# High‐fidelity CRISPR/Cas12a dual‐crRNA screening reveals novel synergistic interactions in hepatocellular carcinoma

## TL;DR

This study introduces a high-fidelity CRISPR/Cas12a method to identify gene interactions in liver cancer, revealing new synergistic gene pairs that could improve treatment strategies.

## Contribution

A novel, high-fidelity CRISPR/Cas12a dual-crRNA screening method using SOE PCR and CeCas12a for efficient and accurate genetic interaction discovery in hepatocellular carcinoma.

## Key findings

- Raf1 and Pkm2 show synergistic interactions that inhibit hepatocellular carcinoma cell growth in vitro and in vivo.
- Low expression of Raf1-Pkm2 is linked to improved patient survival in TCGA and GEO databases.
- The method enables rapid construction of dual-crRNA libraries for widespread use in genetic screening.

## Abstract

CRISPR/Cas12a‐based combinational screening has shown remarkable potential for identifying genetic interactions. Here, we describe an innovative method for combinational genetic screening with rapid construction of a dual‐CRISPR RNA (crRNA) library using gene splicing through overlap extension PCR (SOE PCR) and the adoption of CeCas12a, which we previously identified with strict PAM recognition and low off‐targeting to guarantee fidelity and efficiency. The custom‐pooled SOE crRNA array (SOCA) library for double‐knockout screening could be conveniently constructed in the laboratory for widespread use, and the CeCas12a‐mediated high‐fidelity screen displayed good performance even under a negative selection screen. By designing a SOCA dual‐crRNA library that covered most of the kinase and metabolism‐associated gene targets of FDA‐approved drugs implicated in hepatocellular carcinoma (HCC) tumourigenesis, novel cross‐talk between the two gene sets was negatively selected to inhibit HCC cell growth in vitro and in vivo and was validated using virtual double‐knockdown screening based on TCGA databases. Thus, this rapid, efficient and high‐fidelity double‐knockout screening system is promising for systemically identifying potential genetic interactions between multiple gene sets or combinations of FDA‐ approved drugs for clinical translational medicine in the future.

1. High‐fidelity CRISPR/Cas12a dual‐crRNA screening identifies synergistic interactions of Raf1‐Pkm2 in the development of hepatocellular carcinoma.

2. Raf1 and Pkm2 display a significant clinical correlation in tissue microarray and closely correlated with HCC pathological grading.

3. Low expression of Raf1‐Pkm2 significantly improves patient survival in TCGA and GEO databases.