Priority Research Papers:

Niclosamide suppresses acute myeloid leukemia cell proliferation through inhibition of CREB-dependent signaling pathways

Hee-Don Chae, Nick Cox, Gary V. Dahl, Norman J. Lacayo, Kara L. Davis, Samanta Capolicchio, Mark Smith and Kathleen M. Sakamoto _

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Oncotarget. 2018; 9:4301-4317. https://doi.org/10.18632/oncotarget.23794

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Hee-Don Chae1, Nick Cox2, Gary V. Dahl1, Norman J. Lacayo1, Kara L. Davis1, Samanta Capolicchio1,2, Mark Smith2 and Kathleen M. Sakamoto1

1 Division of Hematology/Oncology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA

2 Medicinal Chemistry Knowledge Center, Stanford ChEM-H, Stanford, CA, USA

Correspondence to:

Kathleen M. Sakamoto, email:

Keywords: niclosamide; acute myeloid leukemia; small molecule; CREB; combination

Received: November 03, 2017 Accepted: December 22, 2017 Published: December 31, 2017


CREB (cAMP Response Element Binding protein) is a transcription factor that is overexpressed in primary acute myeloid leukemia (AML) cells and associated with a decreased event-free survival and increased risk of relapse. We recently reported a small molecule inhibitor of CREB, XX-650-23, which inhibits CREB activity in AML cells. Structure-activity relationship analysis for chemical compounds with structures similar to XX-650-23 led to the identification of the anthelminthic drug niclosamide as a potent anti-leukemic agent that suppresses cell viability of AML cell lines and primary AML cells without a significant decrease in colony forming activity of normal bone marrow cells. Niclosamide significantly inhibited CREB function and CREB-mediated gene expression in cells, leading to apoptosis and G1/S cell cycle arrest with reduced phosphorylated CREB levels. CREB knockdown protected cells from niclosamide treatment-mediated cytotoxic effects. Furthermore, treatment with a combination of niclosamide and CREB inhibitor XX-650-23 showed an additive anti-proliferative effect, consistent with the hypothesis that niclosamide and XX-650-23 regulate the same targets or pathways to inhibit proliferation and survival of AML cells. Niclosamide significantly inhibited the progression of disease in AML patient-derived xenograft (PDX) mice, and prolonged survival of PDX mice. Niclosamide also showed synergistic effects with chemotherapy drugs to inhibit AML cell proliferation. While chemotherapy antagonized the cytotoxic potential of niclosamide, pretreatment with niclosamide sensitized cells to chemotherapeutic drugs, cytarabine, daunorubicin, and vincristine. Therefore, our results demonstrate niclosamide as a potential drug to treat AML by inducing apoptosis and cell cycle arrest through inhibition of CREB-dependent pathways in AML cells.

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