Disease Information

General Information of the Disease (ID: DIS00059)
Name
Cutaneous T-cell lymphoma
ICD
ICD-11: 2B00
Resistance Map
Type(s) of Resistant Mechanism of This Disease
  ADTT: Aberration of the Drug's Therapeutic Target
  EADR: Epigenetic Alteration of DNA, RNA or Protein
  UAPP: Unusual Activation of Pro-survival Pathway
Drug Resistance Data Categorized by Drug
Approved Drug(s)
4 drug(s) in total
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Bortezomib
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Drug Resistance Data Categorized by Their Corresponding Mechanisms
  Epigenetic Alteration of DNA, RNA or Protein (EADR) Click to Show/Hide
Key Molecule: hsa-miR-125b-5p [1]
Resistant Disease Cutaneous T-cell lymphomas [ICD-11: 2B00.0]
Resistant Drug Bortezomib
 Drug Info 
Molecule Alteration Expression
Up-regulation
 Molecule Info 
Experimental Note Identified from the Human Clinical Data
Cell Pathway Regulation Cell apoptosis Inhibition hsa04210
Cell migration Activation hsa04670
Cell proliferation Activation hsa05200
In Vitro Model MyLa2000 cells Skin Homo sapiens (Human) CVCL_8328
SeAx cells Skin Homo sapiens (Human) CVCL_5363
Experiment for
Molecule Alteration		 qRT-PCR
Experiment for
Drug Resistance		 Flow cytometry assay
Mechanism Description Bortezomib repressed cMyc and simultaneously induced miR-125b-5p that exerted a cytoprotective effect through the downmodulation of MAD4. miR-125b-5p can regulates tumor growth in vivo,and increases cellular resistance to proteasome inhibitors via modulation of MAD4.
  Unusual Activation of Pro-survival Pathway (UAPP) Click to Show/Hide
Key Molecule: Max dimerization protein 4 (MXD4) [1]
Resistant Disease Cutaneous T-cell lymphomas [ICD-11: 2B00.0]
Resistant Drug Bortezomib
 Drug Info 
Molecule Alteration Expression
Down-regulation
 Molecule Info 
Experimental Note Identified from the Human Clinical Data
Cell Pathway Regulation Cell apoptosis Inhibition hsa04210
Cell migration Activation hsa04670
Cell proliferation Activation hsa05200
In Vitro Model MyLa2000 cells Skin Homo sapiens (Human) CVCL_8328
SeAx cells Skin Homo sapiens (Human) CVCL_5363
Experiment for
Molecule Alteration		 Western blot analysis
Experiment for
Drug Resistance		 Flow cytometry assay
Mechanism Description Bortezomib repressed cMyc and simultaneously induced miR-125b-5p that exerted a cytoprotective effect through the downmodulation of MAD4. miR-125b-5p can regulates tumor growth in vivo,and increases cellular resistance to proteasome inhibitors via modulation of MAD4.
Cantharidin
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Drug Sensitivity Data Categorized by Their Corresponding Mechanisms
  Unusual Activation of Pro-survival Pathway (UAPP) Click to Show/Hide
Key Molecule: Interleukin-2 receptor subunit alpha (IL-2Ralpha) [2]
Sensitive Disease Cutaneous T-cell lymphomas [ICD-11: 2B00.0]
Sensitive Drug Cantharidin
 Drug Info 
Molecule Alteration Expression
Up-regulation
 Molecule Info 
Experimental Note Revealed Based on the Cell Line Data
Cell Pathway Regulation JAK-STAT signaling pathway Activation hsa04630
AKT/mTOR signaling pathway Regulation N.A.
MAPK signaling pathway Activation hsa04010
In Vitro Model H9SR cells embryonic stem cell Homo sapiens (Human) N.A.
HHSR cells embryonic stem cell Homo sapiens (Human) N.A.
Experiment for
Molecule Alteration		 Western blot assay; Immunohistochemistry
Experiment for
Drug Resistance		 Flow cytometric assay
Mechanism Description Our findings highlight that attenuated ROS accelerates IL-2R translation and therefore brings about aberrant expression of IL-2R protein, leading to overactivation of JAK/STAT, AKT/mTOR and MAPK signaling events, which explains SAHA resistance to CTCL cells. Moreover, cantharidin could overcome SAHA resistance to CTCL by blocking IL-2R-related signaling via ROS dependent manner.
Mogamulizumab
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Drug Resistance Data Categorized by Their Corresponding Mechanisms
  Aberration of the Drug's Therapeutic Target (ADTT) Click to Show/Hide
Key Molecule: C-C motif chemokine receptor 4 (CCR4) [3]
Resistant Disease Cutaneous T-cell lymphomas [ICD-11: 2B00.0]
Resistant Drug Mogamulizumab
 Drug Info 
Molecule Alteration Expression
Down-regulation
 Molecule Info 
Experimental Note Identified from the Human Clinical Data
Experiment for
Molecule Alteration		 Immunohistochemistry assay
Mechanism Description We identified 17 patients with mycosis fungoides or Sezary syndrome who either were intrinsically resistant or acquired resistance to mogamulizumab. Low expression of CCR4 by immunohistochemistry or flow cytometry was found in 65% of patients. Novel emergent CCR4 mutations targeting the N-terminal and transmembrane domains were found in 3 patients after disease progression. Emerging CCR4 copy number loss was detected in 2 patients with CCR4 mutations. Acquisition of CCR4 genomic alterations corresponded with loss of CCR4 antigen expression. We also report on outcomes of three cutaneous T-cell lymphoma patients with gain-of-function CCR4 mutations treated with mogamulizumab. Our study indicates that resistance to mogamulizumab in CTCL frequently involves loss of CCR4 expression and emergence of CCR4 genomic alterations.
Vorinostat
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Drug Resistance Data Categorized by Their Corresponding Mechanisms
  Unusual Activation of Pro-survival Pathway (UAPP) Click to Show/Hide
Key Molecule: Interleukin-2 receptor subunit alpha (IL-2Ralpha) [2]
Resistant Disease Cutaneous T-cell lymphomas [ICD-11: 2B00.0]
Resistant Drug Vorinostat
 Drug Info 
Molecule Alteration Expression
Up-regulation
 Molecule Info 
Experimental Note Revealed Based on the Cell Line Data
Cell Pathway Regulation JAK-STAT signaling pathway Activation hsa04630
AKT/mTOR signaling pathway Regulation N.A.
MAPK signaling pathway Activation hsa04010
In Vitro Model H9SR cells embryonic stem cell Homo sapiens (Human) N.A.
HHSR cells embryonic stem cell Homo sapiens (Human) N.A.
Experiment for
Molecule Alteration		 Western blot assay; Immunohistochemistry
Experiment for
Drug Resistance		 Flow cytometric assay
Mechanism Description Our findings highlight that attenuated ROS accelerates IL-2R translation and therefore brings about aberrant expression of IL-2R protein, leading to overactivation of JAK/STAT, AKT/mTOR and MAPK signaling events, which explains SAHA resistance to CTCL cells. Moreover, cantharidin could overcome SAHA resistance to CTCL by blocking IL-2R-related signaling via ROS dependent manner.
References
Ref 1 cMyc/miR-125b-5p signalling determines sensitivity to bortezomib in preclinical model of cutaneous T-cell lymphomas. PLoS One. 2013;8(3):e59390. doi: 10.1371/journal.pone.0059390. Epub 2013 Mar 19.
Ref 2 Cantharidin overcomes IL-2Ralpha signaling-mediated vorinostat resistance in cutaneous T-cell lymphoma through reactive oxygen species. J Immunother Cancer. 2024 Jul 14;12(7):e009099.
Ref 3 Resistance to mogamulizumab is associated with loss of CCR4 in Cutaneous T-cell Lymphoma .Blood. 2022 Apr 18:blood.2021014468. doi: 10.1182/blood.2021014468. Online ahead of print. 10.1182/blood.2021014468

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