Proteomic profiling reveals pleiotropic antimetabolite activity of triciribine in acute lymphoblastic leukemia

Acute lymphoblastic leukemia (ALL) exhibits marked genetic and metabolic heterogeneity that limits the efficacy of targeted therapies. Antimetabolite strategies remain central to ALL treatment, yet the mechanisms underlying differential drug sensitivity are incompletely defined. Here, we investigated the activity of the purine analog triciribine (TCN) across diverse ALL cellular models. We find that TCN exerts potent cytotoxic effects in multiple ALL cell lines, exceeding those observed with canonical Akt inhibitors in our datasets. Phosphoproteomic analyses indicate that, at early time points, TCN does not primarily suppress Akt signaling but instead induces transient pathway activation accompanied by inhibition of cyclin-dependent kinases in both sensitive and resistant cells. The monophosphorylated metabolite TCN-P represents the predominant intracellular species and requires adenosine kinase (ADK) for activity, with ADK protein levels positively correlating with TCN sensitivity in both cell lines and primary patient samples. Using Proteome Integral Solubility Alteration profiling, we identify candidate protein interactions of TCN-P distributed across multiple cellular pathways, including nucleotide metabolism, DNA replication, and protein synthesis. These interactions are accompanied by impaired purine biosynthesis, DNA damage, translational stress, and cell-cycle arrest, as supported by time-course quantitative proteomics and immunoblot analyses. Together, these findings characterize triciribine as an antileukemic agent with pleiotropic antimetabolite activity in ALL and highlight ADK-dependent metabolism as a key determinant of therapeutic sensitivity, suggesting that ADK levels may serve as a predictive biomarker to stratify patients for triciribine-based precision treatment strategies.