NSD2 Degradation Remediates the Oncogenic Cistrome in t(4;14) Multiple Myeloma

Bo Hu1, Jacob Edwards2, Hardik Modi1

  • 1Bristol Myers Squibb, San Diego, California, United States.

Blood
|June 29, 2026
PubMed

Insights

A new drug, NSD2-LDD, effectively targets and degrades the NSD2 protein in high-risk multiple myeloma (MM) patients with the t(4;14) translocation. This targeted degradation reverses disease-specific gene expression and improves survival in preclinical models.

Area of Science:

  • Oncology
  • Molecular Biology
  • Genetics

Background:

  • The t(4;14) chromosomal translocation is a key driver in a subset of multiple myeloma (MM) patients, leading to overexpression of the NSD2 histone methyltransferase.
  • NSD2 overexpression contributes to aggressive disease phenotypes and poor prognosis in MM.

Purpose of the Study:

  • To discover and characterize a novel therapeutic agent, NSD2-LDD, a ligand-directed degrader (LDD), for targeting NSD2 in t(4;14) multiple myeloma.
  • To investigate the molecular mechanisms by which NSD2 degradation impacts MM cell biology and the tumor microenvironment.

Main Methods:

  • Development of NSD2-LDD, a cereblon-recruiting LDD targeting NSD2 protein isoforms.
  • Assessment of NSD2-LDD efficacy in cellular and in vivo models of t(4;14) MM, including xenografts and genetically engineered mouse models.
  • Integration of patient single-cell profiling, 3D epigenomics, and spatial transcriptomics to understand disease state and therapeutic response.

Main Results:

  • NSD2-LDD selectively degrades full-length and PWWP1 domain-containing NSD2 isoforms, inducing global loss of H3K36me2.
  • Degradation of NSD2 reverses t(4;14) transcriptional programs, suppresses MM phenotypes (stromal adhesion, colony growth), and remodels the bone marrow microenvironment.
  • NSD2-LDD treatment extends median survival in preclinical t(4;14) MM models, correlating with H3K36me2 loss and niche remodeling.

Conclusions:

  • NSD2 is a druggable dependency in t(4;14) multiple myeloma.
  • NSD2-LDD represents a promising novel therapeutic strategy for high-risk MM patients, warranting further clinical development.