Molecular Leukemogenesis Group, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.
Department of Internal Medicine V, Heidelberg University Hospital, 69120, Heidelberg, Germany.
Nat Commun. 2019 Apr 9;10(1):1635. doi: 10.1038/s41467-019-09633-9.
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.
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。