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Splicing modulation sensitizes chronic lymphocytic leukemia cells to venetoclax by remodeling mitochondrial apoptotic dependencies
Elisa ten Hacken, Rebecca Valentin, Fara Faye D. Regis, Jing Sun, Shanye Yin, Lillian Werner, Jing Deng, Michaela Gruber, Jessica Wong, Mei Zheng, Amy L. Gill, Michael Seiler, Peter Smith, Michael Thomas, Silvia Buonamici, Emanuela M. Ghia, Ekaterina Kim, Laura Z. Rassenti, Jan A. Burger, Thomas J. Kipps, Matthew L. Meyerson, Pavan Bachireddy, Lili Wang, Robin Reed, Donna Neuberg, Ruben D. Carrasco, Angela N. Brooks, Anthony Letai, Matthew S. Davids, Catherine J. Wu
Elisa ten Hacken, Rebecca Valentin, Fara Faye D. Regis, Jing Sun, Shanye Yin, Lillian Werner, Jing Deng, Michaela Gruber, Jessica Wong, Mei Zheng, Amy L. Gill, Michael Seiler, Peter Smith, Michael Thomas, Silvia Buonamici, Emanuela M. Ghia, Ekaterina Kim, Laura Z. Rassenti, Jan A. Burger, Thomas J. Kipps, Matthew L. Meyerson, Pavan Bachireddy, Lili Wang, Robin Reed, Donna Neuberg, Ruben D. Carrasco, Angela N. Brooks, Anthony Letai, Matthew S. Davids, Catherine J. Wu
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Research Article Hematology Therapeutics

Splicing modulation sensitizes chronic lymphocytic leukemia cells to venetoclax by remodeling mitochondrial apoptotic dependencies

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Abstract

The identification of targetable vulnerabilities in the context of therapeutic resistance is a key challenge in cancer treatment. We detected pervasive aberrant splicing as a characteristic feature of chronic lymphocytic leukemia (CLL), irrespective of splicing factor mutation status, which was associated with sensitivity to the spliceosome modulator, E7107. Splicing modulation affected CLL survival pathways, including members of the B cell lymphoma-2 (BCL2) family of proteins, remodeling antiapoptotic dependencies of human and murine CLL cells. E7107 treatment decreased myeloid cell leukemia-1 (MCL1) dependence and increased BCL2 dependence, sensitizing primary human CLL cells and venetoclax-resistant CLL-like cells from an Eμ-TCL1–based adoptive transfer murine model to treatment with the BCL2 inhibitor venetoclax. Our data provide preclinical rationale to support the combination of venetoclax with splicing modulators to reprogram apoptotic dependencies in CLL for treating venetoclax-resistant CLL cases.

Authors

Elisa ten Hacken, Rebecca Valentin, Fara Faye D. Regis, Jing Sun, Shanye Yin, Lillian Werner, Jing Deng, Michaela Gruber, Jessica Wong, Mei Zheng, Amy L. Gill, Michael Seiler, Peter Smith, Michael Thomas, Silvia Buonamici, Emanuela M. Ghia, Ekaterina Kim, Laura Z. Rassenti, Jan A. Burger, Thomas J. Kipps, Matthew L. Meyerson, Pavan Bachireddy, Lili Wang, Robin Reed, Donna Neuberg, Ruben D. Carrasco, Angela N. Brooks, Anthony Letai, Matthew S. Davids, Catherine J. Wu

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Figure 4

Splicing modulation sensitizes CLL cells to venetoclax by reducing MCL1 and increasing BCL2 dependence.

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Splicing modulation sensitizes CLL cells to venetoclax by reducing MCL1 ...
(A) Heatmap of percentage cytochrome c loss, as quantified by flow cytometry on 14 CLL samples after overnight treatment with 3 nM E7107 or DMSO in the presence of NK-TERT stromal support (cyan, lowest value; yellow, highest value). Images from left to right refer to overall priming (PUMA 1 μM), BCL2 dependence (BAD 1 μM), MCL1 dependence (MS1 5 μM), BCLxL dependence (HRK 1 μM), and BFL1 dependence (FS1 5 μM). Reported P values were calculated by Wilcoxon signed-rank test. A representation of the data with samples subdivided based on SF3B1 mutation status is provided in Supplemental Figure 4. (B) Normalized viability values as a percentage of the untreated control of 26 CLL samples after 8-hour treatment with 1 nM E7107 and/or 1 nM venetoclax in the absence of stromal support or 20-hour treatment of 12 CLL samples with 3 nM E7107 and/or 1 nM venetoclax in the presence of stromal support by NK-TERT. Reported P values were calculated by 1-way ANOVA with Scheffé’s correction for multiple comparisons. (C) Linear regression of Δ increase in BAD-mediated cytochrome c (Cyt-c) loss (y axis) and Δ increase in cell death of 8 CLL samples after treatment with E7107 and venetoclax (E+V) as compared with venetoclax treatment alone (V) (x axis). Spearman correlation R and P values are indicated in the figure. (D) Western blot analysis of MCL1, BCL2, PARP, and cleaved PARP protein levels before and after treatment with E7107, venetoclax, or the combination of both on 4 CLL samples (CLL7, CLL9, CLL17, CLL28) in the presence of NK-TERT stroma. β-Actin was used as loading control. Treatment conditions were the same as those in B. Molecular weights (in kDa) are indicated in the figure.

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