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Dryad

Programmable and selective silencing of oncogenic fusion transcripts by CRISPR-Cas13b via breakpoint sequence recognition

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Sep 15, 2026 version files 95.31 MB

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Abstract

Oncogenic gene fusions are key drivers of cancer, yet most remain untargetable by current therapies. Here, we establish CRISPR-PspCas13b as a personalizable platform for systematic silencing of various fusion transcripts. We reveal that recognition and cleavage of the breakpoint sequence by PspCas13b disrupts the fusion transcript, resulting in unexpected RNA nicking and ligation near the cleavage site, which generates out-of-frame, translation-incompetent transcripts. Importantly, we demonstrate that targeting the BCR::ABL1 breakpoint sequence efficiently degrades both canonical and drug-resistant BCR::ABL1 mutants, which are the primary drivers of tyrosine kinase inhibitor (TKI) resistance and relapse in chronic myeloid leukemia (CML). Molecular profiling revealed that PspCas13b triggers extensive transcriptomic, proteomic, and phosphoproteomic remodeling, ultimately leading to erythroid differentiation and apoptosis in CML cells that are fully resistant to clinical drugs. Beyond BCR-ABL1 mutants, personalized design of PspCas13b effectively silences other undruggable fusions, including RUNX1::RUNX1T1 and EWSR1::FLI1, key drivers in acute myeloid leukemia and in Ewing’s sarcoma, respectively. Collectively, this study establishes a molecular framework for systematic, precise, and personalizable targeting of otherwise undruggable or drug-resistant oncogenic transcripts.