p53-NEIL1 co-abnormalities induce genomic instability and promote synthetic lethality with Chk1 inhibition in multiple myeloma having concomitant 17p13(del) and 1q21(gain). (Oncogene, Feb 2022)

Phaik Ju Teoh 1 2Omer An 3Tae-Hoon Chung 3Thamil Vaiyapuri 4Anandhkumar Raju 4Michal M Hoppe 3Sabrina H M Toh 3Wilson Wang 5 6Ming Chun Chan 5 6Melissa J Fullwood 3Anand D Jeyasekharan 7 3 8 9Vinay Tergaonkar 4Leilei Chen 3Henry Yang 3Wee Joo Chng 7 3 8 9

Affiliations

1Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. mdctpju@nus.edu.sg.
2Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore. mdctpju@nus.edu.sg.
3Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore.
4Institute of Molecular and Cell Biology (IMCB), Agency for Science. Technology and Research (A-Star), Singapore, Singapore.
5Department of Orthopaedic Surgery, National University Hospital, Singapore, Singapore.
6Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
7Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
8National University Cancer Institute, Singapore, Singapore.
9Department of Haematology-Oncology, National University Cancer Institute of Singapore, National University Health System, Singapore, Singapore.

Abstract

Recurrent cytogenetic abnormalities are the main hallmark of multiple myeloma (MM) and patients having 2 or more high-risk prognostic events are associated with extremely poor outcome. 17p13(del) and 1q21(gain) are critical and independent high-risk cytogenetic markers, however, the biological significance underlying the poor outcome in MM patients having co-occurrence of both these chromosomal aberrations has never been interrogated. Herein, we identified that patients harbouring concomitant 17p13(del) with 1q21(gain) demonstrated the worst prognosis as compared to patients with single- (either 17p13(del) or 1q21(gain)) and with no chromosomal events (WT for both chromosomal loci); and they are highly enriched for genomic instability (GI) signature. We discovered that the GI feature in the patients with concomitant 17p13(del)-1q21(gain) was recapitulating the biological properties of myeloma cells with co-existing p53-deficiency and NEIL1 mRNA-hyper-editing (associated with chromosome 17p and 1q, respectively) that have inherent DNA damage response (DDR) and persistent activation of Chk1 pathway. Importantly, this became a vulnerable point for therapeutic targeting whereby the cells with this co-abnormalities demonstrated hyper-sensitivity to siRNA- and pharmacological-mediated-Chk1 inhibition, as observed at both the in vitro and in vivo levels. Mechanistically, this was attributable to the synthetic lethal relationship between p53-NEIL1-Chk1 abnormalities. The Chk1 inhibitor (AZD7762) tested showed good synergism with standard-of-care myeloma drugs, velcade and melphalan, thus further reinforcing the translational potential of this therapeutic approach. In summary, combination of NEIL1-p53 abnormalities with an ensuing Chk1 activation could serve as an Achilles heel and predispose MM cells with co-existing 1q21(gain) and 17p13(del) to therapeutic vulnerability for Chk1 inhibition.