Gain-of-function mutations of membrane
receptor tyrosine kinase KIT, especially gatekeeper D816V point mutation in KIT, render
kinase autoactivation,
disease progression, and poor prognosis. D816V KIT is found in approximately 80% of the patients with
systemic mastocytosis, and is resistant to the first and second generations of
tyrosine kinase inhibitors (TKI). The purpose of this investigation was aimed at exploring whether
ponatinib (
AP24534), a novel effective TKI against T315I Bcr-Abl, was active against D816V KIT. We discovered that
ponatinib abrogated the phosphorylation of KIT harboring either V560G (sensitive to
imatinib) or D816V mutation (resistant to
imatinib) and the downstream signaling transduction.
Ponatinib inhibited the growth of D816V KIT-expressing cells in culture and nude mouse xenografted
tumor.
Ponatinib triggered apoptosis by inducing the release of
cytochrome c and AIF, downregulation of Mcl-1. Furthermore,
ponatinib abrogated the phosphorylation of β-
catenin at the site Y654, suppressed the translocation of β-
catenin, and inhibited the transcription and
DNA binding of TCF and the expression of its targets (e.g., AXIN2, c-MYC, and CCND1). Moreover,
ponatinib was highly active against xenografted D816V KIT
tumors in nude mice and significantly prolonged the survival of mice with
aggressive systemic mastocytosis or
mast cell leukemia by impeding the expansion and infiltration of mast cells with
imatinib-resistant D814Y KIT. Our findings warrant a clinical trial of
ponatinib in patients with
systemic mastocytosis harboring D816V KIT.