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Menin-KMT2A complex (protein-protein interaction)

Molecular classification
Protein-protein interaction, Epigenetic regulator, Chromatin remodeling complex, Histone modification
01

Overview

The **menin-KMT2A interaction** refers to the binding between menin, a scaffolding protein encoded by the MEN1 gene, and KMT2A (also known as MLL1, a histone-lysine N-methyltransferase). This interaction is essential for the transcriptional activation of key developmental genes, notably the HOX gene cluster, by maintaining active chromatin states through H3K4 methylation[1][3][6]. In hematopoietic malignancies such as acute myeloid leukemia and acute lymphoblastic leukemia, especially those with KMT2A gene rearrangements or mutations in NPM1, the menin-KMT2A interaction becomes a critical oncogenic driver by sustaining aberrant gene expression programs that block differentiation and promote proliferation of leukemic blasts[3][5][7]. Therapeutically, targeted inhibition of this protein-protein interaction using small molecules (e.g., revumenib, JNJ-75276617) disrupts oncogenic transcription, induces differentiation, and leads to apoptosis of leukemia cells[5][7]. This provides a compelling mechanism-based strategy for treating high-risk leukemias with KMT2A or NPM1 genetic alterations, with numerous agents in clinical development.

Other names
Menin-MLL1 interactionMEN1-KMT2A interactionMenin-MLL fusion protein interactionMenin-histone-lysine N-methyltransferase 2A interaction
02

Mechanism of action

Inhibition of menin-KMT2A protein-protein interaction, causing dissociation of the complex from chromatin, downregulation of oncogenic transcription programs (notably HOXA and MEIS1 genes), reversal of differentiation block, and induction of apoptosis in leukemia cells[5][7].

03

Biological functions

Transcriptional regulationEpigenetic maintenanceHematopoiesisCell cycle regulationCell proliferationMaintenance of oncogenic gene expression
04

Disease associations

CancerAcute myeloid leukemia (AML)Acute lymphoblastic leukemia (ALL)Neurodevelopmental syndromes (associated, but primary therapeutic focus is leukemia)
05

Safety considerations

On-target hematological toxicity (most agents target leukemic but also normal hematopoietic cells)Potential resistance mutations in MEN1 gene[5]Cardiotoxicity (evaluated, but not a major concern for JNJ-75276617)[7]
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Interacting drugs

Revumenib

3 more in the full profile.

07

Biomarkers

KMT2A rearrangement (KMT2A-r)NPM1 mutations (NPM1c)HOXA gene expressionMEIS1 gene expressionFLT3 expression

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