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Mitochondrial apoptosis can be effectively targeted in lymphoid malignancies with the FDA-approved B cell lymphoma 2 (BCL-2) inhibitor venetoclax, but resistance to this agent is emerging. We show that venetoclax resistance in chronic lymphocytic leukemia is associated with complex clonal shifts. To identify determinants of resistance, we conducted parallel genome-scale screens of the BCL-2-driven OCI-Ly1 lymphoma cell line after venetoclax exposure along with integrated expression profiling and functional characterization of drug-resistant and engineered cell lines. We identified regulators of lymphoid transcription and cellular energy metabolism as drivers of venetoclax resistance in addition to the known involvement by BCL-2 family members, which were confirmed in patient samples. Our data support the implementation of combinatorial therapy with metabolic modulators to address venetoclax resistance.
[SDV.MHEP.HEM] Life Sciences [q-bio]/Human health and pathology/Hematology, AMPK, Adult, Male, BCL-2, Apoptosis, leucemia linfoc?tica cr?nica de c?lulas B, Venetoclax, Clonal Evolution, Mice, Cell Line, Tumor, Antineoplastic Combined Chemotherapy Protocols, Animals, Humans, Mitochondrion, CRISPR/Cas9, Aged, Aged, 80 and over, Genome-wide screen, genoma, Clonal evolution, Genome, 3201.01 Oncolog?a, leucemia linfocítica crónica de células B, Middle Aged, Bridged Bicyclo Compounds, Heterocyclic, Leukemia, Lymphocytic, Chronic, B-Cell, Mitochondria, Gene Expression Regulation, Neoplastic, 3201.01 Oncología, Metabolism, Drug Resistance, Neoplasm, Drug resistance, Disease Progression, Chronic lymphocytic leukemia, Female, Energy Metabolism
[SDV.MHEP.HEM] Life Sciences [q-bio]/Human health and pathology/Hematology, AMPK, Adult, Male, BCL-2, Apoptosis, leucemia linfoc?tica cr?nica de c?lulas B, Venetoclax, Clonal Evolution, Mice, Cell Line, Tumor, Antineoplastic Combined Chemotherapy Protocols, Animals, Humans, Mitochondrion, CRISPR/Cas9, Aged, Aged, 80 and over, Genome-wide screen, genoma, Clonal evolution, Genome, 3201.01 Oncolog?a, leucemia linfocítica crónica de células B, Middle Aged, Bridged Bicyclo Compounds, Heterocyclic, Leukemia, Lymphocytic, Chronic, B-Cell, Mitochondria, Gene Expression Regulation, Neoplastic, 3201.01 Oncología, Metabolism, Drug Resistance, Neoplasm, Drug resistance, Disease Progression, Chronic lymphocytic leukemia, Female, Energy Metabolism
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