Abstract A20: A leukemic model of acquired resistance to BET inhibition reveals a role for CBP/EP300 bromodomains in the regulation of c-MYC expression

Pharmacological modulation of c-MYC expression has recently become possible through small molecule engagement of the BET bromodomain proteins. As multiple BET inhibitors (BETi) progress through clinical trials, understanding possible mechanisms of acquired resistance becomes imperative to maximize therapeutic efficacy, assess possible drug combination strategies, and identify characteristics of next generation BET inhibitors. In the present study, we describe a cellular model of BETi resistance, which demonstrates a significantly blunted phenotypic and molecular response to BETi. The expression of c-MYC mRNA, highly susceptible to BETi in the parental cells, is restored in resistant cells through transcriptional bypass of BET-mediated co-activation. Through the use of a novel CBP/EP300 bromodomain inhibitor (CBP/EP300i), we show that c-MYC expression in BETi-resistant cells is dependent on CBP/EP300 bromodomain function, and that co-treatment with CBP/EP300i restores phenotypic sensitivity. CBP/EP300i was additionally found to transcriptionally silence MYC expression in numerous myeloma and leukemia derived cell lines in a manner comparable to BETi, identifying a novel modality to pharmacologically target the MYC oncogenic axis. While both BET and CBP/EP300 bromodomains regulate the expression of MYC, their transcriptional and phenotypic effects are otherwise distinct, suggesting that CBP/EP300 bromodomain inhibition may represent an alternative or complementary therapeutic option to BET bromodomain inhibition. Citation Format: Andrew R. Conery, Richard C. Centore, Charlie Hatton, Adrianne Neiss, Hon-Ren Huang, Patricia J. Keller, Alexander M. Taylor, Alexandre Cote, Michael C. Hewitt, Christopher G. Nasveschuk, Yves Leblanc, Shihua Yao, Eneida Pardo, Laura Zawadzke, Florence Poy, Hari Jayaram, Shivangi Joshi, Peter Sandy, Anthony Romero, Terry Crawford, Richard Pastor, Tommy Lai, Kevin Chen, Jian Wang, Steven Magnuson, Brian K. Albrecht, Steve Bellon, Barbara M. Bryant, Robert J. Sims, III. A leukemic model of acquired resistance to BET inhibition reveals a role for CBP/EP300 bromodomains in the regulation of c-MYC expression. [abstract]. In: Proceedings of the AACR Special Conference on Myc: From Biology to Therapy; Jan 7-10, 2015; La Jolla, CA. Philadelphia (PA): AACR; Mol Cancer Res 2015;13(10 Suppl):Abstract nr A20.