Targeting CCR7-PI3Kγ overcomes resistance to tyrosine kinase inhibitors in ALK-rearranged lymphoma

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Authors	MASTINI Cristina CAMPISI Marco PATRUCCO Enrico MURA Giulia FERREIRA Antonio COSTA Carlotta AMBROGIO Chiara GERMENA Giulia MARTINENGO Cinzia PEOLA Silvia MOTA Ines VISSIO Elena MOLINARO Luca ARIGONI Maddalena OLIVERO Martina CALOGERO Raffaele PROKOPH Nina TABBO Fabrizio SHOJI Brent BRUGIERES Laurence GEOERGER Birgit TURNER Suzanne Dawn CUESTA-MATEOS Carlos ALIBERTI Deborah MOLOGNI Luca PIAZZA Rocco GAMBACORTI-PASSERINI Carlo INGHIRAMI Giorgio G CHIONO Valeria KAMM Roger D HIRSCH Emilio KOCH Raphael WEINSTOCK David M ASTER Jon C VOENA Claudia CHIARLE Roberto
Year of publication	2023
Type	Article in Periodical
Magazine / Source	Science Translational Medicine
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://www.science.org/doi/10.1126/scitranslmed.abo3826
Doi	http://dx.doi.org/10.1126/scitranslmed.abo3826
Keywords	CCR7-PI3K?; yrosine kinase inhibitors; ALK-rearranged lymphoma
Description	Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) show potent efficacy in several ALK-driven tumors, but the development of resistance limits their long-term clinical impact. Although resistance mechanisms have been studied extensively in ALK-driven non-small cell lung cancer, they are poorly understood in ALK-driven anaplastic large cell lymphoma (ALCL). Here, we identify a survival pathway supported by the tumor microenvironment that activates phosphatidylinositol 3-kinase ? (PI3K-?) signaling through the C-C motif chemokine receptor 7 (CCR7). We found increased PI3K signaling in patients and ALCL cell lines resistant to ALK TKIs. PI3K? expression was predictive of a lack of response to ALK TKI in patients with ALCL. Expression of CCR7, PI3K?, and PI3Kd were up-regulated during ALK or STAT3 inhibition or degradation and a constitutively active PI3K? isoform cooperated with oncogenic ALK to accelerate lymphomagenesis in mice. In a three-dimensional microfluidic chip, endothelial cells that produce the CCR7 ligands CCL19/CCL21 protected ALCL cells from apoptosis induced by crizotinib. The PI3K?/d inhibitor duvelisib potentiated crizotinib activity against ALCL lines and patient-derived xenografts. Furthermore, genetic deletion of CCR7 blocked the central nervous system dissemination and perivascular growth of ALCL in mice treated with crizotinib. Thus, blockade of PI3K? or CCR7 signaling together with ALK TKI treatment reduces primary resistance and the survival of persister lymphoma cells in ALCL.
Related projects:	National institute for cancer research