New Treatment Strategies for Multiple Myeloma by Targeting BCL-2 and the Mevalonate Pathway

Author(s): Niels W.C.J. van de Donk, Andries C. Bloem, Ellen v. d. Spek, Henk M. Lokhorst

Journal Name: Current Pharmaceutical Design

Volume 12 , Issue 3 , 2006

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Insight into the mechanisms of primary or acquired drug resistance of (hematological) malignancies is critical for the development of new treatment strategies. This review will focus on Bcl-2 and the mevalonate pathway as targets for reversal of drug resistance in multiple myeloma. The Bcl-2 protein is highly expressed in myeloma patients and in vitro studies have shown its role in the regulation of chemosensitivity, which makes Bcl-2 an attractive target for treatment. Statins are widely used for the treatment of hypercholesteremia. Several in vitro studies have shown that statins may also kill hematological malignant cells including myeloma cells. We found that lovastatin induced apoptosis in myeloma and lymphoma cells by inhibition of geranylgeranylation and subsequent down regulation of Mcl-1, probably the most important anti-apoptotic protein in myeloma. Phase 1 and 2 studies have been performed with Bcl-2 antisense oligonucleotides and high dose simvastatin in combination with chemotherapy in heavily pre-treated myeloma patients. Encouraging results from these studies may provide the framework for the future application of new treatment strategies for myeloma

Keywords: Multiple myeloma, drug resistance, apoptosis, proliferation, mevalonate pathway, geranylgeranylation, Bcl-2, Mcl-1

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Article Details

Year: 2006
Page: [327 - 340]
Pages: 14
DOI: 10.2174/138161206775201974
Price: $65

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