Curing APL through PML/RARA degradation by As2O3

V Lallemand-Breitenbach, J Zhu, Z Chen - Trends in molecular medicine, 2012 - cell.com
V Lallemand-Breitenbach, J Zhu, Z Chen
Trends in molecular medicine, 2012cell.com
Acute promyelocytic leukemia (APL) is a hematological malignancy driven by the
PML/RARA oncogene. The prognosis for patients with APL was revolutionized by two
treatments: retinoic acid (RA) and As 2 O 3 (arsenic trioxide). These were both shown a
posteriori to target PML/RARA, explaining their exquisite specificity for APL. Arsenic, as a
single agent, cures up to 70% of patients, whereas APL patients treated with the
combination of RA and As 2 O 3 reach a stunning 90% cure rate. Recent physiopathological …
Acute promyelocytic leukemia (APL) is a hematological malignancy driven by the PML/RARA oncogene. The prognosis for patients with APL was revolutionized by two treatments: retinoic acid (RA) and As2O3 (arsenic trioxide). These were both shown a posteriori to target PML/RARA, explaining their exquisite specificity for APL. Arsenic, as a single agent, cures up to 70% of patients, whereas APL patients treated with the combination of RA and As2O3 reach a stunning 90% cure rate. Recent physiopathological models highlight the key role of RA- and As2O3-triggered PML/RARA degradation, and the molecular mechanisms underlying As2O3-induced PML/RARA degradation have been recently clarified. As discussed below, arsenic binding, oxidation, sumoylation on PML nuclear bodies, and RNF4-mediated ubiquitination all contribute to the As2O3-triggered catabolism of PML/RARA.
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