Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer Res. 2018 Feb 1;78(3):742-757. doi: 10.1158/0008-5472.CAN-17-1494. Epub 2017 Nov 27.
PARP inhibitors (PARPi) benefit only a fraction of breast cancer patients. Several of those patients exhibit intrinsic/acquired resistance mechanisms that limit efficacy of PARPi monotherapy. Here we show how the efficacy of PARPi in triple-negative breast cancers (TNBC) can be expanded by targeting MYC-induced oncogenic addiction. In BRCA-mutant/sporadic TNBC patients, amplification of the MYC gene is correlated with increased expression of the homologous DNA recombination enzyme RAD51 and tumors overexpressing both genes are associated with worse overall survival. Combining MYC blockade with PARPi yielded synthetic lethality in MYC-driven TNBC cells. Using the cyclin-dependent kinase inhibitor dinaciclib, which downregulates MYC expression, we found that combination with the PARPi niraparib increased DNA damage and downregulated homologous recombination, leading to subsequent downregulation of the epithelial-mesenchymal transition and cancer stem-like cell phenotypes. Notably, dinaciclib resensitized TBNC cells, which had acquired resistance to niraparib. We found that the synthetic lethal strategy employing dinaciclib and niraparib was also highly efficacious in ovarian, prostate, pancreatic, colon, and lung cancer cells. Taken together, our results show how blunting MYC oncogene addiction can leverage cancer cell sensitivity to PARPi, facilitating the clinical use of c-myc as a predictive biomarker for this treatment. Dual targeting of MYC-regulated homologous recombination and PARP-mediated DNA repair yields potent synthetic lethality in triple-negative breast tumors and other aggressive tumors characterized by MYC overexpression. .
聚腺苷二磷酸核糖聚合酶(PARP)抑制剂仅对一部分乳腺癌患者有效。其中一些患者存在内在/获得性耐药机制,限制了 PARPi 单药治疗的疗效。在这里,我们展示了如何通过靶向 MYC 诱导的致癌成瘾来扩大 PARPi 在三阴性乳腺癌(TNBC)中的疗效。在 BRCA 突变/散发性 TNBC 患者中,MYC 基因的扩增与同源 DNA 重组酶 RAD51 的表达增加相关,并且过度表达这两种基因的肿瘤与总体生存率降低相关。在 MYC 驱动的 TNBC 细胞中,将 MYC 阻断与 PARPi 联合使用可产生合成致死作用。使用细胞周期蛋白依赖性激酶抑制剂 dinaciclib,其下调 MYC 表达,我们发现与 PARPi niraparib 联合使用可增加 DNA 损伤并下调同源重组,导致随后下调上皮-间充质转化和癌症干细胞样细胞表型。值得注意的是,dinaciclib 使对 niraparib 产生获得性耐药的 TNBC 细胞重新敏感。我们发现,使用 dinaciclib 和 niraparib 的合成致死策略在卵巢癌、前列腺癌、胰腺癌、结肠癌和肺癌细胞中也非常有效。总之,我们的研究结果表明,如何削弱 MYC 癌基因成瘾可以利用癌细胞对 PARPi 的敏感性,促进 c-myc 作为这种治疗的预测性生物标志物的临床应用。靶向 MYC 调节的同源重组和 PARP 介导的 DNA 修复的双重靶向在三阴性乳腺癌肿瘤和其他以 MYC 过表达为特征的侵袭性肿瘤中产生有效的合成致死作用。