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Le Q, Hadland B, Smith JL, Leonti A, Huang BJ, Ries R, Hylkema TA, Castro S, Tang TT, McKay CN, Perkins L, Pardo L, Sarthy J, Beckman AK, Williams R, Idemmili R, Furlan S, Ishida T, Call L, Srivastava S, Loeb AM, Milano F, Imren S, Morris SM, Pakiam F, Olson JM, Loken MR, Eidenschink Brodersen L, Riddell SR, Tarlock K, Bernstein ID, Loeb KR, Meshinchi S. CBFA2T3-GLIS2 model of pediatric acute megakaryoblastic leukemia identifies FOLR1 as a CAR T cell target. J Clin Invest 2022; 132:157101. [PMID: 36136600 DOI: 10.1172/jci157101] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022] Open
Abstract
Fusion oncoproteins are the initiating event in the pathogenesis of many pediatric AML. The CBFA2T3-GLIS2 (C/G) fusion is a product of a cryptic translocation primarily seen in infants and early childhood and is associated with dismal outcome. Here, we demonstrate that the expression of the C/G oncogenic fusion protein promotes the transformation of human cord blood hematopoietic stem/progenitor cells (CB HSPCs) in an endothelial cell (EC) co-culture system, that recapitulates the transcriptome, morphology and immunophenotype of C/G AML and induces highly aggressive leukemia in xenograft models. Interrogating the transcriptome of C/G-CB cells and primary C/G AML identified a library of C/G fusion-specific genes that are potential targets for therapy. We developed chimeric antigen receptor (CAR) T cells directed against one of the targets, FOLR1, and demonstrated their pre-clinical efficacy against C/G AML using in vitro and xenograft models. FOLR1 is also expressed in renal and pulmonary epithelium, raising concerns for toxicity that must be addressed for the clinical application of this therapy. Our findings underscore the role of the endothelial niche in promoting leukemic transformation of C/G-transduced CB HSPCs. Furthermore, this work has broad implications for studies of leukemogenesis applicable to a variety of oncogenic fusion-driven pediatric leukemias, providing a robust and tractable model system to characterize the molecular mechanisms of leukemogenesis and identify biomarkers for disease diagnosis and targets for therapy.
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Affiliation(s)
- Quy Le
- Clincial Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Brandon Hadland
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Jenny L Smith
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Amanda Leonti
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Benjamin J Huang
- Department of Pediatrics, University of California, San Francisco, San Francisco, United States of America
| | - Rhonda Ries
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Tiffany A Hylkema
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Sommer Castro
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Thao T Tang
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Cyd N McKay
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - LaKeisha Perkins
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Laura Pardo
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Jay Sarthy
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Amy K Beckman
- Department of Laboratory Medicine and Pathology, The University of Minnesota, Minneapolis, United States of America
| | - Robin Williams
- Department of Laboratory Medicine and Pathology, The University of Minnesota, Minneapolis, United States of America
| | - Rhonda Idemmili
- Department of Laboratory Medicine and Pathology, The University of Minnesota, Minneapolis, United States of America
| | - Scott Furlan
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Takashi Ishida
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Lindsey Call
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Shivani Srivastava
- Program in Immunology, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Anisha M Loeb
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Filippo Milano
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Suzan Imren
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Shelli M Morris
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, United States of America
| | - Fiona Pakiam
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Insitute, Seattle, United States of America
| | - James M Olson
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Insitute, Seattle, United States of America
| | | | | | - Stanley R Riddell
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Katherine Tarlock
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Irwin D Bernstein
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Keith R Loeb
- Department of Pathology, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Soheil Meshinchi
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
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