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Cancer Prevalence across Vertebrates 脊椎动物的癌症发病率
IF 28.2 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-24 DOI: 10.1158/2159-8290.cd-24-0573
Zachary T. Compton, Walker Mellon, Valerie K. Harris, Shawn Rupp, Diego Mallo, Stefania E. Kapsetaki, Mallory Wilmot, Ryan Kennington, Kathleen Noble, Cristina Baciu, Lucia N. Ramirez, Ashley Peraza, Brian Martins, Sushil Sudhakar, Selin Aksoy, Gabriela Furukawa, Orsolya Vincze, Mathieu Giraudeau, Elizabeth G. Duke, Simon Spiro, Edmund Flach, Hannah Davidson, Christopher I. Li, Ashley Zehnder, Trevor A. Graham, Brigid V. Troan, Tara M. Harrison, Marc Tollis, Joshua D. Schiffman, C. Athena Aktipis, Lisa M. Abegglen, Carlo C. Maley, Amy M. Boddy
Cancer is pervasive across multicellular species, but what explains the differences in cancer prevalence across species? Using 16,049 necropsy records for 292 species spanning three clades of tetrapods (amphibians, sauropsids, and mammals), we found that neoplasia and malignancy prevalence increases with adult mass (contrary to Peto’s paradox) and somatic mutation rate but decreases with gestation time. The relationship between adult mass and malignancy prevalence was only apparent when we controlled for gestation time. Evolution of cancer susceptibility appears to have undergone sudden shifts followed by stabilizing selection. Outliers for neoplasia prevalence include the common porpoise (<1.3%), the Rodrigues fruit bat (<1.6%), the black-footed penguin (<0.4%), ferrets (63%), and opossums (35%). Discovering why some species have particularly high or low levels of cancer may lead to a better understanding of cancer syndromes and novel strategies for the management and prevention of cancer. Significance: Evolution has discovered mechanisms for suppressing cancer in a wide variety of species. By analyzing veterinary necropsy records, we can identify species with exceptionally high or low cancer prevalence. Discovering the mechanisms of cancer susceptibility and resistance may help improve cancer prevention and explain cancer syndromes.
癌症在多细胞物种中普遍存在,但不同物种的癌症发病率有何差异?通过对横跨四足动物三个支系(两栖类、梭形类和哺乳类)的 292 个物种的 16,049 份尸检记录进行分析,我们发现肿瘤和恶性肿瘤的发病率随着成体质量(与佩托悖论相反)和体细胞突变率的增加而增加,但随着妊娠时间的延长而减少。只有当我们控制了妊娠时间后,成体质量与恶性肿瘤发病率之间的关系才变得明显。癌症易感性的进化似乎经历了突然的转变,然后是稳定的选择。肿瘤发病率的异常值包括普通鼠海豚(<1.3%)、罗德里格斯果蝠(<1.6%)、黑脚企鹅(<0.4%)、雪貂(63%)和负鼠(35%)。发现某些物种癌症发病率特别高或特别低的原因,可能有助于更好地了解癌症综合征,并制定新的癌症管理和预防策略。意义重大:进化发现了各种物种抑制癌症的机制。通过分析兽医尸检记录,我们可以确定癌症发病率特别高或特别低的物种。发现癌症易感性和抵抗力的机制可能有助于改善癌症预防和解释癌症综合症。
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引用次数: 0
The Journey of Antibody-Drug Conjugates: Lessons Learned from 40 Years of Development. 抗体药物共轭物的发展历程:从 40 年的发展中汲取的经验教训。
IF 28.2 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-23 DOI: 10.1158/2159-8290.cd-24-0708
Raffaele Colombo,Paolo Tarantino,Jamie R Rich,Patricia M LoRusso,Elisabeth G E de Vries
Antibody-drug conjugates (ADC) represent one of the most rapidly expanding treatment modalities in oncology, with 11 ADCs approved by the FDA and more than 210 currently being tested in clinical trials. Spanning over 40 years, ADC clinical development has enhanced our understanding of the multifaceted mechanisms of action for this class of therapeutics. In this article, we discuss key insights into the toxicity, efficacy, stability, distribution, and fate of ADCs. Furthermore, we highlight ongoing challenges related to their clinical optimization, the development of rational sequencing strategies, and the identification of predictive biomarkers. Significance: The development and utilization of ADCs have allowed for relevant improvements in the prognosis of multiple cancer types. Concomitantly, the rise of ADCs in oncology has produced several challenges, including the prediction of their activity, their utilization in sequence, and minimization of their side effects, that still too often resemble those of the cytotoxic molecule that they carry. In this review, we retrace 40 years of development in the field of ADCs and delve deep into the mechanisms of action of these complex therapeutics and reasons behind the many achievements and failures observed in the field to date.
抗体药物共轭物(ADC)是肿瘤学领域发展最迅速的治疗方式之一,目前已有 11 种 ADC 获得美国食品及药物管理局(FDA)批准,210 多种 ADC 正在接受临床试验。ADC 临床开发历时 40 余年,加深了我们对该类疗法多方面作用机制的了解。在本文中,我们将讨论有关 ADC 的毒性、疗效、稳定性、分布和转归的重要见解。此外,我们还重点介绍了在临床优化、合理测序策略的开发以及预测性生物标记物的鉴定方面所面临的挑战。意义重大:ADCs 的开发和利用使多种癌症类型的预后得到了相关改善。与此同时,ADCs 在肿瘤学领域的兴起也带来了一些挑战,包括对其活性的预测、按顺序使用以及最大限度地减少其副作用,而这些副作用往往与它们所携带的细胞毒性分子的副作用相似。在这篇综述中,我们回顾了 ADC 领域 40 年的发展历程,并深入探讨了这些复杂疗法的作用机制,以及该领域迄今为止取得的众多成就和失败背后的原因。
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引用次数: 0
The Evolutionary Forest of Pancreatic Cancer 胰腺癌的进化森林
IF 28.2 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-08 DOI: 10.1158/2159-8290.cd-23-1541
Katelyn M. Mullen, Jungeui Hong, Marc A. Attiyeh, Akimasa Hayashi, Hitomi Sakamoto, Zachary A. Kohutek, Caitlin A. McIntyre, Haochen Zhang, Alvin P. Makohon-Moore, Amanda Zucker, Laura D. Wood, Matthew A. Myers, Brian J. Arnold, Simone Zaccaria, Joanne F. Chou, Marinela Capanu, Nicholas D. Socci, Benjamin J. Raphael, Christine A. Iacobuzio-Donahue
The genomic features of pancreatic ductal adenocarcinoma (PDAC) have been well described, yet the evolutionary contexts within which those features occur remains unexplored. We studied the genome landscapes, phylogenies and clonal compositions of 91 PDACs in relation to clinicopathologic features. There was no difference in the number of driver mutations or the evolutionary timing that each mutation occurred. High truncal density, a metric of the accumulation of somatic mutations in the lineage that gave rise to each PDAC, was significantly associated with worse overall survival. Polyclonal, monoclonal or mixed polyclonal/monoclonal metastases were identified across the cohort highlighting multiple forms of inter-tumoral heterogeneity. Advanced stage and treated PDACs had higher odds of being polyclonal, whereas oligometastatic PDACs had fewer driver alterations, a lower fractional allelic loss and increased likelihood of being monoclonal. In sum, our findings reveal novel insights into the dynamic nature of the PDAC genome beyond established genetic paradigms.
胰腺导管腺癌(PDAC)的基因组特征已经得到了很好的描述,但这些特征发生的进化背景仍有待探索。我们研究了 91 例 PDAC 的基因组图谱、系统发育和克隆组成与临床病理特征的关系。在驱动突变的数量或每个突变发生的进化时间上没有差异。截干密度高(这是产生每个 PDAC 的系谱中体细胞突变积累的指标)与总生存率较低有显著相关性。在整个组群中发现了多克隆、单克隆或多克隆/单克隆混合转移瘤,突显了多种形式的肿瘤间异质性。晚期和经过治疗的PDAC发生多克隆转移的几率更高,而少转移的PDAC驱动基因改变较少,等位基因丢失的比例较低,发生单克隆转移的可能性增加。总之,我们的研究结果揭示了PDAC基因组动态性质的新见解,超越了既有的遗传范式。
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引用次数: 0
Glioblastoma-cortical organoids recapitulate cell state heterogeneity and intercellular transfer. 胶质母细胞瘤皮质器官再现细胞状态异质性和细胞间转移
IF 29.7 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-07 DOI: 10.1158/2159-8290.CD-23-1336
Vamsi Mangena, Rony Chanoch-Myers, Rafaela Sartore, Bruna Paulsen, Simon Gritsch, Hannah Weisman, Toshiro Hara, Xandra O Breakefield, Koen Breyne, Aviv Regev, Kwanghun Chung, Paola Arlotta, Itay Tirosh, Mario L Suva

Glioblastoma is characterized by heterogeneous malignant cells that are functionally integrated within the neuroglial microenvironment. Here, we model this ecosystem by growing glioblastoma into long-term cultured human cortical organoids that contain the major neuroglial cell types found in the cerebral cortex. Single-cell RNA-seq analysis suggests that, compared to matched gliomasphere models, glioblastoma cortical organoids (GCO) more faithfully recapitulate the diversity and expression programs of malignant cell states found in patient tumors. Additionally, we observe widespread transfer of glioblastoma transcripts and GFP proteins to non-malignant cells in the organoids. Mechanistically, this transfer involves extracellular vesicles and is biased towards defined glioblastoma cell states and astroglia cell types. These results extend previous glioblastoma-organoid modeling efforts and suggest widespread intercellular transfer in the glioblastoma neuroglial microenvironment.

胶质母细胞瘤的特征是神经胶质细胞微环境中功能整合的异质性恶性细胞。在这里,我们通过将胶质母细胞瘤培养到长期培养的人皮质器官组织中来模拟这一生态系统,该器官组织包含大脑皮质中的主要神经胶质细胞类型。单细胞RNA-seq分析表明,与匹配的胶质母球模型相比,胶质母细胞瘤皮质类器官(GCO)更忠实地再现了患者肿瘤中恶性细胞状态的多样性和表达程序。此外,我们还观察到胶质母细胞瘤转录本和 GFP 蛋白广泛转移到器官组织中的非恶性细胞。从机理上讲,这种转移涉及细胞外囊泡,并偏向于确定的胶质母细胞瘤细胞状态和星形胶质细胞类型。这些结果扩展了以前的胶质母细胞瘤-类器官建模工作,并表明胶质母细胞瘤神经胶质细胞微环境中存在广泛的细胞间转移。
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引用次数: 0
Iron-(Fe3+)-Dependent Reactivation of Telomerase Drives Colorectal Cancers. 铁(Fe3+)依赖性端粒酶再激活驱动结直肠癌。
IF 29.7 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-04 DOI: 10.1158/2159-8290.CD-23-1379
Raghuvaran Shanmugam, Prativa Majee, Wei Shi, Mert B Ozturk, Thamil S Vaiyapuri, Khaireen Idzham, Anandhkumar Raju, Seung H Shin, Kerem Fidan, Joo-Leng Low, Joelle Y H Chua, Yap C Kong, Ong Y Qi, Emile Tan, Aik Y Chok, Isaac Seow-En, Ian Wee, Dominique C Macalinao, Dawn Q Chong, Hong Y Chang, Fiona Lee, Wei Q Leow, Maki Murata-Hori, Zhang Xiaoqian, Chia Shumei, Chris S H Tan, Ramanuj Dasgupta, Iain B Tan, Vinay Tergaonkar

Over-consumption of iron-rich red meat and hereditary or genetic iron overload are associated with an increased risk of colorectal carcinogenesis, yet the mechanistic basis of how metal-mediated signaling leads to oncogenesis remains enigmatic. Using fresh colorectal cancer samples we identify Pirin, an iron sensor, that overcomes a rate-limiting step in oncogenesis, by reactivating the dormant human telomerase reverse transcriptase (hTERT) subunit of the telomerase holoenzyme in an iron-(Fe3+)-dependent manner and thereby drives colorectal cancers. Chemical genetic screens combined with isothermal dose-response fingerprinting and mass spectrometry identified a small molecule SP2509 that specifically inhibits Pirin-mediated hTERT reactivation in colorectal cancers by competing with iron-(Fe3+) binding. Our findings, first to document how metal ions reactivate telomerase, provide a molecular mechanism for the well-known association between red meat and increased incidence of colorectal cancers. Small molecules like SP2509 represent a novel modality to target telomerase that acts as a driver of 90% of human cancers and is yet to be targeted in clinic. Significance: We show how iron-(Fe3+) in collusion with genetic factors reactivates telomerase, providing a molecular mechanism for the association between iron overload and increased incidence of colorectal cancers. Although no enzymatic inhibitors of telomerase have entered the clinic, we identify SP2509, a small molecule that targets telomerase reactivation and function in colorectal cancers.

过量食用富含铁的红肉以及遗传性或基因性铁超载与结直肠癌发生风险的增加有关,但金属介导的信号转导如何导致肿瘤发生的机理基础仍然是个谜。通过使用新鲜的结直肠癌(CRC)样本,我们发现了铁传感器 Pirin,它能以铁(Fe3+)依赖的方式重新激活端粒酶全酶中休眠的人类逆转录酶(hTERT)亚基,从而克服致癌过程中的限速步骤,并驱动 CRCs。化学遗传筛选与等温剂量反应指纹图谱和质谱分析相结合,发现了一种小分子 SP2509,它能通过与铁(Fe3+)结合竞争,特异性地抑制 Pirin 介导的 CRC 中 hTERT 的再激活。我们的发现首次记录了金属离子如何重新激活端粒酶,为众所周知的红肉与 CRC 发病率增加之间的联系提供了分子机制。像SP2509这样的小分子药物代表了一种靶向端粒酶的新方法,端粒酶是90%人类癌症的驱动因素,但在临床上尚未成为靶向药物。
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引用次数: 0
Can Ruxolitinib Crash TET2- and IDH2-Driven Clonal Hematopoiesis? Ruxolitinib能否抑制TET2-和IDH2-驱动的克隆性造血?
IF 29.7 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-04 DOI: 10.1158/2159-8290.CD-24-1020
Elmira Khabusheva, Margaret A Goodell

In this issue, Waarts and colleagues developed an advanced ex vivo CRISPR screening platform to identify vulnerabilities in clonal hematopoiesis (CH). This unique system allowed the authors to identify a link between IDH2 and TET2 CH mutations, histone demethylases, and altered cytokine signaling, which enabled targeting by ruxolitinib leading to the elimination of CH clones, offering a possible path for preventing the development of malignancy. See related article by Waarts et al., p. 1860.

在本期杂志中,Waarts及其同事开发了一种先进的体外CRISPR筛选平台,用于识别克隆造血(CH)中的漏洞。这一独特的系统使作者能够确定 IDH2 和 TET2 CH 突变、组蛋白去甲基化酶和细胞因子信号转导改变之间的联系,从而通过 ruxolitinib 靶向消除 CH 克隆,为预防恶性肿瘤的发展提供了可能的途径。参见Waarts等人的相关文章,第1860页。
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引用次数: 0
Ironing Out the Kinks: Arming Natural Killer Cells against Ovarian Cancer. 解决难题:让自然杀伤细胞对抗卵巢癌。
IF 29.7 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-04 DOI: 10.1158/2159-8290.CD-24-1012
Hannah Noelle Bell, Weiping Zou

Ameliorating the tumor immune microenvironment is a key strategy to improve the therapeutic outcomes of patients with cancer. Sandoval and colleagues demonstrate that iron chelation enhances type I IFN production, promotes NK cell tumor trafficking and activation, and synergizes with chemotherapy drug cisplatin to reduce metastatic ovarian cancer progression in murine models. See related article by Sandoval et al., p. 1901.

改善肿瘤免疫微环境是提高癌症患者治疗效果的关键策略。Sandoval 及其同事证明,螯合铁能增强 I 型 IFN 的产生,促进 NK 细胞的肿瘤迁移和激活,并与化疗药物顺铂协同作用,从而在小鼠模型中减少转移性卵巢癌的进展。请参阅 Sandoval 等人的相关文章,第 1901 页。
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引用次数: 0
CRISPR Dependency Screens in Primary Hematopoietic Stem Cells Identify KDM3B as a Genotype-specific Vulnerability in IDH2- and TET2-mutant Cells. 原代造血干细胞的 CRISPR 依赖性筛选确定了 KDM3B 在 IDH2- 和 TET2 突变细胞中的基因型特异性弱点。
IF 29.7 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-04 DOI: 10.1158/2159-8290.CD-23-1092
Michael R Waarts, Shoron Mowla, Meaghan Boileau, Anthony R Martinez Benitez, Junya Sango, Maya Bagish, Inés Fernández-Maestre, Yufan Shan, Shira E Eisman, Young C Park, Matthew Wereski, Isabelle Csete, Kavi O'Connor, Angelica C Romero-Vega, Linde A Miles, Wenbin Xiao, Xiaodi Wu, Richard P Koche, Scott A Armstrong, Alan H Shih, Eirini P Papapetrou, Jason M Butler, Sheng F Cai, Robert L Bowman, Ross L Levine

Clonal hematopoiesis (CH) is a common premalignant state in the blood and confers an increased risk of blood cancers and all-cause mortality. Identification of therapeutic targets in CH has been hindered by the lack of an ex vivo platform amenable for studying primary hematopoietic stem and progenitor cells (HSPCs). Here, we utilize an ex vivo co-culture system of HSPCs with bone marrow endothelial cells to perform CRISPR/Cas9 screens in mutant HSPCs. Our data reveal that loss of the histone demethylase family members Kdm3b and Jmjd1c specifically reduces the fitness of Idh2- and Tet2-mutant HSPCs. Kdm3b loss in mutant cells leads to decreased expression of critical cytokine receptors including Mpl, rendering mutant HSPCs preferentially susceptible to inhibition of downstream JAK2 signaling. Our study nominates an epigenetic regulator and an epigenetically regulated receptor signaling pathway as genotype-specific therapeutic targets and provides a scalable platform to identify genetic dependencies in mutant HSPCs. Significance: Given the broad prevalence, comorbidities, and risk of malignant transformation associated with CH, there is an unmet need to identify therapeutic targets. We develop an ex vivo platform to perform CRISPR/Cas9 screens in primary HSPCs. We identify KDM3B and downstream signaling components as genotype-specific dependencies in CH and myeloid malignancies. See related commentary by Khabusheva and Goodell, p. 1768.

克隆性造血(CH)是血液中一种常见的恶性前状态,会增加罹患血癌和全因死亡率的风险。由于缺乏适合研究原始造血干细胞和祖细胞(HSPCs)的体外平台,一直阻碍着对克隆性造血的治疗目标的鉴定。在这里,我们利用HSPCs与骨髓内皮细胞的体外共培养系统对突变的HSPCs进行CRISPR/Cas9筛选。我们的数据显示,组蛋白去甲基化酶家族成员Kdm3b和Jmjd1c的缺失会特异性地降低Idh2-和Tet2-突变HSPCs的适应性。突变细胞中 Kdm3b 的缺失会导致包括 Mpl 在内的关键细胞因子受体的表达减少,从而使突变的 HSPCs 更容易受到下游 JAK2 信号的抑制。我们的研究将一种表观遗传调节因子和一种受表观遗传调节的受体信号通路提名为基因型特异性治疗靶点,并提供了一个可扩展的平台来鉴定突变 HSPC 的遗传依赖性。
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引用次数: 0
Targeting Acute Myeloid Leukemia Stem Cells through Perturbation of Mitochondrial Calcium. 通过干扰线粒体钙来靶向急性髓性白血病干细胞
IF 29.7 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-04 DOI: 10.1158/2159-8290.CD-23-1145
Anagha Inguva Sheth, Mark J Althoff, Hunter Tolison, Krysta Engel, Maria L Amaya, Anna E Krug, Tracy N Young, Mohammad Minhajuddin, Shanshan Pei, Sweta B Patel, Amanda Winters, Regan Miller, Ian T Shelton, Jonathan St-Germain, Tianyi Ling, Courtney L Jones, Brian Raught, Austin E Gillen, Monica Ransom, Sarah Staggs, Clayton A Smith, Daniel A Pollyea, Brett M Stevens, Craig T Jordan

Acute myeloid leukemia stem cells (LSCs) are uniquely reliant on oxidative phosphorylation (OXPHOS) for survival. Moreover, maintenance of OXPHOS is dependent on BCL-2, creating a therapeutic opportunity to target LSCs using the BCL-2 inhibitor venetoclax. Although venetoclax-based regimens have shown promising clinical activity, the emergence of drug resistance is prevalent. Thus, in the present study, we investigated how mitochondrial properties may influence venetoclax responsiveness. Our data show that utilization of mitochondrial calcium is fundamentally different between drug-responsive and nonresponsive LSCs. By comparison, venetoclax-resistant LSCs demonstrate an active metabolic (i.e., OXPHOS) status with relatively high levels of calcium. Consequently, we tested genetic and pharmacological approaches to target the mitochondrial calcium uniporter. We demonstrate that inhibition of calcium uptake reduces OXPHOS and leads to eradication of venetoclax-resistant LSCs. These findings demonstrate a central role for calcium signaling in LSCs and provide an avenue for clinical management of venetoclax resistance. Significance: We identify increased utilization of mitochondrial calcium as a distinct metabolic requirement of venetoclax-resistant LSCs and demonstrate the potential of targeting mitochondrial calcium uptake as a therapeutic strategy.

急性髓性白血病干细胞(LSCs)的生存独特地依赖于氧化磷酸化(OXPHOS)。此外,OXPHOS的维持依赖于BCL-2,这为使用BCL-2抑制剂venetoclax靶向LSCs创造了治疗机会。虽然以 venetoclax 为基础的治疗方案已显示出良好的临床活性,但耐药性的出现却十分普遍。因此,在本研究中,我们研究了线粒体特性如何影响 Venetoclax 的反应性。我们的数据显示,对药物有反应的 LSCs 和无反应的 LSCs 对线粒体钙的利用有本质区别。相比之下,耐药 LSCs 的代谢(即 OXPHOS)状态更活跃,钙含量相对较高。因此,我们测试了针对线粒体钙离子通道 MCU 的基因和药理学方法。我们证明,抑制钙的摄取会降低 OXPHOS,从而根除对 venetoclax 耐药的 LSCs。这些发现证明了钙信号在LSCs中的核心作用,并为Venetoclax耐药的临床治疗提供了一条途径。
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引用次数: 0
Biologic and Clinical Analysis of Childhood Gamma Delta T-ALL Identifies LMO2/STAG2 Rearrangements as Extremely High Risk. 儿童γδT-ALL的生物学和临床分析确定LMO2/STAG2重排为极高风险。
IF 29.7 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-04 DOI: 10.1158/2159-8290.CD-23-1452
Shunsuke Kimura, Chun Shik Park, Lindsey E Montefiori, Ilaria Iacobucci, Petri Pölönen, Qingsong Gao, Elizabeth D Arnold, Andishe Attarbaschi, Anthony Brown, Barbara Buldini, Kenneth J Caldwell, Yunchao Chang, Chelsey Chen, Cheng Cheng, Zhongshan Cheng, John Choi, Valentino Conter, Kristine R Crews, Hester A de Groot-Kruseman, Takao Deguchi, Mariko Eguchi, Hannah E Muhle, Sarah Elitzur, Gabriele Escherich, Burgess B Freeman, Zhaohui Gu, Katie Han, Keizo Horibe, Toshihiko Imamura, Sima Jeha, Motohiro Kato, Kean H Chiew, Tanya Khan, Michal Kicinski, Stefan Köhrer, Steven M Kornblau, Rishi S Kotecha, Chi-Kong Li, Yen-Chun Liu, Franco Locatelli, Selina M Luger, Elisabeth M Paietta, Atsushi Manabe, Hanne V Marquart, Riccardo Masetti, Mellissa Maybury, Pauline Mazilier, Jules P P Meijerink, Sharnise Mitchell, Takako Miyamura, Andrew S Moore, Koichi Oshima, Katarzyna Pawinska-Wasikowska, Rob Pieters, Mollie S Prater, Shondra M Pruett-Miller, Ching-Hon Pui, Chunxu Qu, Michaela Reiterova, Noemi Reyes, Kathryn G Roberts, Jacob M Rowe, Atsushi Sato, Kjeld Schmiegelow, Martin Schrappe, Shuhong Shen, Szymon Skoczeń, Orietta Spinelli, Jan Stary, Michael Svaton, Masatoshi Takagi, Junko Takita, Yanjing Tang, David T Teachey, Paul G Thomas, Daisuke Tomizawa, Jan Trka, Elena Varotto, Tiffaney L Vincent, Jun J Yang, Allen E J Yeoh, Yinmei Zhou, Martin Zimmermann, Hiroto Inaba, Charles G Mullighan

Acute lymphoblastic leukemia expressing the gamma delta T-cell receptor (γδ T-ALL) is a poorly understood disease. We studied 200 children with γδ T-ALL from 13 clinical study groups to understand the clinical and genetic features of this disease. We found age and genetic drivers were significantly associated with outcome. γδ T-ALL diagnosed in children under 3 years of age was extremely high-risk and enriched for genetic alterations that result in both LMO2 activation and STAG2 inactivation. Mechanistically, using patient samples and isogenic cell lines, we show that inactivation of STAG2 profoundly perturbs chromatin organization by altering enhancer-promoter looping, resulting in deregulation of gene expression associated with T-cell differentiation. High-throughput drug screening identified a vulnerability in DNA repair pathways arising from STAG2 inactivation, which can be targeted by poly(ADP-ribose) polymerase inhibition. These data provide a diagnostic framework for classification and risk stratification of pediatric γδ T-ALL. Significance: Patients with acute lymphoblastic leukemia expressing the gamma delta T-cell receptor under 3 years old or measurable residual disease ≥1% at end of induction showed dismal outcomes and should be classified as having high-risk disease. The STAG2/LMO2 subtype was enriched in this very young age group. STAG2 inactivation may perturb chromatin conformation and cell differentiation and confer vulnerability to poly(ADP-ribose) polymerase inhibition.

表达γδT细胞受体的急性淋巴细胞白血病(yo T-ALL)是一种鲜为人知的疾病。我们对来自 13 个临床研究小组的 200 名yo T-ALL 儿童进行了研究,以了解这种疾病的临床和遗传特征。我们发现年龄和遗传驱动因素与预后密切相关。三岁以下儿童确诊的yo T-ALL风险极高,且富含导致LMO2活化和STAG2失活的遗传改变。从机理上讲,我们利用患者样本和同源细胞系表明,STAG2 失活会通过改变增强子-启动子环路来严重扰乱染色质组织,导致与 T 细胞分化相关的基因表达失调。高通量药物筛选发现了 STAG2 失活导致的 DNA 修复通路中的一个薄弱环节,聚(ADP-核糖)聚合酶(PARP)抑制剂可针对该薄弱环节进行治疗。这些数据为小儿yo T-ALL的分类和风险分层提供了诊断框架。
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引用次数: 0
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Cancer discovery
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