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Identifying Targeted Therapies for CBFA2T3::GLIS2 Acute Myeloid Leukemia

Published inLeukemia, vol. 40, no. 2, p. 383-396
Publication date2026-02
First online date2026-01-08
Abstract

CBFA2T3::GLIS2-positive pediatric acute myeloid leukemia (AML) remains one of the worst prognostic AML subgroups. To uncover innovative targeted therapy approaches in this disease subtype we performed genome-scale CRISPR-Cas9 screening that highlighted a strong, selective dependency on JAK2 compared to other types of cancer. Using a doxycycline-inducible JAK2 knockout (KO) system, we validated JAK2 dependency in CBFA2T3::GLIS2 cell lines, observing impaired proliferation in vitro and in vivo and apoptosis induction in vitro. Both type I (ruxolitinib) and type II (CHZ868) JAK2 inhibitors showed selective in vitro activity in CBFA2T3::GLIS2-positive AML models. To identify resistance and sensitizer mechanisms to JAK2 inhibitors, we used CRISPR-Cas9 ruxolitinib anchor screening in CBFA2T3::GLIS2 AML. sgRNAs targeting negative regulators of the MAPK pathway were enriched in the ruxolitinib-treated cells. Similarly, CBFA2T3::GLIS2 AML sublines grown to resistance under chronic ruxolitinib treatment expressed pathogenic NRAS mutations. Both approaches converged on MAPK pathway activation as a resistance mechanism to ruxolitinib treatment. Combining ruxolitinib with MEK inhibitors showed a synergistic effect in cell lines and patient-derived xenograft (PDX) cells expressing the fusion and in vivo activity in a CBFA2T3::GLIS2 AML PDX, suggesting a potential approach to target this signaling circuitry in this poor outcome AML subtype.

Keywords
  • Animals
  • Apoptosis
  • CRISPR-Cas Systems
  • Cell Line, Tumor
  • Cell Proliferation
  • Drug Resistance, Neoplasm
  • Humans
  • Janus Kinase 2 / antagonists & inhibitors
  • Janus Kinase 2 / genetics
  • Leukemia, Myeloid, Acute / drug therapy
  • Leukemia, Myeloid, Acute / genetics
  • Leukemia, Myeloid, Acute / metabolism
  • Leukemia, Myeloid, Acute / pathology
  • Mice
  • Molecular Targeted Therapy
  • Nitriles
  • Protein Kinase Inhibitors / pharmacology
  • Pyrazoles / pharmacology
  • Pyrimidines
  • Xenograft Model Antitumor Assays
Citation (ISO format)
GONZALES, Fanny et al. Identifying Targeted Therapies for CBFA2T3::GLIS2 Acute Myeloid Leukemia. In: Leukemia, 2026, vol. 40, n° 2, p. 383–396. doi: 10.1038/s41375-025-02845-7
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Identifiers
Additional URL for this publicationhttps://www.nature.com/articles/s41375-025-02845-7
Journal ISSN0887-6924
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Creation08/05/2026 13:38:56
First validation08/05/2026 14:49:34
Update08/05/2026 14:49:34
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