Abstract
Abstract Multiple myeloma is an incurable disease where new treatment strategies are required to improve on current treatment standards. Based on this knowledge we have performed a phase II clinical trial testing the farnesyltransferase inhibitor R115777 in patients with relapsed myeloma (Alsina M. et al, Blood 2004). R115777 was found to have a favorable toxicity profile and 64% of patients achieved disease stabilization. RAS mutation and inhibition of farnesyltransferase did not correlate with clinical efficacy; findings consistent with our prior observation that R115777 induces apoptosis via a Ras independent mechanism (Beaupre D.M. et al, Mol. Cancer Ther. 2004). In order to further characterize the mechanisms by which R115777 induces apoptosis in myeloma cells and to investigate drug resistance, we have identified and characterized a R115777 resistant human myeloma cell line. 8226/S cells were cultured continuously in increasing concentrations of R115777 for over 6 months. 8226/R5 cells were found to be nearly 50 times more resistant to R115777 compared to the parent cell line. K-Ras remained prenylated in both resistant and sensitive cells after R115777 treatment; however, HDJ-2 farnesylation was inhibited in both lines implying that farnesyltranseferase (the drug target) is not modified. 8226/R5 cells were also resistant to a diverse group of anti-tumor agents including PS-341. Many 8226 lines that acquire drug resistance have elevated expression of P-glycoprotein. We found that P-glycoprotein expression is not increased in the 8226/R5 line and furthermore influx and efflux of R115777 was similar in both parent and resistant cells. Expression of the drug resistance proteins hsp27, 70, and 90 were also not increased. Comparison of 8226/S and 8226/R5 gene expression profiles revealed increased expression of JAK2 in resistant cells. Interestingly, STAT3 phosphorylation was significantly increased in the 8226/R5 line consistent with its reported role in myeloma drug resistance. Experiments are underway to delineate the contribution of JAK2 to the multidrug resistant phenotype. Characterization of aberrant JAK2 activation is relevant since constitutive STAT3 activity is frequently observed in primary myeloma isolates.
