Session: 631. Myeloproliferative Syndromes and Chronic Myeloid Leukemia: Basic and Translational: Poster III
Hematology Disease Topics & Pathways:
Research, Combination therapy, Translational Research, MPN, Drug development, Chronic Myeloid Malignancies, Diseases, Treatment Considerations, Myeloid Malignancies, Biological Processes, Molecular biology, Technology and Procedures, Omics technologies
Bomedemstat, a small molecule inhibitor of the histone demethylase LSD1 (KDM1A), has recently evolved as a promising new therapeutic tool in MPN. In clinical trials Bomedemstat showed disease modifying activity reducing both MPN symptoms and clonal burden in a significant number of patients. Whether LSD1-inhibitors retain their ability to modify clonal fitness during progression to blast-phase remains unknown.
We aimed to identify cooperative epigenetic modifiers using a chromatin-focused CRISPR-Cas9 screen. Therefore, we transduced Human Erythroleukemia (HEL) cells, a model for JAK2-mutated blast-phase MPN, with Cas9 and a library of 7856 sgRNAs targeting 719 chromatin-related genes. The cells were then treated with Bomedemstat (100nM), the LSD1-inhibitor GSK2879552 (100nM) or DMSO as diluent control. Of note, the histone methyltransferase DOT1L showed strong synthetic lethal activity with both LSD1-inhibitors. DOT1L catalyzes histone 3 lysine 79 methylation (H3K79me) at transcriptionally active genes and has been shown to be an essential component of an oncogenic chromatin complex in MLL (KMT2A)-rearranged acute leukemia. Hence, we aimed to define the role of DOT1L in blast-phase MPN. CRISPR-Cas9 mediated knockout of DOT1L led to a significant reduction in cellular fitness of HEL cells reflected by a reduced proliferation rate (doubling times: 30h in WT vs. 49h in DOT1L-ko). Furthermore, NXG mice transplanted with DOT1L-ko cells showed a prolonged survival (median survival: 107d for DOT1L-ko (n=7) vs. NT-control (n=4), p<0.001) and a reduction of disease penetrance with 40% of animals not developing blast-phase MPN. Interestingly, the genes regulated by DOT1L in HEL cells differ from those in MLL-rearranged AML, including several JAK-signaling targets (e.g. MPL, JAK1, DUSP6, YBX1, CDK4, CDK6, MYC).
To validate the synthetic lethal interaction between DOT1L and LSD1 we treated DOT1L-ko cells with Bomedemstat or GSK2879552 and discovered a 100-fold increase in drug sensitivity compared to WT cells (MTS-assay). This cooperative effect was caused by an increase in apoptosis (Annexin V, DOT1L-ko+DMSO: 23% vs. DOT1L-ko+Bomedemstat: 39%, p=0.003) and a blockade of S-phase entry (EDU-assay, DOT1L-ko+DMSO: 37.6% vs. DOT1L-ko+Bomedemstat: 8.5%, p<0.001). In RNAseq, LSD1-inhibitor treatment led to a strong repression of cell cycle mediators and an induction of apoptosis-related genes only in DOT1L-ko cells (DESeq2, padj<0.05, FC>2). ChiPseq revealed that most regions at which LSD1 was bound, were co-occupied by DOT1L. Those regions were marked with H3K4me1 and had accessible chromatin indicating LSD1-binding to enhancers. After knockout of DOT1L, chromatin accessibility at those enhancers decreased significantly demonstrating a so far unrecognized role of DOT1L in controlling enhancer activation. Strikingly, most of the LSD1-DOT1L co-occupied enhancers lacked H3K79me2 indicating that DOT1L’s function at these sites is independent of its enzymatic activity. Consistent with this observation, treatment of the MPN blast-phase cell lines HEL or SET2 with LSD1-inhibitors in combination with the DOT1L-inhibitor EPZ5676 only showed a modest cooperative effect.
In summary, our work demonstrates functional cooperativity between DOT1L and LSD1 in blast-phase MPN. This cooperation is caused by orchestrated binding of DOT1L and LSD1 at selected enhancer regions and is independent of DOT1L’s enzymatic activity. This non-canonical function of DOT1L in blast-phase MPN provides a strong rationale for the development of targeted protein degraders (PROTACs) of DOT1L to exploit these findings therapeutically.
Disclosures: Heidel: BMS/Celgene, Novartis, CTI: Research Funding; BMS/Celgene, AOP, Novartis, CTI, Janssen, Abbvie, GSK, Merck, Kartos, Telios: Consultancy. Perner: Syndax: Other: Travel support.