Interleukin 1 Receptor-Associated Kinase 1 (IRAK1) Mutation is a Common, Essential Driver for Kaposi Sarcoma Herpesvirus Lymphoma

Significance Primary effusion lymphoma (PEL) is an AIDS-defining cancer. It is associated with Kaposi sarcoma-associated herpesvirus. To date, no sequencing studies have been conducted for this cancer. We used X chromosome-targeted next-generation sequencing to identify 33 genes with coding region mutations in 100% of cases, including in interleukin 1 receptor-associated kinase 1 (IRAK1). IRAK1 kinase modulates toll-like receptor signaling-mediated immune signaling. It binds to MyD88 adapter protein, which is mutated in a subset of diffuse large B-cell lymphomas. IRAK1, however, had not been linked to cancer. This IRAK1 mutant is constitutively active and essential for PEL survival. This highlights the importance of innate immunity signaling as drivers for cancer, particularly those caused by viruses. It also suggests IRAK1 kinase may be a potential target for therapy.