Abstract
Multiagent combination chemotherapy can be curative in acute lymphoblastic leukemia (ALL). Still, patients with primary refractory disease or with relapsed leukemia have a very poor prognosis. Here we integrate an in-depth dissection of the mutational landscape across diagnostic and relapsed pediatric and adult ALL samples with genome-wide CRISPR screen analysis of gene–drug interactions across seven ALL chemotherapy drugs. By combining these analyses, we uncover diagnostic and relapse-specific mutational mechanisms as well as genetic drivers of chemoresistance. Functionally, our data identify common and drug-specific pathways modulating chemotherapy response and underscore the effect of drug combinations in restricting the selection of resistance-driving genetic lesions. In addition, by identifying actionable targets for the reversal of chemotherapy resistance, these analyses open therapeutic opportunities for the treatment of relapse and refractory disease.
Original language | English (US) |
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Pages (from-to) | 1113-1127 |
Number of pages | 15 |
Journal | Nature Cancer |
Volume | 1 |
Issue number | 11 |
DOIs | |
State | Published - Nov 2020 |
Bibliographical note
Publisher Copyright:© 2020, The Author(s), under exclusive licence to Springer Nature America, Inc.