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Published on: September 12, 2025
BCL2 Amplicon Loss and Transcriptional Remodeling Drives ABT-199 Resistance in B Cell Lymphoma Models
Xiaohong Zhao1, Yuan Ren1, Matthew Lawlor2
1Chemical Biology and Molecular Medicine Program, Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
Abstract:
Drug-tolerant "persister" tumor cells underlie emergence of drug-resistant clones and contribute to relapse and disease progression. Here we report that resistance to the BCL-2 targeting drug ABT-199 in models of mantle cell lymphoma and double-hit lymphoma evolves from outgrowth of persister clones displaying loss of 18q21 amplicons that harbor BCL2. Further, persister status is generated via adaptive super-enhancer remodeling that reprograms transcription and offers opportunities for overcoming ABT-199 resistance. Notably, pharmacoproteomic and pharmacogenomic screens revealed that persisters are vulnerable to inhibition of the transcriptional machinery and especially to inhibition of cyclin-dependent kinase 7 (CDK7), which is essential for the transcriptional reprogramming that drives and sustains ABT-199 resistance. Thus, transcription-targeting agents offer new approaches to disable drug resistance in B-cell lymphomas.
Insights
Drug-tolerant persister cells drive resistance to BCL-2 inhibitor ABT-199 in lymphomas. Targeting transcriptional reprogramming, particularly cyclin-dependent kinase 7 (CDK7), offers a new strategy to overcome this resistance.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Drug-tolerant persister tumor cells are a key factor in the development of drug resistance and disease relapse.
- Resistance to BCL-2 inhibitors like ABT-199 is a significant challenge in treating certain lymphomas.
Purpose of the Study:
- To investigate the mechanisms underlying ABT-199 resistance in mantle cell lymphoma and double-hit lymphoma models.
- To identify vulnerabilities in drug-tolerant persister cells that can be targeted to overcome resistance.
Main Methods:
- Utilized lymphoma models to study ABT-199 resistance.
- Performed pharmacoproteomic and pharmacogenomic screens.
- Analyzed adaptive super-enhancer remodeling and transcriptional reprogramming.
Main Results:
- ABT-199 resistance emerged from persister clones with loss of 18q21 amplicons harboring BCL2.
- Persister status was linked to adaptive super-enhancer remodeling that altered transcription.
- Persister cells showed vulnerability to inhibition of transcriptional machinery, especially CDK7.
Conclusions:
- Targeting transcriptional reprogramming, particularly CDK7, can overcome ABT-199 resistance in B-cell lymphomas.
- Transcription-targeting agents represent a promising therapeutic approach for disabling drug resistance.
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