Mitochondrial Reprogramming Underlies Resistance to BCL-2 Inhibition in Lymphoid Malignancies
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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.
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In chronic lymphocytic leukemia, acquired resistance to venetoclax involves increased mitochondrial mass and enhanced OXPHOS, and inhibiting OXPHOS increases venetoclax sensitivity in culture and in vivo.
“In chronic lymphocytic leukemia, acquired resistance to venetoclax–an inhibitor of the antiapoptotic protein B cell lymphoma-2 (BCL-2)–involves increased mitochondrial mass and enhanced OXPHOS (114). Inhibiting OXPHOS increases venetoclax sensitivity in culture and in vivo.”
From Metabolic reprogramming and cancer progression (2020) · cites this paper as [114]
A recurrent theme in studies of cancer progression is increased reliance of cancer cells on OXPHOS in advanced stages of disease.
“A recurrent theme in studies on cancer progression is the increased reliance of cancer cells on OXPHOS in advanced stages of disease.”
From Metabolic reprogramming and cancer progression (2020) · cites this paper as [114]
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Metabolic reprogramming and cancer progression
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- Authors
- Guièze, R., Liu, V. M., Rosebrock, D., Jourdain, A. A., Hernández-Sánchez, M., Martinez Zurita, A., Sun, J., Ten Hacken, E., Baranowski, K., Thompson, P. A., Heo, J.-M., Cartun, Z., Aygün, O., Iorgulescu, J. B., Zhang, W., Notarangelo, G., Livitz, D., Li, S., Davids, M. S., Biran, A., Fernandes, S. M., Brown, J. R., Lako, A., Ciantra, Z. B., Lawlor, M. A., Keskin, D. B., Udeshi, N. D., Wierda, W. G., Livak, K. J., Letai, A. G., Neuberg, D., Harper, J. W., Carr, S. A., Piccioni, F., Ott, C. J., Leshchiner, I., Johannessen, C. M., Doench, J., Mootha, V. K., Getz, G., & Wu, C. J.
- Affiliations
- Broad Institute (US)
- Harvard University (US)
- Dana-Farber Cancer Institute (US)
- The University of Texas MD Anderson Cancer Center (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Wu, Catherine J.
- ORCID
- Guièze, Romain
- Liu, Vivian M.
- Rosebrock, Daniel
- Jourdain, Alexis A.
- Sun, Jing
- Baranowski, Kaitlyn
- Thompson, Philip A.
- Aygün, Ozan
- Iorgulescu, J. Bryan
- Zhang, Wandi
- Notarangelo, Giulia
- Livitz, Dimitri
- Li, Shuqiang
- Davids, Matthew S.
- Fernandes, Stacey M.
- Brown, Jennifer R.
- Lako, Ana
- Ciantra, Zoe B.
- Lawlor, Matthew A.
- Keskin, Derin B.
- Udeshi, Namrata D.
- Wierda, William G.
- Livak, Kenneth J.
- Letai, Anthony G.
- Neuberg, Donna
- Harper, J. Wade
- Carr, Steven A.
- Piccioni, Federica
- Ott, Christopher J.
- Leshchiner, Ignaty
- Johannessen, Cory M.
- Doench, John
- Mootha, Vamsi K.
- Getz, Gad
- Wu, Catherine J.
- Venue
- Cancer Cell
- Publisher
- Elsevier BV
- Published
- 2019-10
- Volume
- 36
- Issue
- 4
- Pages
- 369-384.e13
- ISSN
- 1535-6108 (ISSN-L)
- PMC
- PMC6801112
- OpenAlex
- W2974182987
- Cited by
- 361
- References
- 98
- Citations by year
- 2026: 30 · 2025: 56 · 2024: 53 · 2023: 59 · 2022: 56 · 2021: 51 · 2020: 54 · 2019: 2
- FWCI
- 13.49
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Cancer Cell (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HAL (submittedVersion)
- DIGITAL.CSIC (Spanish National Research Council (CSIC)) (submittedVersion)
- Gredos (University of Salamanca) (submittedVersion, cc-by-nc-nd)
- Hispana (submittedVersion, cc-by-nc-nd)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Funders
- American Society of Hematology
- Howard Hughes Medical Institute (1RO1CA155010-01A1, 1U10CA180861-01)
- Genentech
- Broad Institute (S63845)
- National Institute of General Medical Sciences (R35GM122455)
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- Fundación Española de Hematología y Hemoterapia
- Gilead Sciences
- Project Management
- AbbVie
- National Cancer Institute (U01 CA214125, R00CA190861, R37 NS083524, U24-CA210986, R01 GM095567, 1U10CA180861-01, 1RO1CA155010-01A1, PO1CA206978, R01CA213442, 2P01CA081534)
- Sociedad Española de Hematología y Hemoterapia
- Janssen Pharmaceuticals
- National Institutes of Health (5T32-HL007627)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cell death mechanisms and regulation
- Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
- Keywords
- venetoclax resistance, BCL-2 inhibition, mitochondrial apoptosis, chronic lymphocytic leukemia, lymphoid malignancies, cellular energy metabolism, metabolic modulators, Bcl-2 family proteins, drug resistance, combination therapy
- MeSH terms
- Adult, Aged, Aged, 80 and over, Animals, Antineoplastic Combined Chemotherapy Protocols, Energy Metabolism, Female, Humans, Male, Middle Aged, Mitochondria, Oxidative Phosphorylation, Sulfonamides, Leukemia, Lymphocytic, Chronic, B-Cell, Gene Expression Regulation, Neoplastic, Treatment Outcome, Apoptosis, Disease Progression, Drug Resistance, Neoplasm, Bridged Bicyclo Compounds, Heterocyclic, Proto-Oncogene Proteins c-bcl-2, Xenograft Model Antitumor Assays, Cell Line, Tumor, Mice, Clonal Evolution, Myeloid Cell Leukemia Sequence 1 Protein
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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