Université de Paris Cité, Institut Necker Enfants-Malades INEM, Institut National de La Santé Et de La Recherche Médicale (Inserm), U1151, Paris, France.
Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades 75743, Paris, France.
Mol Cancer. 2023 Jan 18;22(1):12. doi: 10.1186/s12943-022-01701-x.
The acquisition of genetic abnormalities engendering oncogene dysregulation underpins cancer development. Certain proto-oncogenes possess several dysregulation mechanisms, yet how each mechanism impacts clinical outcome is unclear. Using T-cell acute lymphoblastic leukemia (T-ALL) as an example, we show that patients harboring 5'super-enhancer (5'SE) mutations of the TAL1 oncogene identifies a specific patient subgroup with poor prognosis irrespective of the level of oncogene dysregulation. Remarkably, the MYB dependent oncogenic 5'SE can be targeted using Mebendazole to induce MYB protein degradation and T-ALL cell death. Of note Mebendazole treatment demonstrated efficacy in vivo in T-ALL preclinical models. Our work provides proof of concept that within a specific oncogene driven cancer, the mechanism of oncogene dysregulation rather than the oncogene itself can identify clinically distinct patient subgroups and pave the way for future super-enhancer targeting therapy.
导致癌基因失调的遗传异常的获得是癌症发展的基础。某些原癌基因具有几种失调机制,但每种机制如何影响临床结果尚不清楚。我们以 T 细胞急性淋巴细胞白血病 (T-ALL) 为例,表明携带 TAL1 癌基因 5'超级增强子 (5'SE) 突变的患者,无论癌基因失调程度如何,都确定了一个预后不良的特定患者亚组。值得注意的是,Mebendazole 可靶向作用于依赖 MYB 的致癌性 5'SE,诱导 MYB 蛋白降解和 T-ALL 细胞死亡。值得注意的是,在 T-ALL 临床前模型中,Mebendazole 治疗具有体内疗效。我们的工作提供了一个概念验证,即在特定的癌基因驱动的癌症中,癌基因失调的机制而不是癌基因本身可以确定临床上不同的患者亚组,并为未来的超级增强子靶向治疗铺平道路。