The menin inhibitor SNDX-5613 for KMT2A rearranged or NPM1 mutant leukemia
Ontology highlight
ABSTRACT:
PROVIDER: PRJNA895062 | ENA |
REPOSITORIES: ENA
Dataset's files
| Action | DRS | |||
|---|---|---|---|---|
| SRR22069900_1.fastq.gz | Fastqsanger.gz | |||
| SRR22069900_2.fastq.gz | Fastqsanger.gz | |||
| SRR22069901_1.fastq.gz | Fastqsanger.gz | |||
| SRR22069901_2.fastq.gz | Fastqsanger.gz | |||
| SRR22069890_1.fastq.gz | Fastqsanger.gz |
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Similar Datasets
Project description:Targeting critical epigenetic regulators reverses aberrant transcription in cancer, thereby restoring normal tissue function. The interaction of menin with lysine methyltransferase 2A (KMT2A), an epigenetic regulator, is a dependency in acute leukaemia caused by either rearrangement of KMT2A or mutation in Nucleophosmin 1(NPM1). KMT2A rearrangements occur in up to 10% of acute leukaemias and have an adverse prognosis whereas NPM1 mutations occur in up to 30%, forming the most common genetic alteration in acute myeloid leukaemia7,8. Here, we describe the results of the first-in-human phase 1 clinical trial investigating revumenib (SNDX-5613), a potent and selective oral inhibitor of the menin–KMT2A interaction, in patients with relapsed or refractory acute leukaemia (ClinicalTrials.gov, NCT04065399). We show that therapy with revumenib was associated with a low frequency of grade 3 or higher treatment-related adverse events and a 30% rate of complete remission or complete remission with partial haematologic recovery (CR/CRh) in the efficacy analysis population. Asymptomatic prolongation of the QT interval on electrocardiography was identified as the only dose-limiting toxicity. Remissions occurred in leukaemias refractory to multiple previous lines of therapy. We demonstrate clearance of residual disease using sensitive clinical assays and identify hallmarks of differentiation into normal haematopoietic cells, including differentiation syndrome. These data establish menin inhibition as a therapeutic strategy for susceptible acute leukaemia subtypes.
2023-03-01 | GSE216730 | GEO
Project description:The chromatin adaptor protein Menin (MEN1) is required by acute leukemias driven by mixed lineage leukemia 1 gene rearrangements (KMT2A-r) for sustained leukemogenesis. Menin inhibitors (MIs), which disrupt the Menin-KMT2A interface leading to downregulation of Menin-KMT2A oncogenic transcriptional programs, have shown promising results in recent clinical trials treating acute myeloid leukemia (AML). Decreased Menin protein stability has been observed following treatment with several MIs though proteasomal degradation, though the biological mechanisms that control Menin stability are not well understood. Here we interrogate and compare five clinical MIs and two pre-clinical compounds to characterize the mechanism by which MIs induce Menin degradation and demonstrate that the loss of the Menin-KMT2A interaction results in decreased protein stability of Menin and KMT2A. We have identified the HECT E3 ubiquitin ligase UBR5 as a regulator of Menin protein stability and demonstrate that UBR5 binds to similar sites as the Menin/KMT2A complex on chromatin. Loss of UBR5 leads to transcriptional rescue of Menin-KMT2A target genes leading to decreased sensitivity to all MIs. Thus, we present UBR5 as an important regulator of Menin/KMT2A complex stability and Menin destabilization/subcellular localization as a designable feature of Menin inhibition targeting KMT2A-r leukemias.
2025-08-01 | GSE299103 | GEO
Project description:The chromatin adaptor protein Menin (MEN1) is required by acute leukemias driven by mixed lineage leukemia 1 gene rearrangements (KMT2A-r) for sustained leukemogenesis. Menin inhibitors (MIs), which disrupt the Menin-KMT2A interface leading to downregulation of Menin-KMT2A oncogenic transcriptional programs, have shown promising results in recent clinical trials treating acute myeloid leukemia (AML). Decreased Menin protein stability has been observed following treatment with several MIs though proteasomal degradation, though the biological mechanisms that control Menin stability are not well understood. Here we interrogate and compare five clinical MIs and two pre-clinical compounds to characterize the mechanism by which MIs induce Menin degradation and demonstrate that the loss of the Menin-KMT2A interaction results in decreased protein stability of Menin and KMT2A. We have identified the HECT E3 ubiquitin ligase UBR5 as a regulator of Menin protein stability and demonstrate that UBR5 binds to similar sites as the Menin/KMT2A complex on chromatin. Loss of UBR5 leads to transcriptional rescue of Menin-KMT2A target genes leading to decreased sensitivity to all MIs. Thus, we present UBR5 as an important regulator of Menin/KMT2A complex stability and Menin destabilization/subcellular localization as a designable feature of Menin inhibition targeting KMT2A-r leukemias.
2025-08-01 | GSE299100 | GEO
Project description:MLL1 (KMT2A) rearrangements and NPM1 mutations are associated with acute leukemias whose pathogenesis is critically influenced by protein-protein interactions between menin and MLL1. We hypothesized that targeting the menin-MLL interaction using DS-1594b and targeting the antiapoptotic factor BCL-2 using venetoclax (ABT-199) may promote differentiation and enhance lethality in patients with MLL1-rearranged and NPM1-mutated leukemias. We treated acute myeloid leukemia (AML) cell lines with MLL1 rearrangements, NPM1 mutations, and no mutations and samples from patients with primary AML with ABT-199 alone, DS-1594b alone, and their combination. We measured proliferation, viability, apoptosis, and differentiation using several assays, Western blotting, and BH3 profiling. Treatment with DS-1594b and ABT-199 exerted significant synergy, resulting in enhanced differentiation and inhibited proliferation across several cell lines. In the PDX model, DS-1594b single-agent treatment significantly extended survival (pv=***). Compared with DS-1594b monotherapy, the combination of DS-1594b and ABT-199 more profoundly reduced leukemic burden and prolonged mouse survival (pv=***). Overall, we observed synergistic effects on differentiation induction and proliferation inhibition, both in vitro and in vivo. Menin inhibition is the primary driver of transcription changes in this model, and impact on the expression of antiapoptotic regulators provide mechanistic explanation for the synergy observed between these drugs. Together, this underscores the promise of this combination strategy as a novel therapeutic approach for improving treatment outcomes in patients with these specific genetic alterations.
2025-11-19 | GSE282741 | GEO
Project description:Inhibitors of the Menin-KMT2A interaction are promising agents for the treatment of KMT2A-rearranged (KMT2A-r) leukemias. We evaluated Menin inhibition in patient derived xenografts of KMT2A-r leukemias with high-risk features. Three AMLs with high-risk fusion partners (MLLT10, MLLT4) and two infant ALL samples were sensitive to Menin inhibition. We also evaluated serial samples from two patients with multiply relapsed ALL. We found that highly pretreated KMT2A::AFF1 ALL samples were much less sensitive compared to cells obtained earlier in the same patients’ disease course. Since none of the patients had been treated with a Menin inhibitor, resistance in these highly pretreated samples was acquired in the absence to Menin inhibitor exposure. Transcriptomic analysis documented sustained on-target efficacy towards the canonical targets in the Menin-inhibitor in resistant cells. Targeted genomic analysis documented the emergence of multiple co-mutations, including RAS pathway and TP53 mutations, although neither was sufficient to induce Menin-inhibitor resistance in vitro. Downregulation of KMT3D may account for resistance in one patients; inactivation of KMT2C/D has been reported to result in Menin inhibitor resistance, and KMT2C-edited cells from this patient were selected for in VTP containing growth conditions. Future studies will need to clarify more broadly which genomic/epigenomic alterations drive upfront resistance. Regardless of mechanism, our data supports using Menin-inhibitors upfront or in early lines of therapy before substantial genomic or epigenomic evolution has occurred.
2025-11-14 | GSE309882 | GEO
Project description:Targeting critical epigenetic regulators reverses aberrant transcription in cancer, thereby restoring normal tissue function1-3. The interaction of menin with lysine methyltransferase 2A (KMT2A), an epigenetic regulator, is a dependence in acute leukaemia caused by either rearrangement of KMT2A or mutation of the nucleophosmin 1 gene (NPM1)4-6. KMT2A rearrangements occur in up to 10% of acute leukaemias and have an adverse prognosis, whereas NPM1 mutations occur in up to 30%, forming the most common genetic alteration in acute myeloid leukaemia7,8. Here, we describe the results of the first-in-human phase 1 clinical trial investigating revumenib (SNDX-5613), a potent and selective oral inhibitor of the menin-KMT2A interaction, in patients with relapsed or refractory acute leukaemia (ClinicalTrials.gov, NCT04065399). We show that therapy with revumenib was associated with a low frequency of grade 3 or higher treatment-related adverse events and a 30% rate of complete remission or complete remission with partial haematologic recovery (CR/CRh) in the efficacy analysis population. Asymptomatic prolongation of the QT interval on electrocardiography was identified as the only dose-limiting toxicity. Remissions occurred in leukaemias refractory to multiple previous lines of therapy. We demonstrate clearance of residual disease using sensitive clinical assays and identify hallmarks of differentiation into normal haematopoietic cells, including differentiation syndrome. These data establish menin inhibition as a therapeutic strategy for susceptible acute leukaemia subtypes.
| S-EPMC10060155 | biostudies-literature
Project description:UBR5 Mediates Menin Inhibitor Dependent Menin/KMT2A Complex Stability [ChIP-seq]
| PRJNA1272575 | ENA
Project description:UBR5 Mediates Menin Inhibitor Dependent Menin/KMT2A Complex Stability [RNA-seq]
| PRJNA1272588 | ENA
Project description:Menin inhibitors have entered clinical trials for KMT2A-rearranged and NPM1 mutant acute leukemias and are demonstrating promising activity. CRISPR-Cas9 base editor screening previously predicted several MEN1 mutations that have arisen in patients receiving SNDX-5613 and confer menin inhibitor resistance. The extent to which MEN1 mutations will impact each menin inhibitor is currently unknown. We leveraged advances in CRISPR-Cas9 base editing technology to predict the MEN1 mutation profile that will impact five different menin inhibitors in clinical trials. We found key similarities (M327) and differences (C334, E368, V372) in the profile of MEN1 mutations that affect each compound. The co-crystal structure of menin bound to each compound suggests resistance mechanisms related to how each menin inhibitor binds in the KMT2A binding pocket of menin. Our in vitro and in vivo validation suggests that the MEN1 mutations identified and validated with this approach are likely to arise and impact all menin inhibitors.
2025-11-30 | GSE294624 | GEO
Project description:Menin inhibitors have entered clinical trials for KMT2A-rearranged and NPM1 mutant acute leukemias and are demonstrating promising activity. CRISPR-Cas9 base editor screening previously predicted several MEN1 mutations that have arisen in patients receiving SNDX-5613 and confer menin inhibitor resistance. The extent to which MEN1 mutations will impact each menin inhibitor is currently unknown. We leveraged advances in CRISPR-Cas9 base editing technology to predict the MEN1 mutation profile that will impact five different menin inhibitors in clinical trials. We found key similarities (M327) and differences (C334, E368, V372) in the profile of MEN1 mutations that affect each compound. The co-crystal structure of menin bound to each compound suggests resistance mechanisms related to how each menin inhibitor binds in the KMT2A binding pocket of menin. Our in vitro and in vivo validation suggests that the MEN1 mutations identified and validated with this approach are likely to arise and impact all menin inhibitors.
2025-11-30 | GSE294623 | GEO