1. Germline mutations in mitochondrial complex I reveal genetic and targetable vulnerability in IDH1-mutant acute myeloid leukaemia
- Author
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Bassal, MA, Samaraweera, SE, Lim, K, Bernard, BA, Bailey, S, Kaur, S, Leo, P, Toubia, J, Thompson-Peach, C, Nguyen, T, Maung, KZY, Casolari, DA, Iarossi, DG, Pagani, IS, Powell, J, Pitson, S, Natera, S, Roessner, U, Lewis, ID, Brown, AL, Tenen, DG, Robinson, N, Ross, DM, Majeti, R, Gonda, TJ, Thomas, D, D'Andrea, RJ, Bassal, MA, Samaraweera, SE, Lim, K, Bernard, BA, Bailey, S, Kaur, S, Leo, P, Toubia, J, Thompson-Peach, C, Nguyen, T, Maung, KZY, Casolari, DA, Iarossi, DG, Pagani, IS, Powell, J, Pitson, S, Natera, S, Roessner, U, Lewis, ID, Brown, AL, Tenen, DG, Robinson, N, Ross, DM, Majeti, R, Gonda, TJ, Thomas, D, and D'Andrea, RJ
- Abstract
The interaction of germline variation and somatic cancer driver mutations is under-investigated. Here we describe the genomic mitochondrial landscape in adult acute myeloid leukaemia (AML) and show that rare variants affecting the nuclear- and mitochondrially-encoded complex I genes show near-mutual exclusivity with somatic driver mutations affecting isocitrate dehydrogenase 1 (IDH1), but not IDH2 suggesting a unique epistatic relationship. Whereas AML cells with rare complex I variants or mutations in IDH1 or IDH2 all display attenuated mitochondrial respiration, heightened sensitivity to complex I inhibitors including the clinical-grade inhibitor, IACS-010759, is observed only for IDH1-mutant AML. Furthermore, IDH1 mutant blasts that are resistant to the IDH1-mutant inhibitor, ivosidenib, retain sensitivity to complex I inhibition. We propose that the IDH1 mutation limits the flexibility for citrate utilization in the presence of impaired complex I activity to a degree that is not apparent in IDH2 mutant cells, exposing a mutation-specific metabolic vulnerability. This reduced metabolic plasticity explains the epistatic relationship between the germline complex I variants and oncogenic IDH1 mutation underscoring the utility of genomic data in revealing metabolic vulnerabilities with implications for therapy.
- Published
- 2022