{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:12:58Z","timestamp":1790255578522,"version":"4.1.0"},"reference-count":53,"publisher":"American Society of Hematology","issue":"19","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Interactions between the inhibitor of apoptosis protein antagonist LCL161 and the histone deacetylase inhibitor panobinostat (LBH589) were examined in human multiple myeloma (MM) cells. LCL161 and panobinostat interacted synergistically to induce apoptosis in diverse MM cell lines, including those resistant to bortezomib (PS-R). Similar interactions were observed with other histone deacetylase inhibitors (MS-275) or inhibitors of apoptosis protein antagonists (birinapant). These events were associated with downregulation of the noncanonical (but not the canonical) NF-\u03baB pathway and activation of the extrinsic, caspase-8\u2013related apoptotic cascade. Coexposure of MM cells to LCL161\/LBH589 induced TRAF3 upregulation and led to TRAF2 and NIK downregulation, diminished expression of BCL-XL, and induction of \u03b3H2A.X. Ectopic expression of TRAF2, NIK, or BCL-XL, or short hairpin RNA TRAF3 knock-down, significantly reduced LCL161\/LBH589 lethality, as did ectopic expression of dominant-negative FADD. Stromal\/microenvironmental factors failed to diminish LCL161\/LBH589\u2013induced cell death. The LCL161\/LBH589 regimen significantly increased cell killing in primary CD138+ cells (N = 31) and was particularly effective in diminishing the primitive progenitor cell\u2013enriched CD138\u2013\/19+\/20+\/27+ population (N = 23) but was nontoxic to normal CD34+ cells. Finally, combined LCL161\/LBH589 treatment significantly increased survival compared with single-agent treatment in an immunocompetent 5TGM1 murine MM model. Together, these findings argue that LCL161 interacts synergistically with LBH589 in MM cells through a process involving inactivation of the noncanonical NF-\u03baB pathway and activation of the extrinsic apoptotic pathway, upregulation of TRAF3, and downregulation of TRAF2\/BCL-XL. Notably, this regimen overcomes various forms of resistance, is active against primary MM cells, and displays significant in vivo activity. This strategy warrants further consideration in MM.<\/jats:p>","DOI":"10.1182\/bloodadvances.2020003597","type":"journal-article","created":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T21:58:22Z","timestamp":1630447102000},"page":"3776-3788","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":16,"title":["IAP and HDAC inhibitors interact synergistically in myeloma cells through noncanonical NF-\u03baB\u2013 and caspase-8\u2013dependent mechanisms"],"prefix":"10.1182","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5457-7532","authenticated-orcid":false,"given":"Liang","family":"Zhou","sequence":"first","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, and"},{"name":"Division of 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