Priority Research Papers:

MCL-1-independent mechanisms of synergy between dual PI3K/mTOR and BCL-2 inhibition in diffuse large B cell lymphoma

J. Scott Lee, Sarah S. Tang, Veronica Ortiz, Thanh-Trang Vo and David A. Fruman _

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Oncotarget. 2015; 6:35202-35217. https://doi.org/10.18632/oncotarget.6051

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J. Scott Lee1, Sarah S. Tang1, Veronica Ortiz1, Thanh-Trang Vo1 and David A. Fruman1

1 Department of Molecular Biology and Biochemistry, University of California, Irvine, CA, USA

Correspondence to:

David A. Fruman, email:

Keywords: lymphoma, apoptosis, PI3K, mTOR, BCL-2

Received: August 19, 2015 Accepted: September 24, 2015 Published: October 09, 2015


The PI3K/AKT/mTOR axis promotes survival and is a frequently mutated pathway in cancer. Yet, inhibitors targeting this pathway are insufficient to induce cancer cell death as single agents in some contexts, including diffuse large B cell lymphoma (DLBCL). In these situations, combinations with inhibitors targeting BCL-2 survival proteins (ABT-199 and ABT-263) may hold potential. Indeed, studies have demonstrated marked synergy in contexts where PI3K/mTOR inhibitors suppress expression of the pro-survival protein, MCL-1. In this study, we use BH3 profiling to confirm that BCL-2 and BCL-XL support survival following PI3K pathway inhibition, and that the dual PI3K/mTOR inhibitor BEZ235 strongly synergizes with BCL-2 antagonists in DLBCL. However, we identify an alternative mechanism of synergy between PI3K/mTOR and BCL-2 inhibitors, independent of MCL-1 down-regulation. Instead, we show that suppression of AKT activation by BEZ235 can induce the mitochondrial accumulation of pro-apoptotic BAD and BIM, and that expression of a constitutively active form of AKT prevents sensitization to BCL-2 antagonism. Thus, our work identifies an additional mechanism of synergy between PI3K pathway inhibitors and BCL-2 antagonists that strengthens the rationale for testing this combination in DLBCL.

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