Molecular and Cellular Biochemistry Department, Indiana University, Bloomington, Indiana.
Medical Sciences Program, Indiana University School of Medicine, Bloomington, Indiana.
Clin Cancer Res. 2018 Jul 1;24(13):3163-3175. doi: 10.1158/1078-0432.CCR-18-0204. Epub 2018 Apr 3.
PARP inhibitors (PARPi) are primarily effective against BRCA1/2-mutated breast and ovarian cancers, but resistance due to reversion of mutated BRCA1/2 and other mechanisms is common. Based on previous reports demonstrating a functional role for DNMT1 in DNA repair and our previous studies demonstrating an ability of DNA methyltransferase inhibitor (DNMTi) to resensitize tumors to primary therapies, we hypothesized that combining a DNMTi with PARPi would sensitize PARPi-resistant breast and ovarian cancers to PARPi therapy, independent of BRCA status. Breast and ovarian cancer cell lines (BRCA-wild-type/mutant) were treated with PARPi talazoparib and DNMTi guadecitabine. Effects on cell survival, ROS accumulation, and cAMP levels were examined. , mice bearing either BRCA-proficient breast or ovarian cancer cells were treated with talazoparib and guadecitabine, alone or in combination. Tumor progression, gene expression, and overall survival were analyzed. Combination of guadecitabine and talazoparib synergized to enhance PARPi efficacy, irrespective of BRCA mutation status. Coadministration of guadecitabine with talazoparib increased accumulation of ROS, promoted PARP activation, and further sensitized, in a cAMP/PKA-dependent manner, breast and ovarian cancer cells to PARPi. In addition, DNMTi enhanced PARP "trapping" by talazoparib. Guadecitabine plus talazoparib decreased xenograft tumor growth and increased overall survival in BRCA-proficient high-grade serous ovarian and triple-negative breast cancer models. The novel combination of the next-generation DNMTi guadecitabine and the first-in-class PARPi talazoparib inhibited breast and ovarian cancers harboring either wild-type- or mutant-BRCA, supporting further clinical exploration of this drug combination in PARPi-resistant cancers. .
聚腺苷二磷酸核糖聚合酶(PARP)抑制剂主要对 BRCA1/2 突变的乳腺癌和卵巢癌有效,但由于突变的 BRCA1/2 及其它机制的逆转而产生耐药性较为常见。基于先前的报告表明 DNMT1 在 DNA 修复中具有功能作用,以及我们之前的研究表明 DNA 甲基转移酶抑制剂(DNMTi)有能力使肿瘤对主要治疗药物重新敏感,我们假设将 DNMTi 与 PARPi 联合使用将使 PARPi 耐药的乳腺癌和卵巢癌对 PARPi 治疗敏感,而与 BRCA 状态无关。用 PARPi 他拉唑帕尼和 DNMTi 地西他滨处理乳腺癌和卵巢癌细胞系(BRCA 野生型/突变型)。检测细胞存活、ROS 积累和 cAMP 水平的影响。在携带 BRCA 功能正常的乳腺癌或卵巢癌细胞的小鼠中,单独或联合使用他拉唑帕尼和地西他滨进行治疗。分析肿瘤进展、基因表达和总生存期。地西他滨和他拉唑帕尼联合使用可协同增强 PARPi 的疗效,而与 BRCA 突变状态无关。地西他滨与他拉唑帕尼联合使用可增加 ROS 的积累,促进 PARP 激活,并以 cAMP/PKA 依赖性方式进一步使乳腺癌和卵巢癌细胞对 PARPi 敏感。此外,DNMTi 增强了他拉唑帕尼对 PARP 的“捕获”。地西他滨加他拉唑帕尼可减少 BRCA 功能正常的高级别浆液性卵巢癌和三阴性乳腺癌模型的异种移植肿瘤生长并增加总生存期。新一代 DNMTi 地西他滨与首创 PARPi 他拉唑帕尼的新组合抑制了携带野生型或突变型 BRCA 的乳腺癌和卵巢癌,支持进一步在 PARPi 耐药性癌症中探索这种药物组合。
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