Targeting the epichaperome as an effective precision medicine approach in a novel PML-SYK fusion acute myeloid leukemia

Abstract The epichaperome is a new cancer target composed of hyperconnected networks of chaperome members that facilitate cell survival. Cancers with an altered chaperone configuration may be susceptible to epichaperome inhibitors. We developed a flow cytometry-based assay for evaluation and monitor...

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Main Authors: Mayumi Sugita, David C. Wilkes, Rohan Bareja, Kenneth W. Eng, Sarah Nataraj, Reyna A. Jimenez-Flores, LunBiao Yan, Jeanne Pauline De Leon, Jaclyn A. Croyle, Justin Kaner, Swathi Merugu, Sahil Sharma, Theresa Y. MacDonald, Zohal Noorzad, Palak Panchal, Danielle Pancirer, Shuhua Cheng, Jenny Z. Xiang, Luke Olson, Koen Van Besien, David S. Rickman, Susan Mathew, Wayne Tam, Mark A. Rubin, Himisha Beltran, Andrea Sboner, Duane C. Hassane, Gabriela Chiosis, Olivier Elemento, Gail J. Roboz, Juan Miguel Mosquera, Monica L. Guzman
Format: article
Language:EN
Published: Nature Portfolio 2021
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Online Access:https://doaj.org/article/9b26f08bf6d444edb5f3140c7fcddf4c
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Summary:Abstract The epichaperome is a new cancer target composed of hyperconnected networks of chaperome members that facilitate cell survival. Cancers with an altered chaperone configuration may be susceptible to epichaperome inhibitors. We developed a flow cytometry-based assay for evaluation and monitoring of epichaperome abundance at the single cell level, with the goal of prospectively identifying patients likely to respond to epichaperome inhibitors, to measure target engagement, and dependency during treatment. As proof of principle, we describe a patient with an unclassified myeloproliferative neoplasm harboring a novel PML-SYK fusion, who progressed to acute myeloid leukemia despite chemotherapy and allogeneic stem cell transplant. The leukemia was identified as having high epichaperome abundance. We obtained compassionate access to an investigational epichaperome inhibitor, PU-H71. After 16 doses, the patient achieved durable complete remission. These encouraging results suggest that further investigation of epichaperome inhibitors in patients with abundant baseline epichaperome levels is warranted.