Targeting of epigenetic co-dependencies enhances anti-AML efficacy of Menin inhibitor in AML with MLL1-r or mutant NPM1

Fiskus, Warren, Mill, Christopher P, Birdwell, Christine, Davis, John A, Das, Kaberi, Boettcher, Steffen, Kadia, Tapan M, DiNardo, Courtney D, Takahashi, Koichi, Loghavi, Sanam, Soth, Michael J, Heffernan, Tim, McGeehan, Gerard M, Ruan, Xinjia, Su, Xiaoping, Vakoc, Christopher R, Daver, Naval, Bhalla, Kapil N (April 2023) Targeting of epigenetic co-dependencies enhances anti-AML efficacy of Menin inhibitor in AML with MLL1-r or mutant NPM1. Blood Cancer Journal, 13 (1). p. 53. ISSN 2044-5385

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DOI: 10.1038/s41408-023-00826-6


Monotherapy with Menin inhibitor (MI), e.g., SNDX-5613, induces clinical remissions in patients with relapsed/refractory AML harboring MLL1-r or mtNPM1, but most patients either fail to respond or eventually relapse. Utilizing single-cell RNA-Seq, ChiP-Seq, ATAC-Seq, RNA-Seq, RPPA, and mass cytometry (CyTOF) analyses, present pre-clinical studies elucidate gene-expression correlates of MI efficacy in AML cells harboring MLL1-r or mtNPM1. Notably, MI-mediated genome-wide, concordant, log2 fold-perturbations in ATAC-Seq and RNA-Seq peaks were observed at the loci of MLL-FP target genes, with upregulation of mRNAs associated with AML differentiation. MI treatment also reduced the number of AML cells expressing the stem/progenitor cell signature. A protein domain-focused CRISPR-Cas9 screen in MLL1-r AML cells identified targetable co-dependencies with MI treatment, including BRD4, EP300, MOZ and KDM1A. Consistent with this, in vitro co-treatment with MI and BET, MOZ, LSD1 or CBP/p300 inhibitor induced synergistic loss of viability of AML cells with MLL1-r or mtNPM1. Co-treatment with MI and BET or CBP/p300 inhibitor also exerted significantly superior in vivo efficacy in xenograft models of AML with MLL1-r. These findings highlight novel, MI-based combinations that could prevent escape of AML stem/progenitor cells following MI monotherapy, which is responsible for therapy-refractory AML relapse.

Item Type: Paper
Subjects: ?? Cell Cycle Proteins ??
?? Epigenesis, Genetic ??
?? Histone Demethylases ??
?? Histone-Lysine N-Methyltransferase ??
?? Humans ??
?? Leukemia, Myeloid, Acute ??
?? Myeloid-Lymphoid Leukemia Protein ??
?? Neoplasm Recurrence, Local ??
?? Nuclear Proteins ??
?? Proto-Oncogene Proteins ??
?? Transcription Factors ??
diseases & disorders > cancer > cancer types > acute myeloid leukemia
Investigative techniques and equipment > CRISPR-Cas9
bioinformatics > genomics and proteomics > genetics & nucleic acid processing > epigenetics
bioinformatics > genomics and proteomics > genetics & nucleic acid processing > DNA, RNA structure, function, modification > epigenetics
CSHL Authors:
Communities: CSHL labs > Vakoc lab
SWORD Depositor: CSHL Elements
Depositing User: CSHL Elements
Date: 13 April 2023
Date Deposited: 20 Apr 2023 13:56
Last Modified: 20 Apr 2023 13:56
PMCID: PMC10102188
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