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Identifying molecular vulnerabilities of ALT-dependent cancers

Award Number: R01CA276349
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 03/01/2024
PERIOD OF PERFORMANCE END DATE: 02/28/2029

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Identifying molecular vulnerabilities of ALT-dependent cancers - PROJECT SUMMARY Telomeres are specialized protein-DNA structures that protect the ends of linear chromosomes and maintain genomic stability. Maintenance of adequate telomere length is thus essential for cellular immortalization and tumorigenesis. While most human cancers achieve this through telomerase activation, ~ 5% - 10% of them adopt a recombination-based mechanism termed alternative lengthening of telomeres (ALT) to elongate their telomeres. Although the ALT-driven cancers are generally aggressive with poor prognosis, there are currently no targeted therapies. In human cancers, ALT is strongly associated with genetic alterations that affect histone H3.3 chaperone ATRX-DAXX complex. We and others previously demonstrated that the ATRX-DAXX complex is essential for normal telomere maintenance. We showed that ATRX or DAXX loss, while promoting tumorigenesis by potentiating the ALT-driven immortalization, also creates a persistent telomere replication dysfunction. We therefore hypothesize that ALT-immortalized cancers must have adopted special mechanism(s) to offset their innate telomere DNA replication defects, and thus would be selectively vulnerable to the inhibition of those compensatory pathways. By combining our unique isogenic ALT-immortalization model system and customized domain-focused CRISPR screen platform, we have uncovered a list of selective molecular vulnerabilities including histone lysine demethylase KDM2A for ALT-dependent cells. We demonstrate that KDM2A-mediated H3K36me2 demethylation is required for ALT-directed telomere maintenance. Inactivation of KDM2A impairs ALT-specific multitelomere cluster dissolution, leading to chromosome missegregation and mitotic cell death. The objectives of this proposal are to delineate the molecular mechanism underlying ALT-directed telomere maintenance and to identify mechanism-based therapeutic targets against ALT-driven human cancers. To meet those goals, we will pursue the following three specific aims. In Aim 1, we will investigate the molecular functions of KDM2A in ALT-directed telomere maintenance. In Aim 2, we will define the potential adverse effects and off-tumor toxicities of future KDM2A-targeted therapies. In Aim 3, we will establish an in vivo platform to explore the synthetic- lethal interactions of ALT-driven ATRX-mutant malignant gliomas. Completion of the proposed studies will uncover the molecular mechanisms and critical dependencies underlying ALT-directed telomere maintenance and thus drive the development of novel mechanism-based therapeutics against ALT- dependent cancers including the ATRX mutant malignant gliomas.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $348,958 )
2026	2026	WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY	575 LEXINGTON AVE FL 9	NEW YORK	NY	10022	NEW YORK	USA	Cancer Cause and Prevention Research	000	3	1/26/2026	NON-COMPETING CONTINUATION	$348,958
														Subtotal = $348,958

Issue Date FY: 2025 ( Subtotal = $387,731 )
2025	2025	WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY	575 LEXINGTON AVE FL 9	NEW YORK	NY	10022	NEW YORK	USA	Cancer Cause and Prevention Research	001	2	5/22/2025	NON-COMPETING CONTINUATION	$38,773
2025	2025	WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY	575 LEXINGTON AVE FL 9	NEW YORK	NY	10022	NEW YORK	USA	Cancer Cause and Prevention Research	000	2	2/13/2025	NON-COMPETING CONTINUATION	$348,958
														Subtotal = $387,731

Issue Date FY: 2024 ( Subtotal = $387,731 )
2024	2024	WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY	575 LEXINGTON AVE FL 9	NEW YORK	NY	10022	NEW YORK	USA	Cancer Cause and Prevention Research	000	1	2/7/2024	NEW	$387,731
														Subtotal = $387,731

Grand Total All Awards = $1,124,420

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Identifying molecular vulnerabilities of ALT-dependent cancers

Award Number: R01CA276349

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 03/01/2024

PERIOD OF PERFORMANCE END DATE: 02/28/2029

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