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Publications

Single-cell analysis reveals selection of TP53-mutated clones after MDM2 inhibition


Maslah N, Verger E, Giraudier S, Chea M, Hoffman R, Mascarenhas J, Cassinat B, Kiladjian JJ.
Blood Advances May 2022
Abstract

The mechanisms of transformation of chronic myeloproliferative neoplasms (MPN) to leukemia are largely unknown, but TP53 mutations acquisition is considered a key event in this process. p53 is a main tumor suppressor, but mutations in this protein per se do not confer a proliferative advantage to the cells, and a selection process is needed for the expansion of mutant clones. MDM2 inhibitors may rescue normal p53 from degradation and have been evaluated in a variety of cancers with promising results. However, the impact of these drugs on TP53-mutated cells is underexplored. We report herein evidence of a direct effect of MDM2 inhibition on the selection of MPN patients' cells harboring TP53 mutations. To decipher whether these mutations can arise in a specific molecular context, we used a DNA single-cell approach to determine the clonal architecture of TP53-mutated cells. We observed that TP53 mutations are late events in MPN, mainly occurring in the driver clone, whereas clonal evolution frequently consists of sequential branching instead of linear consecutive acquisition of mutations in the same clone. At the single-cell level, the presence of additional mutations does not influence the selection of TP53 mutant cells by MDM2 inhibitor treatment. Also, we describe an in vitro test allowing to predict the emergence of TP53 mutated clones. Altogether, this is the first demonstration that a drug treatment can directly favor the emergence of TP53-mutated subclones in MPN.

VIEW

Area

Heme

Institution Type

Academia

Indication / Modality

Myeloproliferative Neoplasms (MPN)

Goal of Study

Clonal Evolution, Longitudinal

Key Genes

TP53, JAK2, ASXL1, EZH2, DNMT3A, U2AF1, CALR, TET2, NFE2

PAD Project

No

Analytes Assessed

SNV, InDels

Sample Storage

Fresh Frozen

Sample Prep

Whole Cells

Sample Type

PBMC, Patient Material

Tissue / Organ

Bone Marrow Aspirates

Species

Human

Panel Used

Custom

Proof Point Demonstrated

Clonality, Co-occurrence, Zygosity
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