Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer Res. 2019 Jan 15;79(2):311-319. doi: 10.1158/0008-5472.CAN-18-1003. Epub 2018 Nov 27.
PARP inhibitors (PARPi) have shown remarkable therapeutic efficacy against -mutant cancers through a synthetic lethal interaction. PARPi exert their therapeutic effects mainly through the blockade of ssDNA damage repair, which leads to the accumulation of toxic DNA double-strand breaks specifically in cancer cells with DNA repair deficiency (BCRAness), including those harboring mutations. Here we show that PARPi-mediated modulation of the immune response contributes to their therapeutic effects independently of mutations. PARPi promoted accumulation of cytosolic DNA fragments because of unresolved DNA lesions, which in turn activated the DNA-sensing cGAS-STING pathway and stimulated production of type I IFNs to induce antitumor immunity independent of BRCAness. These effects of PARPi were further enhanced by immune checkpoint blockade. Overall, these results provide a mechanistic rationale for using PARPi as immunomodulatory agents to harness the therapeutic efficacy of immune checkpoint blockade. SIGNIFICANCE: This work uncovers the mechanism behind the clinical efficacy of PARPi in patients with both BRCA-wild-type and BRCA-mutant tumors and provides a rationale for combining PARPi with immunotherapy in patients with cancer.
聚腺苷二磷酸核糖聚合酶(PARP)抑制剂(PARPi)通过合成致死相互作用,对 - 突变癌症显示出显著的治疗效果。PARPi 主要通过阻断 ssDNA 损伤修复发挥其治疗作用,这导致具有 DNA 修复缺陷(BCRAness)的癌细胞中特定的毒性 DNA 双链断裂的积累,包括那些携带 突变的癌细胞。在这里,我们表明,PARPi 介导的免疫反应调节有助于其治疗效果,而与 突变无关。由于未解决的 DNA 损伤,PARPi 促进了细胞溶质 DNA 片段的积累,这反过来又激活了 DNA 感应 cGAS-STING 途径,并刺激产生 I 型 IFNs,从而独立于 BRCAness 诱导抗肿瘤免疫。PARPi 的这些作用通过免疫检查点阻断进一步增强。总之,这些结果为将 PARPi 用作免疫调节剂以利用免疫检查点阻断的治疗效果提供了机制基础。
意义:这项工作揭示了 PARPi 在 BRCA 野生型和 BRCA 突变型肿瘤患者中的临床疗效的背后机制,并为在癌症患者中联合使用 PARPi 和免疫疗法提供了依据。
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