AI Article Synopsis
- Drug resistance in acute myeloid leukemia (AML) limits the effectiveness of targeted therapies like FLT3 inhibitors, which is common in about 25% of AML patients with FLT3 mutations.
- A CRISPR screen revealed that specific genes (LZTR1, NF1, TSC1, TSC2) are involved in the resistance to sorafenib, highlighting the role of the MAPK and MTOR pathways.
- Combining FLT3 inhibitors with MEK inhibitors has shown promise in overcoming resistance in AML patients, suggesting a potential new treatment approach.
Article Abstract
Drug resistance impedes the long-term effect of targeted therapies in acute myeloid leukemia (AML), necessitating the identification of mechanisms underlying resistance. Approximately 25% of AML patients carry FLT3 mutations and develop post-treatment insensitivity to FLT3 inhibitors, including sorafenib. Using a genome-wide CRISPR screen, we identified LZTR1, NF1, TSC1 or TSC2, negative regulators of the MAPK and MTOR pathways, as mediators of sorafenib resistance. Analyses of ex vivo drug sensitivity assays in FLT3-ITD AML patient samples revealed lower expression of LZTR1, NF1, and TSC2 correlated with sorafenib sensitivity. Importantly, MAPK and/or MTOR complex1 (MTORC1) activity were upregulated in AML cells made resistant to several FLT3 inhibitors, including crenolanib, quizartinib, or sorafenib. These cells were sensitive to MEK inhibitors, and the combination of FLT3 and MEK inhibitors showed enhanced efficacy, suggesting its effectiveness in AML patients with FLT3 mutations and those with resistance to FLT3 inhibitors.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719098 | PMC |
| http://dx.doi.org/10.3324/haematol.2020.257964 | DOI Listing |
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