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Constitutive Activation of RAS/MAPK Pathway Cooperates with Trisomy 21 and Is Therapeutically Exploitable in Down Syndrome B-cell Leukemia.


ABSTRACT:

Purpose

Children with Down syndrome (constitutive trisomy 21) that develop acute lymphoblastic leukemia (DS-ALL) have a 3-fold increased likelihood of treatment-related mortality coupled with a higher cumulative incidence of relapse, compared with other children with B-cell acute lymphoblastic leukemia (B-ALL). This highlights the lack of suitable treatment for Down syndrome children with B-ALL.

Experimental design

To facilitate the translation of new therapeutic agents into clinical trials, we built the first preclinical cohort of patient-derived xenograft (PDX) models of DS-ALL, comprehensively characterized at the genetic and transcriptomic levels, and have proven its suitability for preclinical studies by assessing the efficacy of drug combination between the MEK inhibitor trametinib and conventional chemotherapy agents.

Results

Whole-exome and RNA-sequencing experiments revealed a high incidence of somatic alterations leading to RAS/MAPK pathway activation in our cohort of DS-ALL, as well as in other pediatric B-ALL presenting somatic gain of the chromosome 21 (B-ALL+21). In murine and human B-cell precursors, activated KRASG12D functionally cooperates with trisomy 21 to deregulate transcriptional networks that promote increased proliferation and self renewal, as well as B-cell differentiation blockade. Moreover, we revealed that inhibition of RAS/MAPK pathway activation using the MEK1/2 inhibitor trametinib decreased leukemia burden in several PDX models of B-ALL+21, and enhanced survival of DS-ALL PDX in combination with conventional chemotherapy agents such as vincristine.

Conclusions

Altogether, using novel and suitable PDX models, this study indicates that RAS/MAPK pathway inhibition represents a promising strategy to improve the outcome of Down syndrome children with B-cell precursor leukemia.

SUBMITTER: Laurent AP 

PROVIDER: S-EPMC7334063 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Constitutive Activation of RAS/MAPK Pathway Cooperates with Trisomy 21 and Is Therapeutically Exploitable in Down Syndrome B-cell Leukemia.

Laurent Anouchka P AP   Siret Aurélie A   Ignacimouttou Cathy C   Panchal Kunjal K   Diop M'Boyba M   Jenni Silvia S   Tsai Yi-Chien YC   Roos-Weil Damien D   Aid Zakia Z   Prade Nais N   Lagarde Stephanie S   Plassard Damien D   Pierron Gaelle G   Daudigeos Estelle E   Lecluse Yann Y   Droin Nathalie N   Bornhauser Beat C BC   Cheung Laurence C LC   Crispino John D JD   Gaudry Muriel M   Bernard Olivier A OA   Macintyre Elizabeth E   Barin Bonnigal Carole C   Kotecha Rishi S RS   Geoerger Birgit B   Ballerini Paola P   Bourquin Jean-Pierre JP   Delabesse Eric E   Mercher Thomas T   Malinge Sebastien S  

Clinical cancer research : an official journal of the American Association for Cancer Research 20200327 13


<h4>Purpose</h4>Children with Down syndrome (constitutive trisomy 21) that develop acute lymphoblastic leukemia (DS-ALL) have a 3-fold increased likelihood of treatment-related mortality coupled with a higher cumulative incidence of relapse, compared with other children with B-cell acute lymphoblastic leukemia (B-ALL). This highlights the lack of suitable treatment for Down syndrome children with B-ALL.<h4>Experimental design</h4>To facilitate the translation of new therapeutic agents into clini  ...[more]

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