A1 Refereed original research article in a scientific journal
Targeting the mevalonate or Wnt pathways to overcome CAR T-cell resistance in TP53-mutant AML cells
Authors: Mueller, Jan; Schimmer, Roman R.; Koch, Christian; Schneiter, Florin; Fullin, Jonas; Lysenko, Veronika; Pellegrino, Christian; Klemm, Nancy; Russkamp, Norman; Myburgh, Renier; Volta, Laura; Theocharides, Alexandre P. A.; Kurppa, Kari J.; Ebert, Benjamin L.; Schroeder, Timm; Manz, Markus G.; Boettcher, Steffen
Publisher: Wiley-Blackwell
Publication year: 2024
Journal: Embo molecular medicine
Journal name in source: EMBO Molecular Medicine
Volume: 16
Issue: 3
First page : 445
Last page: 474
eISSN: 1757-4684
DOI: https://doi.org/10.1038/s44321-024-00024-2
Publication's open availability at the time of reporting: Open Access
Publication channel's open availability : Open Access publication channel
Web address : https://www.embopress.org/doi/abs/10.1038/s44321-024-00024-2
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/387308279
Self-archived copy's licence: CC BY
Self-archived copy's version: Publisher`s PDF
TP53-mutant acute myeloid leukemia (AML) and myelodysplastic neoplasms (MDS) are characterized by chemotherapy resistance and represent an unmet clinical need. Chimeric antigen receptor (CAR) T-cells might be a promising therapeutic option for TP53-mutant AML/MDS. However, the impact of TP53 deficiency in AML cells on the efficacy of CAR T-cells is unknown. We here show that CAR T-cells engaging TP53-deficient leukemia cells exhibit a prolonged interaction time, upregulate exhaustion markers, and are inefficient to control AML cell outgrowth in vitro and in vivo compared to TP53 wild-type cells. Transcriptional profiling revealed that the mevalonate pathway is upregulated in TP53-deficient AML cells under CAR T-cell attack, while CAR T-cells engaging TP53-deficient AML cells downregulate the Wnt pathway. In vitro rational targeting of either of these pathways rescues AML cell sensitivity to CAR T-cell-mediated killing. We thus demonstrate that TP53 deficiency confers resistance to CAR T-cell therapy and identify the mevalonate pathway as a therapeutic vulnerability of TP53-deficient AML cells engaged by CAR T-cells, and the Wnt pathway as a promising CAR T-cell therapy-enhancing approach for TP53-deficient AML/MDS.
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