Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK.
J Pathol. 2011 Aug;224(4):564-74. doi: 10.1002/path.2925. Epub 2011 Jun 27.
Evasion of apoptosis contributes to both tumourigenesis and drug resistance in non-small cell lung carcinoma (NSCLC). The pro-apoptotic BCL-2 family proteins BAX and BAK are critical regulators of mitochondrial apoptosis. New strategies for targeting NSCLC in a mitochondria-independent manner should bypass this common mechanism of apoptosis block. BRCA1 mutation frequency in lung cancer is low; however, decreased BRCA1 mRNA and protein expression levels have been reported in a significant proportion of lung adenocarcinomas. BRCA1 mutation/deficiency confers a defect in homologous recombination DNA repair that has been exploited by synthetic lethality through inhibition of PARP (PARPi) in breast and ovarian cells; however, it is not known whether this same synthetic lethal mechanism exists in NSCLC cells. Additionally, it is unknown whether the mitochondrial apoptotic pathway is required for BRCA1/PARPi-mediated synthetic lethality. Here we demonstrate that silencing of BRCA1 expression by RNA interference sensitizes NSCLC cells to PARP inhibition. Importantly, this sensitivity was not attenuated in cells harbouring mitochondrial apoptosis block induced by co-depletion of BAX and BAK. Furthermore, we demonstrate that BRCA1 inhibition cannot override platinum resistance, which is often mediated by loss of mitochondrial apoptosis signalling, but can still sensitize to PARP inhibition. Finally we demonstrate the existence of a BRCA1-deficient subgroup (11-19%) of NSCLC patients by analysing BRCA1 protein levels using immunohistochemistry in two independent primary NSCLC cohorts. Taken together, the existence of BRCA1-immunodeficient NSCLC suggests that this molecular subgroup could be effectively targeted by PARP inhibitors in the clinic and that PARP inhibitors could be used for the treatment of BRCA1-immunodeficient, platinum-resistant tumours.
细胞凋亡的逃逸导致非小细胞肺癌(NSCLC)的肿瘤发生和耐药性。促凋亡 BCL-2 家族蛋白 BAX 和 BAK 是线粒体凋亡的关键调节因子。针对 NSCLC 的非线粒体依赖性新策略应该绕过这种常见的凋亡阻断机制。肺癌中 BRCA1 突变频率较低;然而,据报道,相当一部分肺腺癌中 BRCA1 mRNA 和蛋白表达水平降低。BRCA1 突变/缺失导致同源重组 DNA 修复缺陷,已通过抑制 PARP(PARPi)在乳腺癌和卵巢细胞中利用合成致死作用得到证实;然而,尚不清楚相同的合成致死机制是否存在于 NSCLC 细胞中。此外,尚不清楚线粒体凋亡途径是否是 BRCA1/PARPi 介导的合成致死所必需的。在这里,我们通过 RNA 干扰沉默 BRCA1 表达来证明这一点,这使 NSCLC 细胞对 PARP 抑制敏感。重要的是,在同时耗尽 BAX 和 BAK 诱导的线粒体凋亡阻断的细胞中,这种敏感性没有减弱。此外,我们证明 BRCA1 抑制不能克服铂耐药性,铂耐药性通常是由线粒体凋亡信号传导的丧失介导的,但仍然可以对 PARP 抑制敏感。最后,我们通过在两个独立的原发性 NSCLC 队列中使用免疫组织化学分析 BRCA1 蛋白水平来证明 NSCLC 患者中存在 BRCA1 缺陷亚组(11-19%)。总之,BRCA1 缺陷型 NSCLC 的存在表明,这种分子亚组可以在临床上有效地被 PARP 抑制剂靶向,并且 PARP 抑制剂可用于治疗 BRCA1 缺陷型、铂耐药肿瘤。
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