Abstract:
:Anaplastic large cell lymphoma (ALCL) is a T-cell malignancy predominantly driven by a hyperactive anaplastic lymphoma kinase (ALK) fusion protein. ALK inhibitors, such as crizotinib, provide alternatives to standard chemotherapy with reduced toxicity and side effects. Children with lymphomas driven by nucleophosmin 1 (NPM1)-ALK fusion proteins achieved an objective response rate to ALK inhibition therapy of 54% to 90% in clinical trials; however, a subset of patients progressed within the first 3 months of treatment. The mechanism for the development of ALK inhibitor resistance is unknown. Through genome-wide clustered regularly interspaced short palindromic repeats (CRISPR) activation and knockout screens in ALCL cell lines, combined with RNA sequencing data derived from ALK inhibitor-relapsed patient tumors, we show that resistance to ALK inhibition by crizotinib in ALCL can be driven by aberrant upregulation of interleukin 10 receptor subunit alpha (IL10RA). Elevated IL10RA expression rewires the STAT3 signaling pathway, bypassing otherwise critical phosphorylation by NPM1-ALK. IL-10RA expression does not correlate with response to standard chemotherapy in pediatric patients, suggesting that a combination of crizotinib and chemotherapy could prevent ALK inhibitor resistance-specific relapse.
journal_name
Bloodjournal_title
Bloodauthors
Prokoph N,Probst NA,Lee LC,Monahan JM,Matthews JD,Liang HC,Bahnsen K,Montes-Mojarro IA,Karaca-Atabay E,Sharma GG,Malik V,Larose H,Forde SD,Ducray SP,Lobello C,Wang Q,Luan SL,Pospíšilová Š,Gambacorti-Passerini C,Burkdoi
10.1182/blood.2019003793subject
Has Abstractpub_date
2020-10-01 00:00:00pages
1657-1669issue
14eissn
0006-4971issn
1528-0020pii
461097journal_volume
136pub_type
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