Back

Targeting MCL1-driven anti-apoptotic pathways to overcome hypomethylating agent resistance in RAS-mutated chronic myelomonocytic leukemia

Montalban-Bravo, G.; Ma, F.; Thongon, N.; Yang, H.; Ganan-Gomez, I.; Rodriguez-Sevilla, J. J.; Adema, V.; Wildeman, B.; Lockyer, P. P.; Kim, Y. J.; Tanaka, T.; Darbaniyan, F.; Pancholy, S.; Zhang, G.; Al-Atrash, G.; Dwyer, K.; Takahashi, K.; Garcia-Manero, G.; Kantarjian, H.; Colla, S.

2023-04-08 cancer biology
10.1101/2023.04.07.535928 bioRxiv
Show abstract

RAS pathway mutations, which are present in 30% of patients with chronic myelomonocytic leukemia (CMML) at diagnosis, confer a high risk of resistance to and progression after hypomethylating agent (HMA) therapy, the current standard of care for the disease. Using single-cell, multi-omics technologies, we sought to dissect the biological mechanisms underlying the initiation and progression of RAS pathway-mutated CMML. We found that RAS pathway mutations induced the transcriptional reprogramming of hematopoietic stem and progenitor cells (HSPCs), which underwent proliferation and monocytic differentiation in response to cell-intrinsic and -extrinsic inflammatory signaling that also impaired immune cells functions. HSPCs expanded at disease progression and relied on the NF-KB pathway effector MCL1 to maintain their survival, which explains why patients with RAS pathway- mutated CMML do not benefit from BCL2 inhibitors such as venetoclax. Our study has implications for developing therapies to improve the survival of patients with RAS pathway- mutated CMML.

Matching journals

The top 5 journals account for 50% of the predicted probability mass.

50% of probability mass above

"Similar papers" are the closest papers from that journal in the model's embedding space. They show what the match is built on, but the ranking comes mostly from a classifier over the whole training set, not from these examples alone.