Targeting the mevalonate or Wnt pathways to overcome CAR T-cell resistance in TP53-mutant AML cells




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

PublisherWiley-Blackwell

2024

 Embo molecular medicine

EMBO Molecular Medicine

16

3

445

474

1757-4684

DOIhttps://doi.org/10.1038/s44321-024-00024-2

https://www.embopress.org/doi/abs/10.1038/s44321-024-00024-2

https://research.utu.fi/converis/portal/detail/Publication/387308279



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.


Last updated on 17/02/2026 02:42:37 PM