Breaking the oncogenic link: BCL10-MALT1 disruption as a precision strike against NF-κB-driven lymphomas.

The CARMA1-BCL10-MALT1 (CBM) complex plays a pivotal role in mediating antigen receptor-induced activation of NF-κB, a pathway critical for lymphocyte survival and proliferation. In aggressive lymphoid malignancies such as activated B-cell-like diffuse large B-cell lymphoma (ABC-DLBCL), oncogenic mutations drive constitutive CBM complex activation, leading to chronic NF-κB signaling and treatment resistance. Traditional therapeutic approaches have focused on inhibiting MALT1's protease activity; however, these strategies incompletely suppress CBM-driven signaling and may provoke immune-related toxicities by selectively impairing regulatory T cell function. Recent insights into the structural basis of CBM assembly have identified the BCL10-MALT1 interaction, particularly the hydrophobic groove between MALT1's Ig1-Ig2 domains, as a critical therapeutic target. Small-molecule inhibitors such as M1i-124 have demonstrated the ability to disrupt this interaction, leading to dual inhibition of MALT1's scaffolding and protease activities, destabilization of the CBM complex, and selective toxicity toward ABC-DLBCL cells. Preclinical studies show promising efficacy with broad suppression of NF-κB signaling and cytokine production while minimizing off-target effects. This review highlights the biological rationale, preclinical progress, and future directions for targeting the BCL10-MALT1 interface, outlining a transformative strategy for precision therapy in lymphoma and other CBM-dependent diseases.