N-Me, a long range oncogenic enhancer in T-cell acute lymphoblastic leukemia

Efforts to identify and annotate cancer driver genetic lesions have been almost exclusively focused on the analysis of protein coding genes. Here we identify a new long-range acting MYC enhancer controlled by NOTCH1, targeted by recurrent chromosomal duplications in human T-cell acute lymphoblastic leukemia (T-ALL). This highly conserved regulatory element, hereby named N-Me for NOTCH MYC enhancer, is located within a broad super-enhancer region +1.47 Mb from the MYC transcription initiating site, interacts with the MYC proximal promoter and induces orientation-independent MYC expression in reporter assays. Moreover, analysis of N-Me knockout mice demonstrates a selective and essential role of this regulatory element during thymocyte development and in NOTCH1-induced T-ALL. Altogether, these results identify N-Me as a long range oncogenic enhancer directly implicated in the pathogenesis of human leukemia and highlight the fundamental importance of the NOTCH1-MYC regulatory axis in T-cell transformation and as therapeutic target in T-ALL.