2023-12-015 + 2021-08-009 - ALL-BePrecise-2 - Precision medicine in infant t(4;11) pro-B-ALL: targeting the novel biomarker HDAC7
Acute lymphoblastic leukemia (ALL) derived from B cell progenitors (pro-B-ALL) is the most prevalent type of cancer among children that are annually diagnosed of leukemia in Western countries. Despite an 80% of pediatric B-ALL remission has been achieved, a specific subgroup of infant patients (<1 year old) that present a translocation between chromosomes 4 and 11, commonly relapse, converting acute leukemia into the main cause of pediatric cancer-associated death. Survival rate of infants diagnosed with t(4;11) pro-B-ALL does not even reach 35%. Due to their short age and vulnerability, these patients are normally excluded from clinical trials rendering them to no further opportunities than non-targeted chemotherapy or "off-label" use of available drugs. Therefore, there is an urgent need to improve current available therapies.
Recently, Dr Maribel Parra's group has identified HDAC7 as a prognostic factor in infants with this aggressive leukemia. These patients display a general loss in HDAC7 expression. The lowest levels of HDAC7 are associated with a poor outcome of the patients. Additional results show that HDAC7 is also lost in adult patients with t(4;11) pro-B-ALL and diffuse large B cell lymphoma (DLBCL), both aggressive diseases with low survival. Therefore, the identification of those blood cancer patients with low HDAC7 levels is a promising approach to implement personalized medicine strategies aiming to specifically induce HDAC7 expression. In this sense, a novel combinatorial therapy is being developed comprising MI-538 and Chidamide with the capacity to trigger HDAC7 expression in t(4;11) pro-B-ALL cells.