C/EBPα Confers Dependence to Fatty Acid Anabolic Pathways and Vulnerability to Lipid Oxidative Stress–Induced Ferroptosis in FLT3 -Mutant Leukemia

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Sabatier, Marie | Birsen, Rudy | Lauture, Laura | Mouche, Sarah | Angelino, Paolo | Dehairs, Jonas | Goupille, Léa | Boussaid, Ismael | Heiblig, Maël | Boet, Emeline | Sahal, Ambrine | Saland, Estelle | Santos, Juliana | Armengol, Marc | Fernández-Serrano, Miranda | Farge, Thomas | Cognet, Guillaume | Simonetta, Federico | Pignon, Corentin | Graffeuil, Antoine | Mazzotti, Céline | Avet-Loiseau, Hervé | Delos, Océane | Bertrand-Michel, Justine | Chedru, Amélie | Dembitz, Vilma | Gallipoli, Paolo | Anstee, Natasha | Loo, Sun | Wei, Andrew | Carroll, Martin | Goubard, Armelle | Castellano, Rémy | Collette, Yves | Vergez, François | Mansat-de Mas, Véronique | Bertoli, Sarah | Tavitian, Suzanne | Picard, Muriel | Récher, Christian | Bourgès-Abella, Nathalie | Granat, Fanny | Kosmider, Olivier | Sujobert, Pierre | Colsch, Benoit | Joffre, Carine | Stuani, Lucille | Swinnen, Johannes | Guillou, Hervé | Roué, Gael | Hakim, Nawad | Dejean, Anne | Tsantoulis, Petros | Larrue, Clément | Bouscary, Didier | Tamburini, Jerome | Sarry, Jean-Emmanuel

Edité par CCSD ; American Association for Cancer Research -

International audience. Although transcription factor CCAAT-enhancer binding protein α (C/EBPα) is critical for normal and leukemic differentiation, its role in cell and metabolic homeostasis is largely unknown in cancer. Here, multiomics analyses uncovered a coordinated activation of C/EBPα and Fms-like tyrosine kinase 3 (FLT3) that increased lipid anabolism in vivo and in patients with FLT3-mutant acute myeloid leukemia (AML). Mechanistically, C/EBPα regulated the fatty acid synthase (FASN)–stearoyl-CoA desaturase (SCD) axis to promote fatty acid (FA) biosynthesis and desaturation. We further demonstrated that FLT3 or C/EBPα inactivation decreased monounsaturated FA incorporation to membrane phospholipids through SCD downregulation. Consequently, SCD inhibition enhanced susceptibility to lipid redox stress that was exploited by combining FLT3 and glutathione peroxidase 4 inhibition to trigger lipid oxidative stress, enhancing ferroptotic death of FLT3-mutant AML cells. Altogether, our study reveals a C/EBPα function in lipid homeostasis and adaptation to redox stress, and a previously unreported vulnerability of FLT3-mutant AML to ferroptosis with promising therapeutic application. Significance: FLT3 mutations are found in 30% of AML cases and are actionable by tyrosine kinase inhibitors. Here, we discovered that C/EBPα regulates FA biosynthesis and protection from lipid redox stress downstream mutant-FLT3 signaling, which confers a vulnerability to ferroptosis upon FLT3 inhibition with therapeutic potential in AML. This article is highlighted in the In This Issue feature, p. 1501

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