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同源重组 DNA 修复缺陷作为晚期脊索瘤的治疗靶点。

Defective homologous recombination DNA repair as therapeutic target in advanced chordoma.

机构信息

Molecular Leukemogenesis Group, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.

Department of Internal Medicine V, Heidelberg University Hospital, 69120, Heidelberg, Germany.

出版信息

Nat Commun. 2019 Apr 9;10(1):1635. doi: 10.1038/s41467-019-09633-9.

Abstract

Chordomas are rare bone tumors with few therapeutic options. Here we show, using whole-exome and genome sequencing within a precision oncology program, that advanced chordomas (n = 11) may be characterized by genomic patterns indicative of defective homologous recombination (HR) DNA repair and alterations affecting HR-related genes, including, for example, deletions and pathogenic germline variants of BRCA2, NBN, and CHEK2. A mutational signature associated with HR deficiency was significantly enriched in 72.7% of samples and co-occurred with genomic instability. The poly(ADP-ribose) polymerase (PARP) inhibitor olaparib, which is preferentially toxic to HR-incompetent cells, led to prolonged clinical benefit in a patient with refractory chordoma, and whole-genome analysis at progression revealed a PARP1 p.T910A mutation predicted to disrupt the autoinhibitory PARP1 helical domain. These findings uncover a therapeutic opportunity in chordoma that warrants further exploration, and provide insight into the mechanisms underlying PARP inhibitor resistance.

摘要

软骨肉瘤是一种罕见的骨肿瘤,治疗选择有限。在这里,我们在精准肿瘤学计划中使用全外显子组和基因组测序表明,晚期软骨肉瘤(n=11)可能具有同源重组(HR)DNA 修复缺陷和影响 HR 相关基因的改变的基因组模式,例如 BRCA2、NBN 和 CHEK2 的缺失和致病性种系变体。与 HR 缺陷相关的突变特征在 72.7%的样本中显著富集,并与基因组不稳定性共存。聚(ADP-核糖)聚合酶(PARP)抑制剂奥拉帕利对 HR 功能不全的细胞具有优先毒性,在一名难治性软骨肉瘤患者中导致了延长的临床获益,进展时的全基因组分析显示 PARP1 p.T910A 突变可能破坏自抑制 PARP1 螺旋结构域。这些发现揭示了软骨肉瘤的治疗机会,值得进一步探索,并深入了解 PARP 抑制剂耐药的机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d073/6456501/227c3a5b2fe3/41467_2019_9633_Fig1_HTML.jpg

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