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Identification of a Molecularly-Defined Subset of Breast and Ovarian Cancer Models that Respond to WEE1 or ATR Inhibition, Overcoming PARP Inhibitor Resistance.


ABSTRACT:

Purpose

PARP inhibitors (PARPi) induce synthetic lethality in homologous recombination repair (HRR)-deficient tumors and are used to treat breast, ovarian, pancreatic, and prostate cancers. Multiple PARPi resistance mechanisms exist, most resulting in restoration of HRR and protection of stalled replication forks. ATR inhibition was highlighted as a unique approach to reverse both aspects of resistance. Recently, however, a PARPi/WEE1 inhibitor (WEE1i) combination demonstrated enhanced antitumor activity associated with the induction of replication stress, suggesting another approach to tackling PARPi resistance.

Experimental design

We analyzed breast and ovarian patient-derived xenoimplant models resistant to PARPi to quantify WEE1i and ATR inhibitor (ATRi) responses as single agents and in combination with PARPi. Biomarker analysis was conducted at the genetic and protein level. Metabolite analysis by mass spectrometry and nucleoside rescue experiments ex vivo were also conducted in patient-derived models.

Results

Although WEE1i response was linked to markers of replication stress, including STK11/RB1 and phospho-RPA, ATRi response associated with ATM mutation. When combined with olaparib, WEE1i could be differentiated from the ATRi/olaparib combination, providing distinct therapeutic strategies to overcome PARPi resistance by targeting the replication stress response. Mechanistically, WEE1i sensitivity was associated with shortage of the dNTP pool and a concomitant increase in replication stress.

Conclusions

Targeting the replication stress response is a valid therapeutic option to overcome PARPi resistance including tumors without an underlying HRR deficiency. These preclinical insights are now being tested in several clinical trials where the PARPi is administered with either the WEE1i or the ATRi.

SUBMITTER: Serra V 

PROVIDER: S-EPMC9561606 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Identification of a Molecularly-Defined Subset of Breast and Ovarian Cancer Models that Respond to WEE1 or ATR Inhibition, Overcoming PARP Inhibitor Resistance.

Serra Violeta V   Wang Anderson T AT   Castroviejo-Bermejo Marta M   Polanska Urszula M UM   Palafox Marta M   Herencia-Ropero Andrea A   Jones Gemma N GN   Lai Zhongwu Z   Armenia Joshua J   Michopoulos Filippos F   Llop-Guevara Alba A   Brough Rachel R   Gulati Aditi A   Pettitt Stephen J SJ   Bulusu Krishna C KC   Nikkilä Jenni J   Wilson Zena Z   Hughes Adina A   Wijnhoven Paul W G PWG   Ahmed Ambar A   Bruna Alejandra A   Gris-Oliver Albert A   Guzman Marta M   Rodríguez Olga O   Grueso Judit J   Arribas Joaquin J   Cortés Javier J   Saura Cristina C   Lau Alan A   Critchlow Susan S   Dougherty Brian B   Caldas Carlos C   Mills Gordon B GB   Barrett J Carl JC   Forment Josep V JV   Cadogan Elaine E   Lord Christopher J CJ   Cruz Cristina C   Balmaña Judith J   O'Connor Mark J MJ  

Clinical cancer research : an official journal of the American Association for Cancer Research 20221001 20


<h4>Purpose</h4>PARP inhibitors (PARPi) induce synthetic lethality in homologous recombination repair (HRR)-deficient tumors and are used to treat breast, ovarian, pancreatic, and prostate cancers. Multiple PARPi resistance mechanisms exist, most resulting in restoration of HRR and protection of stalled replication forks. ATR inhibition was highlighted as a unique approach to reverse both aspects of resistance. Recently, however, a PARPi/WEE1 inhibitor (WEE1i) combination demonstrated enhanced a  ...[more]

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