Downloaded from genome.cshlp.org on September 26, 2021 - Published by Cold Spring Harbor Laboratory Press Webster et al. Enhancer-targeted genome editing selectively blocks innate resistance to oncokinase inhibition Dan E. Webster1, Brook Barajas1*, Rose T. Bussat1*, Karen J. Yan1, Poornima H. Neela1, Ross J. Flockhart1, Joanna Kovalski1, Ashley Zehnder1, and Paul A. Khavari1, ¶ 1The Program in Epithelial Biology, Stanford University School of Medicine, Stanford, CA 94305 USA *These authors made equal and independent contributions. ¶ Correspondence to: P.A.K. at
[email protected] Running title: Enhancer disruption blocks oncokinase resistance Keywords: Cancer Epigenomics, Enhancer, TALE nuclease, Chromosome conformation, BRAF, MITF Downloaded from genome.cshlp.org on September 26, 2021 - Published by Cold Spring Harbor Laboratory Press ABSTRACT Thousands of putative enhancers are characterized in the human genome, yet few have been shown to have a functional role in cancer progression. Inhibiting oncokinases, such as EGFR, ALK, ERBB2, and BRAF, is a mainstay of current cancer therapy but is hindered by innate drug resistance mediated by upregulation of the HGF receptor, MET. The mechanisms mediating such genomic responses to targeted therapy are unknown. Here, we identify lineage- specific enhancers at the MET locus for multiple common tumor types, including a melanoma lineage-specific enhancer 63kb downstream of the MET TSS. This enhancer displays inducible chromatin looping with the MET promoter to upregulate MET expression upon BRAF inhibition. Epigenomic analysis demonstrated that the melanocyte-specific transcription factor, MITF, mediates this enhancer function. Targeted genomic deletion (<7bp) of the MITF motif within the MET enhancer suppressed inducible chromatin looping and innate drug resistance, while maintaining MITF-dependent, inhibitor-induced melanoma cell differentiation.