Detalle Publicación

Biallelic TET2 mutations confer sensitivity to 5 '-azacitidine in acute myeloid leukemia

Autores: Stoelzel, F. (Autor de correspondencia); Fordham, S. E.; Nandana, D.; Lin, W. Y.; Blair, H.; Elstob, C.; Bell, H. L.; Mohr, B.; Ruhnke, L.; Kunadt, D.; Dill, C.; Allsop, D.; Piddock, R.; Soura, E. N.; Park, C.; Fadly, M.; Rahman, T.; Alharbi, A.; Wobus, M.; Altmann, H.; Roellig, C.; Wagenfuehr, L.; Jones, G. L.; Menne, T.; Jackson, G. H.; Marr, H. J.; Fitzgibbon, J.; Onel, K.; Meggendorfer, M.; Robinson, A.; Bziuk, Z.; Bowes, E.; Heidenreich, O.; Haferlach, T.; Villar Fernández, Sara; Ariceta Ganuza, Beñat; Ayala-Díaz, R.; Altschuler, S. J.; Wu, L. F.; Prosper Cardoso, Felipe; Montesinos, P.; Martínez-López, J.; Bornhaeuser, M.; Allan, J. M. (Autor de correspondencia)
Título de la revista: JCI INSIGHT
ISSN: 2379-3708
Volumen: 8
Número: 2
Páginas: e150368
Fecha de publicación: 2023
Precision medicine can significantly improve outcomes for patients with cancer, but implementation requires comprehensive characterization of tumor cells to identify therapeutically exploitable vulnerabilities. Here, we describe somatic biallelic TET2 mutations in an elderly patient with acute myeloid leukemia (AML) that was chemoresistant to anthracycline and cytarabine but acutely sensitive to 5 '-azacitidine (5 '-Aza) hypomethylating monotherapy, resulting in long-term morphological remission. Given the role of TET2 as a regulator of genomic methylation, we hypothesized that mutant TET2 allele dosage affects response to 5 '-Aza. Using an isogenic cell model system and an orthotopic mouse xenograft, we demonstrate that biallelic TET2 mutations confer sensitivity to 5 '-Aza compared with cells with monoallelic mutations. Our data argue in favor of using hypomethylating agents for chemoresistant disease or as first-line therapy in patients with biallelic TET2-mutated AML and demonstrate the importance of considering mutant allele dosage in the implementation of precision medicine for patients with cancer.