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Lin X, Soni A, Hessenow R, Sun Y, Mladenov E, Guberina M, Stuschke M, Iliakis G. Talazoparib enhances resection at DSBs and renders HR-proficient cancer cells susceptible to Polθ inhibition. Radiother Oncol 2024; 200:110475. [PMID: 39147034 DOI: 10.1016/j.radonc.2024.110475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 07/02/2024] [Accepted: 08/12/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND AND PURPOSE The PARP inhibitor (PARPi), Talazoparib (BMN673), effectively and specifically radiosensitizes cancer cells. Radiosensitization is mediated by a shift in the repair of ionizing radiation (IR)-induced DNA double-strand breaks (DSBs) toward PARP1-independent, alternative end-joining (alt-EJ). DNA polymerase theta (Polθ) is a key component of this PARP1-independent alt-EJ pathway and we show here that its inhibition can further radiosensitize talazoparib-treated cells. The purpose of the present work is to explore mechanisms and dynamics underpinning enhanced talazoparib radiosensitization by Polθ inhibitors in HR-proficient cancer cells. METHODS AND MATERIALS Radiosensitization to PARPis, talazoparib, olaparib, rucaparib and veliparib was assessed by clonogenic survival. Polθ-proficient and -deficient cells were treated with PARPis and/or with the Polθ inhibitors ART558 or novobiocin. The role of DNA end-resection was studied by down-regulating CtIP and MRE11 expression using siRNAs. DSB repair was assessed by scoring γH2AX foci. The formation of chromosomal abnormalities was assessed as evidence of alt-EJ function using G2-specific cytogenetic analysis. RESULTS Talazoparib exerted pronounced radiosensitization that varied among the tested cancer cell lines; however, radiosensitization was undetectable in normal cells. Other commonly used PARPis, olaparib, veliparib, or rucaparib were ineffective radiosensitizers under our experimental conditions. Although genetic ablation or pharmacological inhibition of Polθ only mildly radiosensitized cancer cells, talazoparib-treated cells were markedly further radiosensitized. Mechanistically, talazoparib shunted DSBs to Polθ-dependent alt-EJ by enhancing DNA end-resection in a CtIP- and MRE11-dependent manner - an effect detectable at low, but not high IR doses. Chromosomal translocation analysis in talazoparib-treated cells exposed to Polθ inhibitors suggested that PARP1- and Polθ-dependent alt-EJ pathways may complement, but also back up each other. CONCLUSION We propose that talazoparib promotes low-dose, CtIP/MRE11-dependent resection and increases the reliance of irradiated HR-proficient cancer cells, on Polθ-mediated alt-EJ. The combination of Polθ inhibitors with talazoparib suppresses this option and causes further radiosensitization. The results suggest that Polθ inhibition may be exploited to maximize talazoparib radiosensitization of HR-proficient tumors in the clinic.
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Affiliation(s)
- Xixi Lin
- Division of Experimental Radiation Biology, Department of Radiation Therapy, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany; Institute of Medical Radiation Biology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Aashish Soni
- Division of Experimental Radiation Biology, Department of Radiation Therapy, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany; Institute of Medical Radiation Biology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany.
| | - Razan Hessenow
- West German Proton Therapy Center Essen (WPE), University of Duisburg-Essen, 45147, Essen, Germany
| | - Yanjie Sun
- Institute of Medical Radiation Biology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany; West German Proton Therapy Center Essen (WPE), University of Duisburg-Essen, 45147, Essen, Germany
| | - Emil Mladenov
- Division of Experimental Radiation Biology, Department of Radiation Therapy, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany; Institute of Medical Radiation Biology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Maja Guberina
- Department of Radiation Therapy, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, German Cancer Research Center (DKFZ), 45147, Essen, Germany
| | - Martin Stuschke
- Division of Experimental Radiation Biology, Department of Radiation Therapy, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany; Department of Radiation Therapy, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, German Cancer Research Center (DKFZ), 45147, Essen, Germany
| | - George Iliakis
- Division of Experimental Radiation Biology, Department of Radiation Therapy, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany; Institute of Medical Radiation Biology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany.
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Stradella A, Johnson M, Goel S, Park H, Lakhani N, Arkenau H, Galsky MD, Calvo E, Baz V, Moreno V, Saavedra O, Luen SJ, Mu S, Wan Q, Chang V, Zhang W, Barve M. Phase 1b study to assess the safety, tolerability, and clinical activity of pamiparib in combination with temozolomide in patients with locally advanced or metastatic solid tumors. Cancer Med 2024; 13:e7385. [PMID: 38970256 PMCID: PMC11226541 DOI: 10.1002/cam4.7385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Pamiparib is a potent, selective, poly (ADP-ribose) polymerase 1/2 inhibitor that demonstrates synthetic lethality in cells with breast cancer susceptibility gene mutations or other homologous recombination deficiency. This two-stage phase 1b study (NCT03150810) assessed pamiparib in combination with temozolomide (TMZ) in adult patients with histologically confirmed locally advanced and metastatic solid tumors. METHODS Oral pamiparib 60 mg was administered twice daily. During the dose-escalation stage, increasing doses of TMZ (40-120 mg once daily pulsed or 20-40 mg once daily continuous) were administered to determine the recommended dose to be administered in the dose-expansion stage. The primary objectives were to determine safety and tolerability, maximum tolerated/administered dose, recommended phase 2 dose and schedule, and antitumor activity of pamiparib in combination with TMZ. Pharmacokinetics of pamiparib and TMZ and biomarkers were also assessed. RESULTS Across stages, 139 patients were treated (dose escalation, n = 66; dose expansion, n = 73). The maximum tolerated dose of TMZ, which was administered during dose expansion, was 7-day pulsed 60 mg once daily. The most common treatment-emergent adverse events (TEAEs) were anemia (dose escalation, 56.1%; dose expansion, 63.0%), nausea (dose escalation, 54.5%; dose expansion, 49.3%), and fatigue (dose escalation, 48.5%; dose expansion, 47.9%). In the dose-escalation stage, four patients experienced dose-limiting toxicities (three neutropenia and one neutrophil count decreased). No TEAEs considered to be related to study drug treatment resulted in death. Antitumor activity was modest, indicated by confirmed overall response rate (dose escalation, 13.8%; dose expansion, 11.6%), median progression-free survival (3.7 and 2.8 months), and median overall survival (10.5 and 9.2 months). Administration of combination therapy did not notably impact pamiparib or TMZ pharmacokinetics. CONCLUSIONS Pamiparib in combination with TMZ had a manageable safety profile. Further investigation of the efficacy of this combination in tumor types with specific DNA damage repair deficiencies is warranted.
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Affiliation(s)
- Agostina Stradella
- Institut Català d'Oncologia–Hospital Duran I Reynals, L'Hospitalet de LlobregatCatalunyaSpain
| | - Melissa Johnson
- Sarah Cannon Research Institute, Tennessee Oncology, PLLCNashvilleTennesseeUSA
| | - Sanjay Goel
- Rutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
| | - Haeseong Park
- Washington University School of MedicineSt. LouisMissouriUSA
- Dana‐Farber Cancer InstituteBostonMassachusettsUSA
| | | | - Hendrik‐Tobias Arkenau
- Sarah Cannon Research Institute, UCL Cancer Institute, University College LondonLondonUK
| | - Matthew D. Galsky
- The Tisch Cancer InstituteIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Emiliano Calvo
- START Madrid‐HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle OñaMadridSpain
| | - Vicente Baz
- Hospital Universitario Virgen MacarenaSevilleSpain
| | - Victor Moreno
- START Madrid‐FJDFundacion Jimenez Diaz University HospitalMadridSpain
| | | | - Stephen J. Luen
- Division of Cancer ResearchPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- The Sir Peter MacCallum Department of Medical OncologyThe University of MelbourneMelbourneVictoriaAustralia
| | - Song Mu
- BeiGene, USA IncRidgefield ParkNew JerseyUSA
| | | | | | - Wa Zhang
- BeiGene (Beijing) Co., LtdBeijingChina
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Madorsky Rowdo FP, Xiao G, Khramtsova GF, Nguyen J, Martini R, Stonaker B, Boateng R, Oppong JK, Adjei EK, Awuah B, Kyei I, Aitpillah FS, Adinku MO, Ankomah K, Osei-Bonsu EB, Gyan KK, Altorki NK, Cheng E, Ginter PS, Hoda S, Newman L, Elemento O, Olopade OI, Davis MB, Martin ML, Bargonetti J. Patient-derived tumor organoids with p53 mutations, and not wild-type p53, are sensitive to synergistic combination PARP inhibitor treatment. Cancer Lett 2024; 584:216608. [PMID: 38199587 PMCID: PMC10922546 DOI: 10.1016/j.canlet.2024.216608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024]
Abstract
Poly (ADP-ribose) polymerase inhibitors (PARPi) are used for patients with BRCA1/2 mutations, but patients with other mutations may benefit from PARPi treatment. Another mutation that is present in more cancers than BRCA1/2 is mutation to the TP53 gene. In 2D breast cancer cell lines, mutant p53 (mtp53) proteins tightly associate with replicating DNA and Poly (ADP-ribose) polymerase (PARP) protein. Combination drug treatment with the alkylating agent temozolomide and the PARPi talazoparib kills mtp53 expressing 2D grown breast cancer cell lines. We evaluated the sensitivity to the combination of temozolomide plus PARPi talazoparib treatment to breast and lung cancer patient-derived tumor organoids (PDTOs). The combination of the two drugs was synergistic for a cytotoxic response in PDTOs with mtp53 but not for PDTOs with wtp53. The combination of talazoparib and temozolomide induced more DNA double-strand breaks in mtp53 expressing organoids than in wild-type p53 expressing organoids as shown by increased γ-H2AX protein expression. Moreover, breast cancer tissue microarrays (TMAs) showed a positive correlation between stable p53 and high PARP1 expression in sub-groups of breast cancers, which may indicate sub-classes of breast cancers sensitive to PARPi therapy. These results suggest that mtp53 could be a biomarker to predict response to the combination of PARPi talazoparib-temozolomide treatment.
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Affiliation(s)
| | - Gu Xiao
- The Department of Biological Sciences Hunter College, Belfer Building, City University of New York, New York, NY, 10021, USA
| | - Galina F Khramtsova
- Center for Clinical Cancer Genetics and Global Health and Section of Hematology and Oncology, Department of Medicine, University of Chicago, Chicago, IL, 60637, USA
| | - John Nguyen
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Rachel Martini
- Department of Surgery, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Brian Stonaker
- Department of Surgery, Weill Cornell Medicine, New York, NY, 10021, USA
| | | | | | | | | | - Ishmael Kyei
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Michael O Adinku
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - Kofi K Gyan
- Department of Surgery, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Nasser K Altorki
- Department of Cardiothoracic Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Esther Cheng
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Paula S Ginter
- Department of Pathology, NYU Langone Hospital-Long Island, Mineola, NY, USA
| | - Syed Hoda
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Lisa Newman
- Department of Surgery, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Olivier Elemento
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Olufunmilayo I Olopade
- Center for Clinical Cancer Genetics and Global Health and Section of Hematology and Oncology, Department of Medicine, University of Chicago, Chicago, IL, 60637, USA
| | - Melissa B Davis
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, 10021, USA; Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA, 30310, USA
| | - M Laura Martin
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Jill Bargonetti
- The Department of Biological Sciences Hunter College, Belfer Building, City University of New York, New York, NY, 10021, USA; Department of Cell and Developmental Biology, Weill Cornell Medical College, New York City, NY, 10021, USA; The Graduate Center Biology and Biochemistry Programs of City University of New York, New York, NY, 10016, USA.
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Madorsky Rowdo FP, Xiao G, Khramtsova GF, Nguyen J, Olopade OI, Martini R, Stonaker B, Boateng R, Oppong JK, Adjei EK, Awuah B, Kyei I, Aitpillah FS, Adinku MO, Ankomah K, Osei-Bonsu EB, Gyan KK, Altorki NK, Cheng E, Ginter PS, Hoda S, Newman L, Elemento O, Davis MB, Martin ML, Bargonetti J. Patient-derived tumor organoids with p53 mutations, and not wild-type p53, are sensitive to synergistic combination PARP inhibitor treatment. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.22.544406. [PMID: 38076873 PMCID: PMC10705575 DOI: 10.1101/2023.06.22.544406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Poly (ADP-ribose) polymerase inhibitors (PARPi) are used for patients with BRCA1/2 mutations, but patients with other mutations may benefit from PARPi treatment. Another mutation that is present in more cancers than BRCA1/2 is mutation to the TP53 gene. In 2D breast cancer cell lines, mutant p53 (mtp53) proteins tightly associate with replicating DNA and Poly (ADP-ribose) polymerase (PARP) protein. Combination drug treatment with the alkylating agent temozolomide and the PARPi talazoparib kills mtp53 expressing 2D grown breast cancer cell lines. We evaluated the sensitivity to the combination of temozolomide plus PARPi talazoparib treatment to breast and lung cancer patient-derived tumor organoids (PDTOs). The combination of the two drugs was synergistic for a cytotoxic response in PDTOs with mtp53 but not for PDTOs with wtp53. The combination of talazoparib and temozolomide induced more DNA double-strand breaks in mtp53 expressing organoids than in wild-type p53 expressing organoids as shown by increased γ-H2AX protein expression. Moreover, breast cancer tissue microarrays (TMAs) showed a positive correlation between stable p53 and high PARP1 expression in sub-groups of breast cancers, which may indicate sub-classes of breast cancers sensitive to PARPi therapy. These results suggest that mtp53 could be a biomarker to predict response to the combination of PARPi talazoparib-temozolomide treatment.
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Affiliation(s)
| | - Gu Xiao
- The Department of Biological Sciences Hunter College, Belfer Building, City University of New York, New York, NY10021
| | - Galina F Khramtsova
- Center for Clinical Cancer Genetics and Global Health and Section of Hematology and Oncology, Department of Medicine, University of Chicago, Chicago, IL 60637
| | - John Nguyen
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York, NY10021
| | - Olufunmilayo I Olopade
- Center for Clinical Cancer Genetics and Global Health and Section of Hematology and Oncology, Department of Medicine, University of Chicago, Chicago, IL 60637
| | - Rachel Martini
- Department of Surgery, Weill Cornell Medicine, New York, NY10021
| | - Brian Stonaker
- Department of Surgery, Weill Cornell Medicine, New York, NY10021
| | | | | | | | | | - Ishmael Kyei
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | | | | | - Kofi K. Gyan
- Department of Surgery, Weill Cornell Medicine, New York, NY10021
| | - Nasser K. Altorki
- Department of Cardiothoracic Surgery, Weill Cornell Medical College, New York, NY
| | - Esther Cheng
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY
| | - Paula S. Ginter
- Department of Pathology, NYU Langone Hospital-Long Island, Mineola, NY
| | - Syed Hoda
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY
| | - Lisa Newman
- Department of Surgery, Weill Cornell Medicine, New York, NY10021
| | - Olivier Elemento
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York, NY10021
| | - Melissa B. Davis
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York, NY10021
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310
| | - M. Laura Martin
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York, NY10021
| | - Jill Bargonetti
- The Department of Biological Sciences Hunter College, Belfer Building, City University of New York, New York, NY10021
- Department of Cell and Developmental Biology, Weill Cornell Medical College, New York City, NY 10021
- The Graduate Center Biology and Biochemistry Programs of City University of New York, New York, NY 10016
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