Enhanced synergy of pacritinib with temsirolimus and sunitinib in preclinical renal cell carcinoma model by targeting JAK2/STAT pathway

J Chemother. 2024 May;36(3):238-248. doi: 10.1080/1120009X.2023.2274700. Epub 2023 Nov 2.

Abstract

Pacritinib is an oral medication that inhibits several kinases including JAK2, FLT3, IRAK and STAT3. It has been recently approved to treat patients with thrombocytopenia and myelofibrosis. Studies are currently exploring the potential use of pacritinib in treating other types of cancer such as leukaemia, breast cancer and prostate cancer. Our study aimed to investigate the effects of pacritinib alone and its combination with standard of care in renal cell carcinoma (RCC). We showed that pacritinib dose-dependently decreased viability of RCC cells, with IC50 at nanomolar or low micromolar concentration rage. Pacritinib inhibited cell proliferation, decreased colony formation, and increased apoptosis. Interestingly, pacritinib exhibited synergistic effects when combined with temsirolimus and sunitinib, but antagonistic effects when combined with doxorubicin, in a panel of RCC cell lines. We also confirmed that the combination of pacritinib with temsirolimus and sunitinib resulted in synergistic effects in RCC mouse models, with complete inhibition of tumour growth throughout the treatment period. Mechanistic studies indicated that the inhibition of JAK2, but not IRAK, was the main contributor to the anti-RCC activity of pacritinib. Our study is the first to demonstrate that pacritinib shows promise as a treatment option for RCC and underscores the therapeutic potential of targeting the JAK2/STAT signalling pathway in RCC.

Keywords: JAK2/STAT; Pacritinib; RCC; doxorubicin; sunitinib; temsirolimus.

MeSH terms

  • Animals
  • Bridged-Ring Compounds* / pharmacology
  • Carcinoma, Renal Cell* / drug therapy
  • Carcinoma, Renal Cell* / pathology
  • Cell Line, Tumor
  • Humans
  • Janus Kinase 2 / antagonists & inhibitors
  • Janus Kinase 2 / metabolism
  • Kidney Neoplasms* / drug therapy
  • Kidney Neoplasms* / pathology
  • Mice
  • Protein Kinase Inhibitors / therapeutic use
  • Pyrimidines*
  • STAT3 Transcription Factor / antagonists & inhibitors
  • STAT3 Transcription Factor / metabolism
  • Sirolimus* / analogs & derivatives
  • Sirolimus* / pharmacology
  • Sunitinib / therapeutic use

Substances

  • 11-(2-pyrrolidin-1-ylethoxy)-14,19-dioxa-5,7,26-triazatetracyclo(19.3.1.1(2,6).1(8,12))heptacosa-1(25),2(26),3,5,8,10,12(27),16,21,23-decaene
  • Bridged-Ring Compounds
  • JAK2 protein, human
  • Janus Kinase 2
  • Protein Kinase Inhibitors
  • Pyrimidines
  • Sirolimus
  • STAT3 protein, human
  • STAT3 Transcription Factor
  • Sunitinib
  • temsirolimus