Anchalee; Dover, George J; Mays, Abbie; Zwiebel, James; Murgo, Anthony; Weng, Li Jun; Herman, James G.

In: Cancer Research, Vol. 66, No. 12, 15.06.2006, p. 6361-6369.

Research output: Contribution to journalArticle

Gore, SD, Baylin, SB, Sugar, E, Carraway, H, Miller, CB, Carducci, MA, Grever, M, Galm, O, Dauses, T, Karp, J, Rudek-Renaut, M, Zhao, M, Smith, BD, Manning, J, Jiemjit, A, Dover, GJ, Mays, A, Zwiebel, J, Murgo, A, Weng, LJ & Herman, JG 2006, 'Combined DNA methyltransferase and histone deacetylase inhibition in the treatment of myeloid neoplasms', Cancer Research, vol. 66, no. 12, pp. 6361-6369. https://doi.org/10.1158/0008-5472.CAN-06-0080
Gore, Steven D. ; Baylin, Stephen B ; Sugar, Elizabeth ; Carraway, Hetty ; Miller, Carole B. ; Carducci, Michael A ; Grever, Michael ; Galm, Oliver ; Dauses, Tianna ; Karp, Judith ; Rudek-Renaut, Michelle ; Zhao, Ming ; Smith, B Douglas ; Manning, Jasper ; Jiemjit, Anchalee ; Dover, George J ; Mays, Abbie ; Zwiebel, James ; Murgo, Anthony ; Weng, Li Jun ; Herman, James G. / Combined DNA methyltransferase and histone deacetylase inhibition in the treatment of myeloid neoplasms. In: Cancer Research. 2006 ; Vol. 66, No. 12. pp. 6361-6369.
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