Combinatorial strategies targeting NEAT1 and AURKA as new potential therapeutic options for multiple myeloma

Haematologica. 2024 Dec 1;109(12):4040-4055. doi: 10.3324/haematol.2024.285470.

Abstract

Multiple myeloma (MM) is a dreadful disease, marked by the uncontrolled proliferation of clonal plasma cells within the bone marrow. It is characterized by a highly heterogeneous clinical and molecular background, supported by severe genomic alterations. Important de-regulation of long non-coding RNA (lncRNA) expression, which can influence progression and therapy resistance, has been reported in MM patients. NEAT1 is a lncRNA essential for nuclear paraspeckles and is involved in the regulation of gene expression. We showed that NEAT1 supports MM proliferation, making this lncRNA an attractive therapeutic candidate. Here, we used a combinatorial strategy integrating transcriptomic and computational approaches with functional high-throughput drug screening to identify compounds that synergize with NEAT1 inhibition in restraining MM cell growth. AURKA inhibitors were identified as top-scoring drugs in these analyses. We showed that the combination of NEAT1 silencing and AURKA inhibitors in MM profoundly impairs microtubule organization and mitotic spindle assembly, finally leading to cell death. Analysis of the large publicly available CoMMpass dataset showed that, in MM patients, AURKA expression is strongly associated with reduced progression-free survival (P<0.0001) and overall survival (P<0.0001) probabilities and patients with high levels of expression of both NEAT1 and AURKA have a worse clinical outcome. Finally, using RNA-sequencing data from NEAT1 knockdown MM cells, we identified the AURKA allosteric regulator TPX2 as a new NEAT1 target in MM and as a mediator of the interplay between AURKA and NEAT1, therefore providing a possible explanation for the synergistic activity observed upon their combinatorial inhibition.

MeSH terms

  • Aurora Kinase A* / antagonists & inhibitors
  • Aurora Kinase A* / genetics
  • Aurora Kinase A* / metabolism
  • Cell Line, Tumor
  • Cell Proliferation / drug effects
  • Gene Expression Regulation, Neoplastic / drug effects
  • Humans
  • Molecular Targeted Therapy
  • Multiple Myeloma* / drug therapy
  • Multiple Myeloma* / genetics
  • Multiple Myeloma* / metabolism
  • Multiple Myeloma* / mortality
  • Multiple Myeloma* / pathology
  • Prognosis
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use
  • RNA, Long Noncoding* / genetics

Substances

  • Aurora Kinase A
  • RNA, Long Noncoding
  • NEAT1 long non-coding RNA, human
  • AURKA protein, human
  • Protein Kinase Inhibitors

Grants and funding

Funding: The research leading to these results has received funding from AIRC under IG 2020 – ID. 24365 – P.I. Neri Antonino. Also, ET is supported by AIRC-MFAG 2022-ID.27606, VF is supported by AIRC-MFAG 2023-ID. 28974, NA is supported by AIRC-IG-24449 ), RP is suppoterted by AIRC- IG21585, NB is funded by the European Research Council under the European Union’s Horizon 2020 research and innovation program (grant agreement no. 817997). NP received a fellowship by the PhD program in Clinical and Experimental Medicine of University of Modena and Reggio Emilia. VT received a fellowship by the PhD program in Experimental Medicine of the University of Milan.