University of Veterinary Medicine Vienna Targeting NRAS via miR-1304-5p or farnesyltransferase inhibition confers sensitivity to ALK inhibitors in ALK-mutant neuroblastoma Targeting Anaplastic lymphoma kinase (ALK) is a promising therapeutic strategy for aberrant ALK-expressing malignancies including neuroblastoma, but resistance to ALK tyrosine kinase inhibitors (ALK TKI) is a distinct possibility necessitating drug combination therapeutic approaches. Using high-throughput, genome-wide CRISPR-Cas9 knockout screens, we identify miR-1304-5p loss as a desensitizer to ALK TKIs in aberrant ALK-expressing neuroblastoma; inhibition of miR-1304-5p decreases, while mimics of this miRNA increase the sensitivity of neuroblastoma cells to ALK TKIs. We show that miR-1304-5p targets NRAS, decreasing cell viability via induction of apoptosis. It follows that the farnesyltransferase inhibitor (FTI) lonafarnib in addition to ALK TKIs act synergistically in neuroblastoma, inducing apoptosis in vitro. In particular, on combined treatment of neuroblastoma patient derived xenografts with an FTI and an ALK TKI complete regression of tumour growth is observed although tumours rapidly regrow on cessation of therapy. Overall, our data suggests that combined use of ALK TKIs and FTIs, constitutes a therapeutic approach to treat high risk neuroblastoma although prolonged therapy is likely required to prevent relapse. en TEXT journal article Wissenschaftlicher Artikel Articolo di rivista Text journal article Testo Articolo di rivista Text Wissenschaftlicher Artikel Cancer Therapeutic Resistance Cancer Therapy Paediatric Cancer 2024 2024 Perla Pucci Liam Lee Miao Han Jamie D. Matthews Leila Jahangiri Michaela Schlederer Eleanor Manners Annabel Sorby-Adams Joshua Kaggie Ricky Trigg Christopher Steel Lucy Hare Emily James Nina Prokoph Stephen P Ducray Olaf Merkel F. Rifatbegovic Ji Luo Sabine Taschner-Mandl Lukas Kenner Suzanne Turner Amos Burke Nature Publishing Group