DRP1-mediated mitochondrial fragmentation is a druggable vulnerability in multiple myeloma

M Maria Eugenia Gallo Cantafio (University Magna Graecia of Catanzaro, Catanzaro, Italy) N Noemi Puccio (Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Reggio Emilia, Italy) R Roberta Torcasio (Dana-Farber Cancer Institute, Boston, Massachusetts, United States) I Ilenia Valentino (University Magna Graecia of Catanzaro, Catanzaro, Italy) L Ludovica Ganino (University Magna Graecia of Catanzaro, Catanzaro, Italy) Y Yuanyuan Jin A Anil Aktas Samur (Dana Farber Cancer Institution, Boston, Massachusetts, United States) P Pierpaolo Murfone (University of Catanzaro, Catanzaro, Italy) A Alessia Gallo (IRCCS ISMETT, Palermo, Italy) M Mehmet K. Samur (Dana-Farber Cancer Institute and Harvard School of Public Health, Boston, Massachusetts, United States) N Nicola Cuscino (IRCCS ISMETT, Palermo, Italy) C Cesarina Giallongo I Ida Daniela Perrotta (University of Calabria, Rende CS, Italy) A Alessia Ciarrocchi (Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy) F Federico Tallarigo (anatomia patologica, Crotone, Italy) E Ernestina Marianna De Francesco (University of Enna "Kore", Enna, Italy) D Davide Barbuto R Ross David Jansen-van Vuuren (University of Ljubljana, Ljubljana, Slovenia) L Luka Jedlovčnik (University of Ljubljana, Faculty of Chemistry and Chemical Technology, Ljubljana, Slovenia) D Danchen Wu (Queen's University, Kingston, Ontario, Canada) E Enrica Antonia Martino (Azienda Ospedaliera Annunziata, Cosenza, Italy) D Daniele Tibullo F Francesco Di Raimondo M Massimo Gentile (Azienda Ospedaliera Annunziata, Cosenza, Italy) A Antonino Neri (Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy) S Stephen L. Archer (Translational Institute of Medicine (TIME), Queen's University, Kingston, Canada) E Eugenio Morelli (INOC - Istituto Nazionale Oncologico Candiolo, Candiolo, Italy) N Nikhil C. Munshi G Giuseppe Viglietto (University of Catanzaro, Catanzaro, Italy) M Mariateresa Fulciniti (Dana Farber Cancer Institute, Boston, Massachusetts, United States) N Nicola Amodio (University of Catanzaro, Catanzaro, Italy)

Abstract

Mitochondrial dynamics is a key regulator of cellular homeostasis, orchestrating metabolic reprogramming that fuels tumor progression and treatment resistance. In multiple myeloma (MM), however, the functional relevance of mitochondrial remodeling has not been fully defined. Using ultrastructural analyses, we reveal that MM cells display a highly fragmented mitochondrial network, a phenotype further exacerbated in both cell lines and primary MM cells resistant to proteasome inhibitors. Transcriptomic profiling across multiple patient-derived datasets consistently demonstrated upregulation of DNM1L gene, which encodes the mitochondrial fission GTPase DRP1, particularly in relapsed and refractory MM, and revealed a significant association with inferior overall survival. Disrupting mitochondrial fission, either through genetic targeting of DNM1L or pharmacologic inhibition of DRP1 with the selective small molecule inhibitor Drpitor1a, resulted in pronounced mitochondrial dysfunction, impaired oxidative phosphorylation, and potent anti-myeloma activity in vitro, culminating in a hybrid cell death program with a predominant apoptotic component accompanied by ferroptotic features. These effects were recapitulated in vivo in a bortezomib-resistant xenograft model, where either DNM1L depletion or DRP1 inhibition produced similar outcomes. Mechanistically, the transcription factor c-MYC upregulated DNM1L expression, and DRP1-dependent mitochondrial fragmentation sustained MYC-driven oxidative metabolism and lipid synthesis. Altogether, these findings establish aberrant mitochondrial fission as a pathogenic hallmark of MM and highlight DRP1 inhibition as a promising therapeutic approach, especially for relapsed or refractory disease.

Article Details

Journal Blood
Volume / Issue Vol. 1, Issue 1
Published August 03, 2026
ISSN 0006-4971
Publisher Elsevier BV

Journal Info

Blood

Elsevier BV

ISSN: 0006-4971 Health Sciences

Authors (31)

M

Maria Eugenia Gallo Cantafio

University Magna Graecia of Catanzaro, Catanzaro, Italy

N

Noemi Puccio

Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Reggio Emilia, Italy

R

Roberta Torcasio

Dana-Farber Cancer Institute, Boston, Massachusetts, United States

I

Ilenia Valentino

University Magna Graecia of Catanzaro, Catanzaro, Italy

L

Ludovica Ganino

University Magna Graecia of Catanzaro, Catanzaro, Italy

Y

Yuanyuan Jin

A

Anil Aktas Samur

Dana Farber Cancer Institution, Boston, Massachusetts, United States

P

Pierpaolo Murfone

University of Catanzaro, Catanzaro, Italy

A

Alessia Gallo

IRCCS ISMETT, Palermo, Italy

M

Mehmet K. Samur

Dana-Farber Cancer Institute and Harvard School of Public Health, Boston, Massachusetts, United States

N

Nicola Cuscino

IRCCS ISMETT, Palermo, Italy

C

Cesarina Giallongo

I

Ida Daniela Perrotta

University of Calabria, Rende CS, Italy

A

Alessia Ciarrocchi

Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy

F

Federico Tallarigo

anatomia patologica, Crotone, Italy

E

Ernestina Marianna De Francesco

University of Enna "Kore", Enna, Italy

D

Davide Barbuto

R

Ross David Jansen-van Vuuren

University of Ljubljana, Ljubljana, Slovenia

L

Luka Jedlovčnik

University of Ljubljana, Faculty of Chemistry and Chemical Technology, Ljubljana, Slovenia

D

Danchen Wu

Queen's University, Kingston, Ontario, Canada

E

Enrica Antonia Martino

Azienda Ospedaliera Annunziata, Cosenza, Italy

D

Daniele Tibullo

F

Francesco Di Raimondo

M

Massimo Gentile

Azienda Ospedaliera Annunziata, Cosenza, Italy

A

Antonino Neri

Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy

S

Stephen L. Archer

Translational Institute of Medicine (TIME), Queen's University, Kingston, Canada

E

Eugenio Morelli

INOC - Istituto Nazionale Oncologico Candiolo, Candiolo, Italy

N

Nikhil C. Munshi

G

Giuseppe Viglietto

University of Catanzaro, Catanzaro, Italy

M

Mariateresa Fulciniti

Dana Farber Cancer Institute, Boston, Massachusetts, United States

N

Nicola Amodio

University of Catanzaro, Catanzaro, Italy