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McCormick A, Swaisland H, Reddy VP, Learoyd M, Scarfe G. In vitro evaluation of the inhibition and induction potential of olaparib, a potent poly(ADP-ribose) polymerase inhibitor, on cytochrome P450. Xenobiotica 2017; 48:555-564. [PMID: 28657402 DOI: 10.1080/00498254.2017.1346332] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
1. In vitro studies were conducted to evaluate potential inhibitory and inductive effects of the poly(ADP-ribose) polymerase (PARP) inhibitor, olaparib, on cytochrome P450 (CYP) enzymes. Inhibitory effects were determined in human liver microsomes (HLM); inductive effects were evaluated in cultured human hepatocytes. 2. Olaparib did not inhibit CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2D6 or CYP2E1 and caused slight inhibition of CYP2C9, CYP2C19 and CYP3A4/5 in HLM up to a concentration of 100 μM. However, olaparib (17-500 μM) inhibited CYP3A4/5 with an IC50 of 119 μM. In time-dependent CYP inhibition assays, olaparib (10 μM) had no effect against CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6 and CYP2E1 and a minor effect against CYP3A4/5. In a further study, olaparib (2-200 μM) functioned as a time-dependent inhibitor of CYP3A4/5 (KI, 72.2 μM and Kinact, 0.0675 min-1). Assessment of the CYP induction potential of olaparib (0.061-44 μM) showed minor concentration-related increases in CYP1A2 and more marked increases in CYP2B6 and CYP3A4 mRNA, compared with positive control activity; however, no significant change in CYP3A4/5 enzyme activity was observed. 3. Clinically significant drug-drug interactions due to olaparib inhibition or induction of hepatic or intestinal CYP3A4/5 cannot be excluded. It is recommended that olaparib is given with caution with narrow therapeutic range or sensitive CYP3A substrates, and that prescribers are aware that olaparib may reduce exposure to substrates of CYP2B6.
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Affiliation(s)
| | | | - Venkatesh Pilla Reddy
- b Drug Metabolism and Pharmacokinetics, IMED Oncology, AstraZeneca , Cambridge , UK , and
| | - Maria Learoyd
- c Quantitative Clinical Pharmacology, IMED Oncology, AstraZeneca , Cambridge , UK
| | - Graeme Scarfe
- b Drug Metabolism and Pharmacokinetics, IMED Oncology, AstraZeneca , Cambridge , UK , and
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102
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Schoonen PM, Talens F, Stok C, Gogola E, Heijink AM, Bouwman P, Foijer F, Tarsounas M, Blatter S, Jonkers J, Rottenberg S, van Vugt MATM. Progression through mitosis promotes PARP inhibitor-induced cytotoxicity in homologous recombination-deficient cancer cells. Nat Commun 2017; 8:15981. [PMID: 28714471 PMCID: PMC5520019 DOI: 10.1038/ncomms15981] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 05/17/2017] [Indexed: 12/13/2022] Open
Abstract
Mutations in homologous recombination (HR) genes BRCA1 and BRCA2 predispose to tumorigenesis. HR-deficient cancers are hypersensitive to Poly (ADP ribose)-polymerase (PARP) inhibitors, but can acquire resistance and relapse. Mechanistic understanding how PARP inhibition induces cytotoxicity in HR-deficient cancer cells is incomplete. Here we find PARP inhibition to compromise replication fork stability in HR-deficient cancer cells, leading to mitotic DNA damage and consequent chromatin bridges and lagging chromosomes in anaphase, frequently leading to cytokinesis failure, multinucleation and cell death. PARP-inhibitor-induced multinucleated cells fail clonogenic outgrowth, and high percentages of multinucleated cells are found in vivo in remnants of PARP inhibitor-treated Brca2-/-;p53-/- and Brca1-/-;p53-/- mammary mouse tumours, suggesting that mitotic progression promotes PARP-inhibitor-induced cell death. Indeed, enforced mitotic bypass through EMI1 depletion abrogates PARP-inhibitor-induced cytotoxicity. These findings provide insight into the cytotoxic effects of PARP inhibition, and point at combination therapies to potentiate PARP inhibitor treatment of HR-deficient tumours.
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Affiliation(s)
- Pepijn M. Schoonen
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Francien Talens
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Colin Stok
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Ewa Gogola
- Division of Molecular Pathology and Cancer Genomics Netherlands, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Anne Margriet Heijink
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Peter Bouwman
- Division of Molecular Pathology and Cancer Genomics Netherlands, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Floris Foijer
- European Research Institute for the Biology of Ageing, University of Groningen University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Madalena Tarsounas
- The CRUK/MRC Oxford Institute, Old Road Campus Research Building, OX3 7DQ Oxford, UK
| | - Sohvi Blatter
- Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Laenggassstrasse 122, 3012 Bern, Switzerland
| | - Jos Jonkers
- Division of Molecular Pathology and Cancer Genomics Netherlands, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Sven Rottenberg
- Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Laenggassstrasse 122, 3012 Bern, Switzerland
| | - Marcel A. T. M. van Vugt
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
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103
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Oei AL, Ahire VR, van Leeuwen CM, Ten Cate R, Stalpers LJA, Crezee J, Kok HP, Franken NAP. Enhancing radiosensitisation of BRCA2-proficient and BRCA2-deficient cell lines with hyperthermia and PARP1-i. Int J Hyperthermia 2017; 34:39-48. [PMID: 28540821 DOI: 10.1080/02656736.2017.1324642] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Poly(ADP-ribose)polymerase1 (PARP1) is an important enzyme in regulating DNA replication. Inhibition of PARP1 can lead to collapsed DNA forks which subsequently causes genomic instability, making DNA more susceptible in developing fatal DNA double strand breaks. PARP1-induced DNA damage is generally repaired by homologous recombination (HR), in which BRCA2 proteins are essential. Therefore, BRCA2-deficient tumour cells are susceptible to treatment with PARP1-inhibitors (PARP1-i). Recently, BRCA2 was shown to be down-regulated by hyperthermia (HT) temporarily, and this consequently inactivated HR for several hours. In this study, we investigated whether HT exclusively interferes with HR by analysing thermal radiosensitisation of BRCA2-proficient and deficient cells. After elucidating the equitoxicity of PARP1-i on BRCA2-proficient and deficient cells, we studied the cell survival, apoptosis, DNA damage (γ-H2AX foci and comet assay) and cell cycle distribution after different treatments. PARP1-i sensitivity strongly depends on the BRCA2 status. BRCA2-proficient and deficient cells are radiosensitised by HT, indicating that HT does not exclusively act by inhibition of HR. In all cell lines, the addition of HT to radiotherapy and PARP1-i resulted in the lowest cell survival, the highest levels of DNA damage and apoptotic levels compared to duo-modality treatments. Concluding, HT not only inhibits HR, but also has the capability of radiosensitising BRCA2-deficient cells. Thus, in case of BRCA2-mutation carriers, combining HT with PARP1-i may boost the treatment efficacy. This combination therapy would be effective for all patients with PARP1-i regardless of their BRCA status.
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Affiliation(s)
- Arlene L Oei
- a Laboratory for Experimental Oncology and Radiobiology (LEXOR) , Center for Experimental and Molecular Medicine , Amsterdam , The Netherlands.,b Department of Radiotherapy , University of Amsterdam , Amsterdam , The Netherlands
| | - Vidhula R Ahire
- a Laboratory for Experimental Oncology and Radiobiology (LEXOR) , Center for Experimental and Molecular Medicine , Amsterdam , The Netherlands.,b Department of Radiotherapy , University of Amsterdam , Amsterdam , The Netherlands
| | - C M van Leeuwen
- c Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - Rosemarie Ten Cate
- a Laboratory for Experimental Oncology and Radiobiology (LEXOR) , Center for Experimental and Molecular Medicine , Amsterdam , The Netherlands.,b Department of Radiotherapy , University of Amsterdam , Amsterdam , The Netherlands
| | - Lukas J A Stalpers
- a Laboratory for Experimental Oncology and Radiobiology (LEXOR) , Center for Experimental and Molecular Medicine , Amsterdam , The Netherlands.,b Department of Radiotherapy , University of Amsterdam , Amsterdam , The Netherlands
| | - Johannes Crezee
- c Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - H Petra Kok
- c Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - Nicolaas A P Franken
- a Laboratory for Experimental Oncology and Radiobiology (LEXOR) , Center for Experimental and Molecular Medicine , Amsterdam , The Netherlands.,b Department of Radiotherapy , University of Amsterdam , Amsterdam , The Netherlands
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104
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Sherry MR, Hay TJM, Gulak MA, Nassiri A, Finnen RL, Banfield BW. The Herpesvirus Nuclear Egress Complex Component, UL31, Can Be Recruited to Sites of DNA Damage Through Poly-ADP Ribose Binding. Sci Rep 2017; 7:1882. [PMID: 28507315 PMCID: PMC5432524 DOI: 10.1038/s41598-017-02109-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 04/07/2017] [Indexed: 12/20/2022] Open
Abstract
The herpes simplex virus (HSV) UL31 gene encodes a conserved member of the herpesvirus nuclear egress complex that not only functions in the egress of DNA containing capsids from the nucleus, but is also required for optimal replication of viral DNA and its packaging into capsids. Here we report that the UL31 protein from HSV-2 can be recruited to sites of DNA damage by sequences found in its N-terminus. The N-terminus of UL31 contains sequences resembling a poly (ADP-ribose) (PAR) binding motif suggesting that PAR interactions might mediate UL31 recruitment to damaged DNA. Whereas PAR polymerase inhibition prevented UL31 recruitment to damaged DNA, inhibition of signaling through the ataxia telangiectasia mutated DNA damage response pathway had no effect. These findings were further supported by experiments demonstrating direct and specific interaction between HSV-2 UL31 and PAR using purified components. This study reveals a previously unrecognized function for UL31 and may suggest that the recognition of PAR by UL31 is coupled to the nuclear egress of herpesvirus capsids, influences viral DNA replication and packaging, or possibly modulates the DNA damage response mounted by virally infected cells.
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Affiliation(s)
- Maxwell R Sherry
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada
| | - Thomas J M Hay
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada
| | - Michael A Gulak
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada
| | - Arash Nassiri
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada
| | - Renée L Finnen
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada
| | - Bruce W Banfield
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada.
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105
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Guppy BJ, McManus KJ. Synthetic lethal targeting of RNF20 through PARP1 silencing and inhibition. Cell Oncol (Dordr) 2017; 40:281-292. [PMID: 28462496 DOI: 10.1007/s13402-017-0323-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2017] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The identification of novel therapeutic targets that exploit the aberrant genetics driving oncogenesis is critical to better combat cancer. RNF20 is somatically altered in numerous cancers, and its diminished expression drives genome instability, a driving factor of oncogenesis. Accordingly, we sought to determine whether PARP1 silencing and inhibition could preferentially kill RNF20-deficient cells using a synthetic lethal strategy. METHODS RNF20 and PARP1 were silenced using RNAi-based approaches. Direct synthetic lethal tests were performed by silencing RNF20 with and without PARP1 and the impact on cell numbers was evaluated using semi-quantitative imaging microscopy. Next, Olaparib and BMN673 (PARP1 inhibitors) were evaluated for their ability to induce preferential killing in RNF20 silenced cells, while real-time cell analyses were used to distinguish cell cytotoxicity from cell cycle arrest. Finally, quantitative imaging microscopy was employed to evaluate marks associated with DNA double-strand breaks (γ-H2AX) and apoptosis (cleaved Caspase-3). RESULTS We found that PARP1 silencing resulted in a decrease in number of RNF20 silenced cells relative to controls. We further found that Olaparib and BMN673 treatments also resulted in fewer RNF20 silenced cells relative to controls. Finally, we found by quantitative imaging microscopy that RNF20 silenced cells treated with BMN673 exhibited significant increases in γ-H2AX and cleaved Caspase-3, suggesting that these treatments induce DNA double-strand breaks that are not adequately repaired within RNF20-silenced cells. CONCLUSIONS Collectively, our data indicate that RNF20 and PARP1 are synthetic lethal interactors, suggesting that cancers with diminished RNF20 expression and/or function may be susceptible to PARP1 inhibitors.
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Affiliation(s)
- Brent J Guppy
- Department of Biochemistry & Medical Genetics, University of Manitoba, Winnipeg, MB, Canada.,CancerCare Manitoba, Research Institute in Oncology and Hematology, ON6010 - 675 McDermot Avenue, Winnipeg, MB, R3E 0V9, Canada
| | - Kirk J McManus
- Department of Biochemistry & Medical Genetics, University of Manitoba, Winnipeg, MB, Canada. .,CancerCare Manitoba, Research Institute in Oncology and Hematology, ON6010 - 675 McDermot Avenue, Winnipeg, MB, R3E 0V9, Canada.
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106
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Discovery of 2-substituted 1 H -benzo[ d ]immidazole-4-carboxamide derivatives as novel poly(ADP-ribose)polymerase-1 inhibitors with in vivo anti-tumor activity. Eur J Med Chem 2017; 132:26-41. [DOI: 10.1016/j.ejmech.2017.03.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/06/2017] [Accepted: 03/08/2017] [Indexed: 11/23/2022]
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107
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Robert M, Frenel JS, Gourmelon C, Patsouris A, Augereau P, Campone M. Olaparib for the treatment of breast cancer. Expert Opin Investig Drugs 2017; 26:751-759. [DOI: 10.1080/13543784.2017.1318847] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Marie Robert
- Medical oncology, Institut de Cancérologie de l’Ouest, René Gauducheau, St Herblain, France
| | - Jean-Sébastien Frenel
- Medical oncology, Institut de Cancérologie de l’Ouest, René Gauducheau, St Herblain, France
| | - Carole Gourmelon
- Medical oncology, Institut de Cancérologie de l’Ouest, René Gauducheau, St Herblain, France
| | - Anne Patsouris
- Medical oncology, Institut de Cancérologie de l’Ouest, Paul Papin, Angers, France
| | - Paule Augereau
- Medical oncology, Institut de Cancérologie de l’Ouest, Paul Papin, Angers, France
| | - Mario Campone
- Medical oncology, Institut de Cancérologie de l’Ouest, René Gauducheau, St Herblain, France
- Centre de Recherche en Cancérologie Nantes-Angers (CRNA), France
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108
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Kanjanapan Y, Lheureux S, Oza AM. Niraparib for the treatment of ovarian cancer. Expert Opin Pharmacother 2017; 18:631-640. [DOI: 10.1080/14656566.2017.1297423] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Yada Kanjanapan
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Stephanie Lheureux
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Amit M. Oza
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
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109
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Wilson RH, Evans TRJ, Middleton MR, Molife LR, Spicer J, Dieras V, Roxburgh P, Giordano H, Jaw-Tsai S, Goble S, Plummer R. A phase I study of intravenous and oral rucaparib in combination with chemotherapy in patients with advanced solid tumours. Br J Cancer 2017; 116:884-892. [PMID: 28222073 PMCID: PMC5379148 DOI: 10.1038/bjc.2017.36] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 12/14/2016] [Accepted: 01/20/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This study evaluated safety, pharmacokinetics, and clinical activity of intravenous and oral rucaparib, a poly(ADP-ribose) polymerase inhibitor, combined with chemotherapy in patients with advanced solid tumours. METHODS Initially, patients received escalating doses of intravenous rucaparib combined with carboplatin, carboplatin/paclitaxel, cisplatin/pemetrexed, or epirubicin/cyclophosphamide. Subsequently, the study was amended to focus on oral rucaparib (once daily, days 1-14) combined with carboplatin (day 1) in 21-day cycles. Dose-limiting toxicities (DLTs) were assessed in cycle 1 and safety in all cycles. RESULTS Eighty-five patients were enrolled (22 breast, 15 ovarian/peritoneal, and 48 other primary cancers), with a median of three prior therapies (range, 1-7). Neutropenia (27.1%) and thrombocytopenia (18.8%) were the most common grade ⩾3 toxicities across combinations and were DLTs with the oral rucaparib/carboplatin combination. Maximum tolerated dose for the combination was 240 mg per day oral rucaparib and carboplatin area under the curve 5 mg ml-1 min-1. Oral rucaparib demonstrated dose-proportional kinetics, a long half-life (≈17 h), and good bioavailability (36%). Pharmacokinetics were unchanged by carboplatin coadministration. The rucaparib/carboplatin combination had radiologic antitumour activity, primarily in BRCA1- or BRCA2-mutated breast and ovarian/peritoneal cancers. CONCLUSIONS Oral rucaparib can be safely combined with a clinically relevant dose of carboplatin in patients with advanced solid tumours (Trial registration ID: NCT01009190).
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Affiliation(s)
- Richard H Wilson
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7AE, UK
- Northern Ireland Cancer Center, Belfast City Hospital, 51 Lisburn Road, Belfast BT9 7AB, UK
| | - TR Jeffry Evans
- Beatson West of Scotland Cancer Centre, and Institute of Cancer Sciences, University of Glasgow, Garscube Estate, Switchback Road, Bearsden, Glasgow G61 1BD, UK
| | - Mark R Middleton
- National Institute for Health Research Biomedical Research Centre, Churchill Hospital, and Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - L Rhoda Molife
- Drug Development Unit, Royal Marsden Hospital/Institute of Cancer Research, Downs Road, Sutton, Surrey SM2 5PT, UK
| | - James Spicer
- Division of Cancer Studies, King's College London, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
| | - Veronique Dieras
- Department of Medical Oncology, Institut Curie, 26, rue d'Ulm, Paris 75005 France
| | - Patricia Roxburgh
- Beatson West of Scotland Cancer Centre, and Institute of Cancer Sciences, University of Glasgow, Garscube Estate, Switchback Road, Bearsden, Glasgow G61 1BD, UK
| | - Heidi Giordano
- Clovis Oncology, Inc., Boulder, 5500 Flatiron Parkway, Boulder, CO 80301, USA
| | - Sarah Jaw-Tsai
- Clovis Oncology, Inc., Boulder, 5500 Flatiron Parkway, Boulder, CO 80301, USA
| | - Sandra Goble
- Clovis Oncology, Inc., Boulder, 5500 Flatiron Parkway, Boulder, CO 80301, USA
| | - Ruth Plummer
- Northern Centre for Cancer Care, Freeman Hospital, Freeman Road, High Heaton, Newcastle Upon Tyne NE7 7DN, UK
- Northern Institute for Cancer Research, Newcastle University, Paul O'Gorman Building, Framlington Place, Newcastle Upon Tyne NE2 4HH, UK
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110
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Ang YLE, Tan DSP. Development of PARP inhibitors in gynecological malignancies. Curr Probl Cancer 2017; 41:273-286. [PMID: 28583748 DOI: 10.1016/j.currproblcancer.2017.02.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 01/12/2017] [Accepted: 02/21/2017] [Indexed: 11/25/2022]
Abstract
PARP inhibitors demonstrate synthetic lethality in tumors with BRCA1/2 mutations and other homologous recombination repair deficiencies by interfering with DNA repair and causing direct toxicity to DNA through PARP trapping. PARP inhibitors have been shown to be beneficial in the treatment of BRCA1/2-mutated ovarian cancers, which has led to a shift in the treatment paradigm of this disease. Further studies to establish the role of PARP inhibitors during earlier stages of treatment are ongoing. The use of PARP inhibitors in other cancers with homologous recombination repair deficiencies, such as breast cancer and prostate cancer, is gradually evolving as well, including their use in the neoadjuvant and adjuvant settings. PARP inhibitor combination strategies with chemotherapy, targeted agents, radiotherapy, and immunotherapy are also being explored. The role of predictive biomarkers, including molecular signatures and homologous recombination deficiency scores based on loss of heterozygosity and other structural genomic aberrations, will be crucial to improved patient stratification to enhance the clinical utility of PARP inhibitors. This may also allow the use of PARP inhibitors to be extended beyond tumors with specific homologous recombination DNA repair gene mutations in the future. An improved understanding of the mechanisms underlying PARP inhibitor resistance will also be important to enable the development of new approaches to increase efficacy. This is a field rich in opportunity, and the coming years should see a better understanding of which patients we should be treating with PARP inhibitors and where these agents should come in over the course of treatment.
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Affiliation(s)
- Yvonne L E Ang
- Department of Hematology-Oncology, National University Cancer Institute, National University Health System, Singapore, Singapore
| | - David S P Tan
- Department of Hematology-Oncology, National University Cancer Institute, National University Health System, Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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111
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Xu H, Di Antonio M, McKinney S, Mathew V, Ho B, O'Neil NJ, Santos ND, Silvester J, Wei V, Garcia J, Kabeer F, Lai D, Soriano P, Banáth J, Chiu DS, Yap D, Le DD, Ye FB, Zhang A, Thu K, Soong J, Lin SC, Tsai AHC, Osako T, Algara T, Saunders DN, Wong J, Xian J, Bally MB, Brenton JD, Brown GW, Shah SP, Cescon D, Mak TW, Caldas C, Stirling PC, Hieter P, Balasubramanian S, Aparicio S. CX-5461 is a DNA G-quadruplex stabilizer with selective lethality in BRCA1/2 deficient tumours. Nat Commun 2017; 8:14432. [PMID: 28211448 PMCID: PMC5321743 DOI: 10.1038/ncomms14432] [Citation(s) in RCA: 346] [Impact Index Per Article: 49.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 12/28/2016] [Indexed: 12/29/2022] Open
Abstract
G-quadruplex DNAs form four-stranded helical structures and are proposed to play key roles in different cellular processes. Targeting G-quadruplex DNAs for cancer treatment is a very promising prospect. Here, we show that CX-5461 is a G-quadruplex stabilizer, with specific toxicity against BRCA deficiencies in cancer cells and polyclonal patient-derived xenograft models, including tumours resistant to PARP inhibition. Exposure to CX-5461, and its related drug CX-3543, blocks replication forks and induces ssDNA gaps or breaks. The BRCA and NHEJ pathways are required for the repair of CX-5461 and CX-3543-induced DNA damage and failure to do so leads to lethality. These data strengthen the concept of G4 targeting as a therapeutic approach, specifically for targeting HR and NHEJ deficient cancers and other tumours deficient for DNA damage repair. CX-5461 is now in advanced phase I clinical trial for patients with BRCA1/2 deficient tumours (Canadian trial, NCT02719977, opened May 2016).
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Affiliation(s)
- Hong Xu
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Marco Di Antonio
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Steven McKinney
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Veena Mathew
- Terry Fox Laboratory, BC Cancer Agency, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Brandon Ho
- Department of Biochemistry and Donnelly Centre, University of Toronto, 160 College Street, Toronto, Ontario, Canada M5S 3E1
| | - Nigel J. O'Neil
- Michael Smith Laboratories, University of British Columbia, Vancouver, Canada V6T 1Z4
| | - Nancy Dos Santos
- Advanced Therapeutics, BC Cancer Agency and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Jennifer Silvester
- Campbell Family Institute for Breast Cancer Research, Princess Margret Cancer Centre, 610 University Avenue, Toronto, Canada M5G 2M9
| | - Vivien Wei
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Jessica Garcia
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Farhia Kabeer
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Daniel Lai
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Priscilla Soriano
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Judit Banáth
- Department of Integrative Oncology, BC Cancer Agency, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Derek S. Chiu
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Damian Yap
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Daniel D. Le
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Frank B. Ye
- Michael Smith Laboratories, University of British Columbia, Vancouver, Canada V6T 1Z4
| | - Anni Zhang
- Terry Fox Laboratory, BC Cancer Agency, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Kelsie Thu
- Campbell Family Institute for Breast Cancer Research, Princess Margret Cancer Centre, 610 University Avenue, Toronto, Canada M5G 2M9
| | - John Soong
- Senhwa Biosciences, Inc., 9 F, No.205-1, Section 3, Peihsin Road, Hsintien District, New Taipei City 23143, Taiwan R.O.C
| | - Shu-chuan Lin
- Senhwa Biosciences, Inc., 9 F, No.205-1, Section 3, Peihsin Road, Hsintien District, New Taipei City 23143, Taiwan R.O.C
| | - Angela Hsin Chin Tsai
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Tomo Osako
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Teresa Algara
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Darren N. Saunders
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Jason Wong
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Jian Xian
- Cancer Research UK Cambridge Research Institute and Department of Oncology, University of Cambridge, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - Marcel B. Bally
- Advanced Therapeutics, BC Cancer Agency and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - James D. Brenton
- Cancer Research UK Cambridge Research Institute and Department of Oncology, University of Cambridge, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - Grant W. Brown
- Department of Biochemistry and Donnelly Centre, University of Toronto, 160 College Street, Toronto, Ontario, Canada M5S 3E1
| | - Sohrab P. Shah
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - David Cescon
- Campbell Family Institute for Breast Cancer Research, Princess Margret Cancer Centre, 610 University Avenue, Toronto, Canada M5G 2M9
- Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada M5S 1A8
| | - Tak W. Mak
- Campbell Family Institute for Breast Cancer Research, Princess Margret Cancer Centre, 610 University Avenue, Toronto, Canada M5G 2M9
| | - Carlos Caldas
- Cancer Research UK Cambridge Research Institute and Department of Oncology, University of Cambridge, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - Peter C. Stirling
- Terry Fox Laboratory, BC Cancer Agency, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
| | - Phil Hieter
- Michael Smith Laboratories, University of British Columbia, Vancouver, Canada V6T 1Z4
| | - Shankar Balasubramanian
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Samuel Aparicio
- Department of Molecular Oncology, British Columbia Cancer Research Centre, and Department of Pathology and Laboratory Medicine, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3
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van de Ven M, van der Burg E, van der Gulden H, Klarenbeek S, Bouwman P, Jonkers J. Prophylactic window therapy with the clinical poly(ADP-ribose) polymerase inhibitor olaparib delays BRCA1-deficient mammary tumour formation in mice. J Pathol 2017; 241:511-521. [PMID: 27943283 DOI: 10.1002/path.4857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 11/07/2016] [Accepted: 11/17/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Marieke van de Ven
- Division of Molecular Pathology and Cancer Genomics Netherlands; The Netherlands Cancer Institute; Amsterdam The Netherlands
- MCCA Preclinical Intervention Unit; The Netherlands Cancer Institute; Amsterdam The Netherlands
| | - Eline van der Burg
- Division of Molecular Pathology and Cancer Genomics Netherlands; The Netherlands Cancer Institute; Amsterdam The Netherlands
| | - Hanneke van der Gulden
- Division of Molecular Pathology and Cancer Genomics Netherlands; The Netherlands Cancer Institute; Amsterdam The Netherlands
| | - Sjoerd Klarenbeek
- Division of Molecular Pathology and Cancer Genomics Netherlands; The Netherlands Cancer Institute; Amsterdam The Netherlands
| | - Peter Bouwman
- Division of Molecular Pathology and Cancer Genomics Netherlands; The Netherlands Cancer Institute; Amsterdam The Netherlands
| | - Jos Jonkers
- Division of Molecular Pathology and Cancer Genomics Netherlands; The Netherlands Cancer Institute; Amsterdam The Netherlands
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Cardillo TM, Sharkey RM, Rossi DL, Arrojo R, Mostafa AA, Goldenberg DM. Synthetic Lethality Exploitation by an Anti-Trop-2-SN-38 Antibody-Drug Conjugate, IMMU-132, Plus PARP Inhibitors in BRCA1/2-wild-type Triple-Negative Breast Cancer. Clin Cancer Res 2017; 23:3405-3415. [PMID: 28069724 DOI: 10.1158/1078-0432.ccr-16-2401] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 12/21/2016] [Accepted: 12/28/2016] [Indexed: 11/16/2022]
Abstract
Purpose: Both PARP inhibitors (PARPi) and sacituzumab govitecan (IMMU-132) are currently under clinical evaluation in triple-negative breast cancer (TNBC). We sought to investigate the combined DNA-damaging effects of the topoisomerase I (Topo I)-inhibitory activity of IMMU-132 with PARPi disruption of DNA repair in TNBC.Experimental Design:In vitro, human TNBC cell lines were incubated with IMMU-132 and various PARPi (olaparib, rucaparib, or talazoparib) to determine the effect on growth, double-stranded DNA (dsDNA) breaks, and cell-cycle arrest. Mice bearing BRCA1/2-mutated or -wild-type human TNBC tumor xenografts were treated with the combination of IMMU-132 and PARPi (olaparib or talazoparib). Study survival endpoint was tumor progression to >1.0 cm3 and tolerability assessed by hematologic changes.Results: Combining IMMU-132 in TNBC with all three different PARPi results in synergistic growth inhibition, increased dsDNA breaks, and accumulation of cells in the S-phase of the cell cycle, regardless of BRCA1/2 status. A combination of IMMU-132 plus olaparib or talazoparib produces significantly improved antitumor effects and delay in time-to-tumor progression compared with monotherapy in mice bearing BRCA1/2-mutated HCC1806 TNBC tumors. Furthermore, in mice bearing BRCA1/2-wild-type tumors (MDA-MB-468 or MDA-MB-231), the combination of IMMU-132 plus olaparib imparts a significant antitumor effect and survival benefit above that achieved with monotherapy. Most importantly, this combination was well tolerated, with no substantial changes in hematologic parameters.Conclusions: These data demonstrate the added benefit of combining Topo I inhibition mediated by IMMU-132 with synthetic lethality provided by PARPi in TNBC, regardless of BRCA1/2 status, thus supporting the rationale for such a combination clinically. Clin Cancer Res; 23(13); 3405-15. ©2017 AACR.
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Guo ZP, Hu YC, Xie Y, Jin F, Song ZQ, Liu XD, Ma T, Zhou PK. MLN4924 suppresses the BRCA1 complex and synergizes with PARP inhibition in NSCLC cells. Biochem Biophys Res Commun 2017; 483:223-229. [DOI: 10.1016/j.bbrc.2016.12.162] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 12/23/2016] [Indexed: 10/20/2022]
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Liu Y, Burness ML, Martin-Trevino R, Guy J, Bai S, Harouaka R, Brooks MD, Shang L, Fox A, Luther TK, Davis A, Baker TL, Colacino J, Clouthier SG, Shao ZM, Wicha MS, Liu S. RAD51 Mediates Resistance of Cancer Stem Cells to PARP Inhibition in Triple-Negative Breast Cancer. Clin Cancer Res 2016; 23:514-522. [DOI: 10.1158/1078-0432.ccr-15-1348] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 07/29/2016] [Accepted: 08/01/2016] [Indexed: 11/16/2022]
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A comprehensive look of poly(ADP-ribose) polymerase inhibition strategies and future directions for cancer therapy. Future Med Chem 2016; 9:37-60. [PMID: 27995810 DOI: 10.4155/fmc-2016-0113] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The finding of promising drugs represents a huge challenge in cancer therapeutics, therefore it is important to seek out novel approaches and elucidate essential cellular processes in order to identify potential drug targets. Studies on DNA repair pathway suggested that an enzyme, PARP, which plays a significant role in DNA repair responses, could be targeted in cancer therapy. Hence, the efficacy of PARP inhibitors in cancer therapy has been investigated and has progressed from the laboratory to clinics, with olaparib having already been approved by the US FDA for ovarian cancer treatment. Here, we have discussed the development of PARP inhibitors, strategies to improve their selectivity and efficacy, including innovative combinational and synthetic lethality approaches to identify effective PARP inhibitors in cancer treatment.
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New Targeted Agents in Gynecologic Cancers: Synthetic Lethality, Homologous Recombination Deficiency, and PARP Inhibitors. Curr Treat Options Oncol 2016; 17:12. [PMID: 26931795 DOI: 10.1007/s11864-015-0378-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OPINION STATEMENT Inhibitors of poly (ADP-ribose) polymerase (PARP) have emerged as a new class of anti-cancer drugs, specifically for malignancies bearing aberrations of the homologous recombination pathway, like those with mutations in the BRCA 1 and BRCA 2 genes. Olaparib, a potent PARP1 and PARP2 inhibitor, has been shown to significantly increase progression-free survival (PFS) in women with recurrent ovarian cancer related to a germline BRCA mutation and is currently approved fourth-line treatment in these patients. PARP inhibitors (PARPi) target the genetic phenomenon known as synthetic lethality to exploit faulty DNA repair mechanisms. While ovarian cancer is enriched with a population of tumors with known homologous recombination defects, investigations are underway to help identify pathways in other gynecologic cancers that may demonstrate susceptibility to PARPi through synthetically lethal mechanisms. The ARIEL2 trial prospectively determined a predictive assay to identify patients with HRD. The future of cancer therapeutics will likely incorporate these HRD assays to determine the best treatment plan for patients. While the role of PARPi is less clear in non-ovarian gynecologic cancers, the discovery of a predictive assay for HRD may open the door for clinical trials in these other gynecologic cancers enriched with patients with HRD. Identification of patients with tumors deficient in homologous repair or have HRD-like behavior moves cancer treatment towards individualized therapies in order to maximize treatment effect and quality of life for women living with gynecologic cancers.
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118
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Ledermann JA, Harter P, Gourley C, Friedlander M, Vergote I, Rustin G, Scott C, Meier W, Shapira-Frommer R, Safra T, Matei D, Fielding A, Bennett B, Parry D, Spencer S, Mann H, Matulonis U. Quality of life during olaparib maintenance therapy in platinum-sensitive relapsed serous ovarian cancer. Br J Cancer 2016; 115:1313-1320. [PMID: 27824811 PMCID: PMC5129820 DOI: 10.1038/bjc.2016.348] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 09/23/2016] [Accepted: 09/30/2016] [Indexed: 01/09/2023] Open
Abstract
Background: Maintenance monotherapy with the poly(ADP-ribose) polymerase inhibitor olaparib significantly prolongs progression-free survival over placebo in patients with platinum-sensitive relapsed serous ovarian cancer, with greatest benefit seen in patients with a BRCA1/2 mutation (BRCAm). Preservation of health-related quality of life (HRQoL) is important during maintenance therapy; we evaluated the effect of olaparib on HRQoL in this Phase II trial (NCT00753545, Study 19). Methods: Patients received olaparib 400 mg b.i.d. (capsules) or placebo until progression. Patient-reported HRQoL and disease-related symptoms were evaluated using the FACT-Ovarian (FACT-O) questionnaire (completed at baseline and every 28 days until progression), the FACT/NCCN Ovarian Symptom Index (FOSI) and the Trial Outcome Index (TOI). TOI of the FACT-O was the primary measure. Results: Overall, 265 women were randomised to maintenance olaparib (n=136) or placebo (n=129). Compliance for HRQoL assessment was high (∼80% over time). Most patients in both arms reported a best response of ‘no change' on TOI (81%) and other HRQoL measures. There were no statistically significant differences in time to worsening or improvement rates of TOI, FOSI and FACT-O scores in the overall, BRCAm and germline BRCAm populations. Conclusions: Maintenance treatment with olaparib was well tolerated and had no adverse impact on HRQoL in this study of patients with platinum-sensitive relapsed serous ovarian cancer who had responded to their most recent platinum-based therapy (partial or complete response). Interpretation of the HRQoL results in this population may differ from patients who have not responded to their most recent platinum-based therapy.
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Affiliation(s)
- Jonathan A Ledermann
- University College London, Cancer Research UK and UCL Cancer Trials Centre, 90 Tottenham Court Road, London W1T 4TJ, UK
| | - Philipp Harter
- Kliniken Essen Mitte, Henricistraße 95, D-45136 Essen, Germany
| | - Charlie Gourley
- University of Edinburgh Cancer Research UK Centre, MRC IGMM, Western General Hospital, Crewe Road South, Edinburgh EH4 2XR, UK
| | - Michael Friedlander
- UNSW Clinical School, Prince of Wales Hospital, High Street, Randwick, NSW 2031, Australia
| | - Ignace Vergote
- University of Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Gordon Rustin
- Mount Vernon Hospital, Rickmansworth Road, Northwood HA6 2RN, UK
| | - Clare Scott
- Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050, Australia
| | - Werner Meier
- Evangelisches Krankenhaus, Kirchfeldstraße 40, 40217 Düsseldorf, Germany
| | | | - Tamar Safra
- Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 64239, Israel
| | - Daniela Matei
- Indiana University School of Medicine, 980 West Walnut Street, Indianapolis, IN 46202, USA
| | - Anitra Fielding
- AstraZeneca, Mereside, Alderley Park, Macclesfield SK10 4TG, UK
| | - Bryan Bennett
- AstraZeneca, Mereside, Alderley Park, Macclesfield SK10 4TG, UK
| | - David Parry
- AstraZeneca, Mereside, Alderley Park, Macclesfield SK10 4TG, UK
| | - Stuart Spencer
- AstraZeneca, Mereside, Alderley Park, Macclesfield SK10 4TG, UK
| | - Helen Mann
- AstraZeneca, Mereside, Alderley Park, Macclesfield SK10 4TG, UK
| | - Ursula Matulonis
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA
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McCormick A, Swaisland H. In vitro assessment of the roles of drug transporters in the disposition and drug-drug interaction potential of olaparib. Xenobiotica 2016; 47:903-915. [PMID: 27684210 DOI: 10.1080/00498254.2016.1241449] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
1. In vitro assessments were conducted to examine interactions between olaparib (a potent oral inhibitor of poly[ADP-ribose] polymerase) and drug transporters. 2. Olaparib showed inhibition of the hepatic drug uptake transporters OATP1B1 (IC50 values of 20.3 μM and 27.1 μM) and OCT1 (IC50 37.9 μM), but limited inhibition of OATP1B3 (25% at 100 μM); inhibition of the renal uptake transporters OCT2 (IC50 19.9 μM) and OAT3 (IC50 18.4 μM), but limited inhibition of OAT1 (13.5% at 100 μM); inhibition of the renal efflux transporters MATE1 and MATE2K (IC50s 5.50 μM and 47.1 μM, respectively); inhibition of the efflux transporter MDR1 (IC50 76.0 μM), but limited inhibition of BCRP (47% at 100 μM) and no inhibition of MRP2. At clinically relevant exposures, olaparib has the potential to cause pharmacokinetic interactions via inhibition of OCT1, OCT2, OATP1B1, OAT3, MATE1 and MATE2K in the liver and kidney, as well as MDR1 in the liver and GI tract. Olaparib was found to be a substrate of MDR1 but not of several other transporters. 3. Our assessments indicate that olaparib is a substrate of MDR1 and may cause clinically meaningful inhibition of MDR1, OCT1, OCT2, OATP1B1, OAT3, MATE1 and MATE2K.
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120
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Oplustil O'Connor L, Rulten SL, Cranston AN, Odedra R, Brown H, Jaspers JE, Jones L, Knights C, Evers B, Ting A, Bradbury RH, Pajic M, Rottenberg S, Jonkers J, Rudge D, Martin NMB, Caldecott KW, Lau A, O'Connor MJ. The PARP Inhibitor AZD2461 Provides Insights into the Role of PARP3 Inhibition for Both Synthetic Lethality and Tolerability with Chemotherapy in Preclinical Models. Cancer Res 2016; 76:6084-6094. [PMID: 27550455 DOI: 10.1158/0008-5472.can-15-3240] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 07/26/2016] [Indexed: 11/16/2022]
Abstract
The PARP inhibitor AZD2461 was developed as a next-generation agent following olaparib, the first PARP inhibitor approved for cancer therapy. In BRCA1-deficient mouse models, olaparib resistance predominantly involves overexpression of P-glycoprotein, so AZD2461 was developed as a poor substrate for drug transporters. Here we demonstrate the efficacy of this compound against olaparib-resistant tumors that overexpress P-glycoprotein. In addition, AZD2461 was better tolerated in combination with chemotherapy than olaparib in mice, which suggests that AZD2461 could have significant advantages over olaparib in the clinic. However, this superior toxicity profile did not extend to rats. Investigations of this difference revealed a differential PARP3 inhibitory activity for each compound and a higher level of PARP3 expression in bone marrow cells from mice as compared with rats and humans. Our findings have implications for the use of mouse models to assess bone marrow toxicity for DNA-damaging agents and inhibitors of the DNA damage response. Finally, structural modeling of the PARP3-active site with different PARP inhibitors also highlights the potential to develop compounds with different PARP family member specificity profiles for optimal antitumor activity and tolerability. Cancer Res; 76(20); 6084-94. ©2016 AACR.
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Affiliation(s)
| | - Stuart L Rulten
- Genome Damage and Stability Centre, University of Sussex, Falmer, Brighton, United Kingdom
| | | | - Rajesh Odedra
- AstraZeneca, Alderley Park, Macclesfield, United Kingdom
| | - Henry Brown
- AstraZeneca, Alderley Park, Macclesfield, United Kingdom
| | - Janneke E Jaspers
- Division of Molecular Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands. Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Louise Jones
- KuDOS Pharmaceuticals Ltd, Cambridge, United Kingdom
| | | | - Bastiaan Evers
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Attilla Ting
- AstraZeneca, Alderley Park, Macclesfield, United Kingdom
| | | | - Marina Pajic
- Division of Molecular Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Sven Rottenberg
- Division of Molecular Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Jos Jonkers
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - David Rudge
- AstraZeneca, Alderley Park, Macclesfield, United Kingdom
| | | | - Keith W Caldecott
- Genome Damage and Stability Centre, University of Sussex, Falmer, Brighton, United Kingdom
| | - Alan Lau
- AstraZeneca, Alderley Park, Macclesfield, United Kingdom
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Dhillon KK, Bajrami I, Taniguchi T, Lord CJ. Synthetic lethality: the road to novel therapies for breast cancer. Endocr Relat Cancer 2016; 23:T39-55. [PMID: 27528623 DOI: 10.1530/erc-16-0228] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 08/15/2016] [Indexed: 12/12/2022]
Abstract
When the BRCA1 and BRCA2 tumour suppressor genes were identified in the early 1990s, the immediate implications of mapping, cloning and delineating the sequence of these genes were that individuals in families with a BRCA gene mutation could be tested for the presence of a mutation and their risk of developing cancer could be predicted. Over time though, the discovery of BRCA1 and BRCA2 has had a much greater influence than many might have imagined. In this review, we discuss how the discovery of BRCA1 and BRCA2 has not only provided an understanding of the molecular processes that drive tumourigenesis but also reignited an interest in therapeutically exploiting loss-of-function alterations in tumour suppressor genes.
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Affiliation(s)
| | - Ilirjana Bajrami
- The CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research CentreThe Institute of Cancer Research, London, UK
| | | | - Christopher J Lord
- The CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research CentreThe Institute of Cancer Research, London, UK
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Dirix L, Swaisland H, Verheul HM, Rottey S, Leunen K, Jerusalem G, Rolfo C, Nielsen D, Molife LR, Kristeleit R, Vos-Geelen JD, Mau-Sørensen M, Soetekouw P, van Herpen C, Fielding A, So K, Bannister W, Plummer R. Effect of Itraconazole and Rifampin on the Pharmacokinetics of Olaparib in Patients With Advanced Solid Tumors: Results of Two Phase I Open-label Studies. Clin Ther 2016; 38:2286-2299. [DOI: 10.1016/j.clinthera.2016.08.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/22/2016] [Accepted: 08/23/2016] [Indexed: 12/20/2022]
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Stoppa-Lyonnet D. The biological effects and clinical implications of BRCA mutations: where do we go from here? Eur J Hum Genet 2016; 24 Suppl 1:S3-9. [PMID: 27514841 PMCID: PMC5141575 DOI: 10.1038/ejhg.2016.93] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BRCA1 and BRCA2 are tumour-suppressor genes encoding proteins that are essential for the repair of DNA double-strand breaks by homologous recombination (HR). Cells that lack either BRCA1 or BRCA2 repair these lesions by alternative, more error-prone mechanisms. Individuals carrying germline pathogenic mutations in BRCA1 or BRCA2 are at highly elevated risk of developing breast and/or ovarian cancer. Genetic testing for germline pathogenic mutations in BRCA1 and BRCA2 has proved to be a valuable tool for determining eligibility for cancer screening and prevention programmes. In view of increasing evidence that the HR DNA repair pathway can also be disrupted by sequence variants in other genes, screening for other BRCA-like defects has potential implications for patient care. Additionally, there is a growing argument for directly testing tumours for pathogenic mutations in BRCA1, BRCA2 and other genes involved in HR-DNA repair as inactivation of these genes may be strictly somatic. Tumours in which HR-DNA repair is altered are most likely to respond to emerging targeted therapies, such as inhibitors of poly-ADP ribose polymerase. This review highlights the biological role of pathogenic BRCA mutations and other associated defects in DNA damage repair mechanisms in breast and ovarian cancer, with particular focus on implications for patient management strategies.
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Affiliation(s)
- Dominique Stoppa-Lyonnet
- Department of Tumour Biology, Institut Curie, Paris, France
- INSERM U830, Institut Curie, Paris, France
- Department de Génétique, Université Paris Descartes, Service de Génétique, Institut Curie, Paris, France
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124
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Martinez JS, Baldeyron C, Carreira A. Molding BRCA2 function through its interacting partners. Cell Cycle 2016; 14:3389-95. [PMID: 26566862 DOI: 10.1080/15384101.2015.1093702] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The role of the tumor suppressor BRCA2 has been shaped over 2 decades thanks to the discovery of its protein and nucleic acid partners, biochemical and structural studies of the protein, and the functional evaluation of germline variants identified in breast cancer patients. Yet, the pathogenic and functional effect of many germline mutations in BRCA2 remains undetermined, and the heterogeneity of BRCA2-associated tumors challenges the identification of causative variants that drive tumorigenesis. In this review, we propose an overview of the established and emerging interacting partners and functional pathways attributed to BRCA2, and we speculate on how variants altering these functions may contribute to cancer susceptibility.
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Affiliation(s)
- Juan S Martinez
- a Institut Curie; Centre de Recherche ; Orsay , France.,b CNRS UMR3348; Genotoxic Stress and Cancer; Centre Universitaire ; Orsay , France
| | - Céline Baldeyron
- a Institut Curie; Centre de Recherche ; Orsay , France.,b CNRS UMR3348; Genotoxic Stress and Cancer; Centre Universitaire ; Orsay , France
| | - Aura Carreira
- a Institut Curie; Centre de Recherche ; Orsay , France.,b CNRS UMR3348; Genotoxic Stress and Cancer; Centre Universitaire ; Orsay , France
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Swaisland H, Plummer R, So K, Garnett S, Bannister W, Fabre MA, Dota C, Fielding A. Olaparib does not cause clinically relevant QT/QTc interval prolongation in patients with advanced solid tumours: results from two phase I studies. Cancer Chemother Pharmacol 2016; 78:775-84. [PMID: 27553432 DOI: 10.1007/s00280-016-3124-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 07/29/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Some therapeutic agents in oncology can be causally associated with specific cardiovascular events including QT/QTc interval prolongation. We investigated the effect of multiple dosing of the oral poly (ADP-ribose)-polymerase (PARP) inhibitor, olaparib (tablet formulation) on QT/QTc interval. METHODS Two phase I, open-label, three-part studies (NCT01921140 [study 4] and NCT01900028 [study 7]) were conducted in adults with refractory/resistant advanced solid tumours. In both studies, parts A and B assessed the QT/QTc interval effects of single-dose oral olaparib 100 (study 4) or 300 (study 7) mg and multiple-dose olaparib 300 mg bid for 5 days, respectively, while part C evaluated continued access to olaparib for additional safety analyses. An ANCOVA model tested the primary objective of multiple-dose effects of olaparib on QT interval corrected using Fridericia's formula (QTcF). RESULTS Data from 119 and 109 patients were pooled from parts A and B, respectively, for QT/QTc analysis. At pre-dose and up to 12 h post-dose, the upper limits of the 90 % confidence intervals (CIs) for the difference in QTcF least squares means after olaparib multiple dosing versus control (day -1) were <10 ms, suggesting a lack of clinically relevant effect on cardiac repolarization. A slight shortening of QTcF was observed at most time points versus control. QTcF results for the individual studies and single-dose olaparib paralleled the primary multiple-dose pooled analysis, with upper limits of the 90 % CIs < 10 ms. CONCLUSION Olaparib tablets administered as multiple or single doses had no clinically significant effect on QT/QTc interval.
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Affiliation(s)
| | - Ruth Plummer
- Northern Centre for Cancer Care, Newcastle-upon-Tyne, UK
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Yonemori K, Tamura K, Kodaira M, Fujikawa K, Sagawa T, Esaki T, Shirakawa T, Hirai F, Yokoi Y, Kawata T, Hatano B, Takahashi Y. Safety and tolerability of the olaparib tablet formulation in Japanese patients with advanced solid tumours. Cancer Chemother Pharmacol 2016; 78:525-31. [PMID: 27422301 PMCID: PMC5010592 DOI: 10.1007/s00280-016-3106-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 07/08/2016] [Indexed: 01/24/2023]
Abstract
PURPOSE This was the first Phase I study to assess the safety and tolerability of the tablet formulation of olaparib (Lynparza™), an oral poly(ADP-ribose) polymerase inhibitor, in Japanese patients with advanced solid tumours. The pharmacokinetic profile and antitumour activity of olaparib tablets were also assessed. METHODS In this open-label, multicentre study (D081BC00001; NCT01813474), a single dose of olaparib (200 or 300 mg, tablets) was administered on day 1, followed 48 h afterwards by multiple dosing (200 or 300 mg twice daily [bid]) for 28-day cycles. Doses were escalated in successive cohorts, with an expansion cohort enrolled at the highest dose that was confirmed to be tolerable during dose escalation. RESULTS Twenty-eight patients were enrolled and 23 were treated (n = 4, 7 and 12 at 200, 300 and 300 [expansion] mg bid, respectively). No patients experienced a dose-limiting toxicity, so the maximum tolerated dose was not defined. The most frequent adverse events were nausea (43.5 %), decreased appetite (30.4 %), anaemia (26.1 %) and constipation (26.1 %). No patient had dose reductions, two had dose interruptions, and two discontinued treatment because of adverse events. Absorption of olaparib was rapid following single and multiple dosing, and plasma concentrations declined biphasically after single dosing. No patients had a confirmed antitumour response. CONCLUSIONS Olaparib tablet doses of 200 and 300 mg bid were considered tolerable in Japanese patients with advanced solid tumours. Consistent with the global olaparib programme, 300 mg bid was selected as the recommended tablet dose for future studies. CLINICAL TRIAL REGISTRATION NUMBER NCT01813474.
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Affiliation(s)
- Kan Yonemori
- Department of Breast and Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Kenji Tamura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Makoto Kodaira
- Department of Breast and Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Koshi Fujikawa
- Department of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, Hokkaido, Japan
| | - Tamotsu Sagawa
- Department of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, Hokkaido, Japan
| | - Taito Esaki
- Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Tsuyoshi Shirakawa
- Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Fumihiko Hirai
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | | | | | | | - Yasuo Takahashi
- Department of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, Hokkaido, Japan
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Ter Brugge P, Kristel P, van der Burg E, Boon U, de Maaker M, Lips E, Mulder L, de Ruiter J, Moutinho C, Gevensleben H, Marangoni E, Majewski I, Józwiak K, Kloosterman W, van Roosmalen M, Duran K, Hogervorst F, Turner N, Esteller M, Cuppen E, Wesseling J, Jonkers J. Mechanisms of Therapy Resistance in Patient-Derived Xenograft Models of BRCA1-Deficient Breast Cancer. J Natl Cancer Inst 2016; 108:djw148. [PMID: 27381626 DOI: 10.1093/jnci/djw148] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 05/12/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Although BRCA1-deficient tumors are extremely sensitive to DNA-damaging drugs and poly(ADP-ribose) polymerase (PARP) inhibitors, recurrences do occur and, consequently, resistance to therapy remains a serious clinical problem. To study the underlying mechanisms, we induced therapy resistance in patient-derived xenograft (PDX) models of BRCA1-mutated and BRCA1-methylated triple-negative breast cancer. METHODS A cohort of 75 mice carrying BRCA1-deficient breast PDX tumors was treated with cisplatin, melphalan, nimustine, or olaparib, and treatment sensitivity was determined. In tumors that acquired therapy resistance, BRCA1 expression was investigated using quantitative real-time polymerase chain reaction and immunoblotting. Next-generation sequencing, methylation-specific multiplex ligation-dependent probe amplification (MLPA) and Target Locus Amplification (TLA)-based sequencing were used to determine mechanisms of BRCA1 re-expression in therapy-resistant tumors. RESULTS BRCA1 protein was not detected in therapy-sensitive tumors but was found in 31 out of 42 resistant cases. Apart from previously described mechanisms involving BRCA1-intragenic deletions and loss of BRCA1 promoter hypermethylation, a novel resistance mechanism was identified in four out of seven BRCA1-methylated PDX tumors that re-expressed BRCA1 but retained BRCA1 promoter hypermethylation. In these tumors, we found de novo gene fusions that placed BRCA1 under the transcriptional control of a heterologous promoter, resulting in re-expression of BRCA1 and acquisition of therapy resistance. CONCLUSIONS In addition to previously described clinically relevant resistance mechanisms in BRCA1-deficient tumors, we describe a novel resistance mechanism in BRCA1-methylated PDX tumors involving de novo rearrangements at the BRCA1 locus, demonstrating that BRCA1-methylated breast cancers may acquire therapy resistance via both epigenetic and genetic mechanisms.
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Affiliation(s)
- Petra Ter Brugge
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Petra Kristel
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Eline van der Burg
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Ute Boon
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Michiel de Maaker
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Esther Lips
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Lennart Mulder
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Julian de Ruiter
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Catia Moutinho
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Heidrun Gevensleben
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Elisabetta Marangoni
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Ian Majewski
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Katarzyna Józwiak
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Wigard Kloosterman
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Markus van Roosmalen
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Karen Duran
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Frans Hogervorst
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Nick Turner
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Manel Esteller
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Edwin Cuppen
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Jelle Wesseling
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
| | - Jos Jonkers
- Affiliations of authors: Division of Molecular Pathology and Cancer Genomics Centre Netherlands (PtB, PK, EvdB, UB, MdM, EL, LM, JdR, JW, JJ), Division of Molecular Carcinogenesis (IM), Department of Epidemiology and Biostatistics (KJ), and Family Cancer Clinic and Department of Pathology (FH), The Netherlands Cancer Institute, Amsterdam, the Netherlands; Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain (CM, ME); The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK (HG, NT); Laboratory of Preclinical Investigation, Translational Research Department, Curie Institute, Paris, France (EM); Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands (WK, MvR, KD, EC); Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain (ME); Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain (ME)
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Schouten PC, Dackus GMHE, Marchetti S, van Tinteren H, Sonke GS, Schellens JHM, Linn SC. A phase I followed by a randomized phase II trial of two cycles carboplatin-olaparib followed by olaparib monotherapy versus capecitabine in BRCA1- or BRCA2-mutated HER2-negative advanced breast cancer as first line treatment (REVIVAL): study protocol for a randomized controlled trial. Trials 2016; 17:293. [PMID: 27323902 PMCID: PMC4915081 DOI: 10.1186/s13063-016-1423-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 06/02/2016] [Indexed: 11/10/2022] Open
Abstract
Background Preclinical studies in breast cancer models showed that BRCA1 or BRCA2 deficient cell lines, when compared to BRCA proficient cell lines, are extremely sensitive to PARP1 inhibition. When combining the PARP1 inhibitor olaparib with cisplatin in a BRCA1-mutated breast cancer mouse model, the combination induced a larger response than either of the two compounds alone. Several clinical studies have investigated single agent therapy or combinations of both drugs, but no randomized clinical evidence exists for the superiority of carboplatin-olaparib versus standard of care therapy in patients with BRCA1- or BRCA2--mutated metastatic breast cancer. Methods/design This investigator-initiated study contains two parts. Part 1 is a traditional 3 + 3 dose escalation study of the carboplatin-olaparib combination followed by olaparib monotherapy. The carboplatin dose will be escalated from area under the curve (AUC) 3 to AUC 4 with an olaparib dose of 25 mg BID. Olaparib is subsequently escalated to 50, 75, and 100 mg BID until >1/6 of patients develop dose-limiting toxicity (DLT). The dose level below will be the maximum tolerable dose (MTD). It is expected that 15–20 patients are needed in Part I. In Part 2 BRCA1- or BRCA2-mutated HER2-negative breast cancer patients will be randomized between standard capecitabine 1250 mg/m2 BID day 1–14 q day 22, versus 2 cycles carboplatin-olaparib followed by olaparib monotherapy 300 mg BID. In total 104 events in 110 patients need to be observed to detect a 75 % clinically meaningful improvement in progression-free survival (PFS), from a median of 4 months (control) to 7 months (experimental) assuming a 2-year accrual and ≥6 months of follow-up with 80 % power (5 %, two-sided significance level). After progression on first line treatment, patients will receive physician’s best choice of paclitaxel, vinorelbine, eribulin, or capecitabine (experimental arm only) at standard dose. A compassionate use program of olaparib is available for patients in the standard arm after progression on second line treatment. Discussion Results might be pivotal for registration of olaparib as standard first line treatment in advanced BRCA1- or BRCA2-mutated breast cancer. Trial registration ClinicalTrials.gov identifier: NCT02418624. Registered on 9 March 2015. EudraCT number: 2013-005590-41. Registered on 15 October 2014. Protocol version 3.0. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1423-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Philip C Schouten
- Department of Molecular Pathology, Antoni van Leeuwenhoek Hospital - Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands
| | - Gwen M H E Dackus
- Department of Molecular Pathology, Antoni van Leeuwenhoek Hospital - Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands.,Department of Pathology, Utrecht University Medical Center, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
| | - Serena Marchetti
- Division of Medical Oncology, Antoni van Leeuwenhoek Hospital - Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands.,Department of Clinical Pharmacology, Antoni van Leeuwenhoek Hospital - Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands
| | - Harm van Tinteren
- Department of Biometrics, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands
| | - Gabe S Sonke
- Division of Medical Oncology, Antoni van Leeuwenhoek Hospital - Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands
| | - Jan H M Schellens
- Department of Molecular Pathology, Antoni van Leeuwenhoek Hospital - Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands.,Division of Medical Oncology, Antoni van Leeuwenhoek Hospital - Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands.,Department of Clinical Pharmacology, Antoni van Leeuwenhoek Hospital - Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands.,Faculty of Science, Utrecht Institute of Pharmaceutical Sciences (UIPS), Universiteitsweg 99, 3584CG, Utrecht, The Netherlands
| | - Sabine C Linn
- Department of Molecular Pathology, Antoni van Leeuwenhoek Hospital - Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands. .,Department of Pathology, Utrecht University Medical Center, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands. .,Division of Medical Oncology, Antoni van Leeuwenhoek Hospital - Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands.
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129
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Abstract
INTRODUCTION Despite recent advances in the management of epithelial ovarian cancer, overall survival rates remain poor, and there is a pressing need to develop novel therapeutic agents and maintenance strategies to improve outcomes for women with this disease. Olaparib, a potent oral poly(ADP-ribose) polymerase (PARP) inhibitor, has demonstrated antitumor activity in women with ovarian cancer, associated with homologous recombination deficiency. AREAS COVERED This review outlines the rationale for PARP inhibitor therapy in ovarian cancer and summarizes the efficacy and tolerability data for olaparib to date. Ongoing phase III clinical trials of olaparib in ovarian cancer will be discussed. EXPERT OPINION There are a number of issues regarding the optimal use of olaparib in ovarian cancer, including the identification of a homologous recombination deficiency signature to predict treatment response, establishment of the optimal treatment setting (maintenance or relapsed disease), and evaluation of cost-effectiveness. Finally, the long term consequences of PARP inhibitors, including the risk of myelodysplasia and acute myeloid leukemia need to be quantified in ongoing large phase III clinical trials.
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Affiliation(s)
- Jennifer McLachlan
- a Gynaecology Unit , The Royal Marsden NHS Foundation Trust , London , UK
| | - Susana Banerjee
- a Gynaecology Unit , The Royal Marsden NHS Foundation Trust , London , UK
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130
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Ganguly B, Dolfi SC, Rodriguez-Rodriguez L, Ganesan S, Hirshfield KM. Role of Biomarkers in the Development of PARP Inhibitors. BIOMARKERS IN CANCER 2016; 8:15-25. [PMID: 26997874 PMCID: PMC4786099 DOI: 10.4137/bic.s36679] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/28/2015] [Accepted: 12/31/2015] [Indexed: 01/01/2023]
Abstract
Defects in DNA repair lead to genomic instability and play a critical role in cancer development. Understanding the process by which DNA damage repair is altered or bypassed in cancer may identify novel therapeutic targets and lead to improved patient outcomes. Poly(adenosine diphosphate-ribose) polymerase 1 (PARP1) has an important role in DNA repair, and novel therapeutics targeting PARP1 have been developed to treat cancers with defective DNA repair pathways. Despite treatment successes with PARP inhibitors (PARPi), intrinsic and acquired resistances have been observed. Preclinical studies and clinical trials in cancer suggest that combination therapy using PARPi and platinating agents is more effective than monotherapy in circumventing drug resistance mechanisms. Additionally, identification of biomarkers in response to PARPi will lead to improved patient selection for targeted cancer treatment. Recent technological advances have provided the necessary tools to examine many potential avenues to develop such biomarkers. This review examines the mechanistic rationale of PARP inhibition and potential biomarkers in their development for personalized therapy.
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Affiliation(s)
- Bratati Ganguly
- Department of Medicine, Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Sonia C. Dolfi
- Department of Medicine, Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Lorna Rodriguez-Rodriguez
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Shridar Ganesan
- Department of Medicine, Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Kim M. Hirshfield
- Department of Medicine, Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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131
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Wang J, Chen H, Chen X, Lin H. Expression of Tumor-Related Macrophages and Cytokines After Surgery of Triple-Negative Breast Cancer Patients and its Implications. Med Sci Monit 2016; 22:115-20. [PMID: 26752006 PMCID: PMC4712964 DOI: 10.12659/msm.895386] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background Triple-negative breast cancer (TNBC) has negative expression of progesterone receptor (PR) and estrogen receptor (ER), and low expression of human epithelial growth factor receptor-2 (HER-2). This study aimed to investigate the expressional profile of cytokines in TNBC patients with significant expression of macrophages. Material/Methods Immunohistochemical (IHC) S-P staining method was used to detect the tumor-associated macrophages (TAMs) marker CD68 expression in 48 cases of TNBC samples. The correlation between CD68 expression and prognosis was analyzed. Expressions of key cytokines – interleukin-6 (IL-6), IL-10, IL-12, IL-1β, chemokine (C-C motif) ligand-5 (CCL-5), and macrophage inflammatory protein-2 (MIP-2) – were quantified by RT-PCR and enzyme-linked immunosorbent assay (ELISA). Results Thirty-four out of 48 TNBC samples (71.4%) had CD68-positive expression. IL-6 and CCL-5 were up-regulated in high-infiltrated tumors when compared to low-infiltrated samples. Other cytokines had no significant difference regarding the expression level across groups. Conclusions TAMs were up-regulated in most TNBC patients after the surgery. Its expression suggested unfavorable prognosis, especially in the high-infiltrated group. Those tumors with more macrophage also had elevated expression of cytokine IL-6 and chemotactic factor CCL-5, both of which have potency to be clinical index and drug target for TNBC.
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Affiliation(s)
- Jianguo Wang
- Department of General Surgery, The Central Hospital of Xiangtan City, Xiangtan, Hunan, China (mainland)
| | - Hongwu Chen
- Department of Emergency, The Eastern Hospital of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China (mainland)
| | - Xingwu Chen
- Department of Science and Education, The Central Hospital of Xiangtan City, Xiangtan, Hunan, China (mainland)
| | - Hui Lin
- Department of General Surgery, The Central Hospital of Xiangtan City, Xiangtan, Hunan, China (mainland)
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132
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Kan C, Zhang J. BRCA1 Mutation: A Predictive Marker for Radiation Therapy? Int J Radiat Oncol Biol Phys 2015; 93:281-93. [PMID: 26383678 DOI: 10.1016/j.ijrobp.2015.05.037] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 05/08/2015] [Accepted: 05/21/2015] [Indexed: 02/01/2023]
Abstract
DNA repair, in particular, DNA double-strand break (DSB) repair, is essential for the survival of both normal and cancer cells. An elaborate repair mechanism has been developed in cells to efficiently repair the damaged DNA. The pathways predominately involved in DSB repair are homologous recombination and classic nonhomologous end-joining, although the alternative NHEJ pathway, a third DSB repair pathway, could also be important in certain contexts. The protein of BRCA1 encoded by the tumor suppressor gene BRCA1 regulates all DSB repair pathways. Given that DSBs represent the most biologically significant lesions induced by ionizing radiation and that impaired DSB repair leads to radiation sensitivity, it has been expected that cancer patients with BRCA1 mutations should benefit from radiation therapy. However, the clinical data have been conflicting and inconclusive. We provide an overview about the current status of the data regarding BRCA1 deficiency and radiation therapy sensitivity in both experimental models and clinical investigations. In addition, we discuss a strategy to potentiate the effects of radiation therapy by poly(ADP-ribose) polymerase inhibitors, the pharmacologic drugs being investigated as monotherapy for the treatment of patients with BRCA1/2 mutations.
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Affiliation(s)
- Charlene Kan
- Department of Radiation Oncology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Junran Zhang
- Department of Radiation Oncology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
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133
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Abstract
The nuclear enzyme poly (ADP-ribose) polymerase (PARP) represents an important novel target in the treatment of ovarian cancer. This article charts over 50 years of research from the discovery of the first PARP enzyme in 1963, to the approval and licensing in 2015 of the first PARP inhibitor, olaparib (Lynparza), in the treatment of BRCA-mutated ovarian cancer.
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Affiliation(s)
- Yvette Drew
- Northern Institute for Cancer
Research, Newcastle University, Newcastle upon Tyne,
UK
- Northern Centre for Cancer Care,
Freeman Hospital, Newcastle upon Tyne, UK
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134
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Yadav BS, Chanana P, Jhamb S. Biomarkers in triple negative breast cancer: A review. World J Clin Oncol 2015; 6:252-263. [PMID: 26677438 PMCID: PMC4675910 DOI: 10.5306/wjco.v6.i6.252] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 12/19/2014] [Accepted: 10/08/2015] [Indexed: 02/06/2023] Open
Abstract
Breast cancer is an intrinsically heterogeneous disease. In the world about 1 million cases of breast cancer are diagnosed annually and more than 170000 are triple-negative. Characteristic feature of triple negative breast cancer (TNBC) is that it lacks expression of oestrogen, progesterone and human epidermal growth factor receptor-2/neu receptors. They comprise 15%-20% of all breast cancers. We did a systematic review of PubMed and conference databases to identify studies published on biomarkers in TNBC. We included studies with biomarkers including: Epidermal growth factor receptor, vascular endothelial growth factor, c-Myc, C-kit and basal cytokeratins, Poly(ADP-ribose) polymerase-1, p53, tyrosinase kinases, m-TOR, heat and shock proteins and TOP-2A in TNBC. We also looked for studies published on synthetic lethality and inhibition of angiogenesis, growth, and survival pathways. TNBC is a complex disease subtype with many subclasses. Majority TNBC have a basal-like molecular phenotype by gene expression profiling. Their clinical and pathologic features overlap with hereditary BRCA1 related breast cancers. Management of these tumours is a challenge to the clinician because of its aggressive behaviour, poor outcome, and absence of targeted therapies. As the complexity of this disease is being simplified over time new targets are also being discovered for the treatment of this disease. There are many biomarkers in TNBC being used in clinical practice. Biomarkers may be useful as prognostic or predictive indicators as well as suggest possible targets for novel therapies. Many targeted agents are being studied for treatment of TNBC.
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135
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Ying S, Chen Z, Medhurst AL, Neal JA, Bao Z, Mortusewicz O, McGouran J, Song X, Shen H, Hamdy FC, Kessler BM, Meek K, Helleday T. DNA-PKcs and PARP1 Bind to Unresected Stalled DNA Replication Forks Where They Recruit XRCC1 to Mediate Repair. Cancer Res 2015; 76:1078-88. [PMID: 26603896 DOI: 10.1158/0008-5472.can-15-0608] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 09/12/2015] [Indexed: 12/12/2022]
Abstract
A series of critical pathways are responsible for the detection, signaling, and restart of replication forks that encounter blocks during S-phase progression. Small base lesions may obstruct replication fork progression and processing, but the link between repair of small lesions and replication forks is unclear. In this study, we investigated a hypothesized role for DNA-PK, an important enzyme in DNA repair, in cellular responses to DNA replication stress. The enzyme catalytic subunit DNA-PKcs was phosphorylated on S2056 at sites of stalled replication forks in response to short hydroxyurea treatment. Using DNA fiber experiments, we found that catalytically active DNA-PK was required for efficient replication restart of stalled forks. Furthermore, enzymatically active DNA-PK was also required for PARP-dependent recruitment of XRCC1 to stalled replication forks. This activity was enhanced by preventing Mre11-dependent DNA end resection, suggesting that XRCC1 must be recruited early to an unresected stalled fork. We also found that XRCC1 was required for effective restart of a subset of stalled replication forks. Overall, our work suggested that DNA-PK and PARP-dependent recruitment of XRCC1 is necessary to effectively protect, repair, and restart stalled replication forks, providing new insight into how genomic stability is preserved.
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Affiliation(s)
- Songmin Ying
- Department of Respiratory and Critical Care Medicine of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. Department of Pharmacology, Zhejiang University School of Medicine, Hangzhou, China.
| | - Zhihui Chen
- Department of Gastrointestinal and Pancreatic Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Annette L Medhurst
- Department of Oncology, CR-UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
| | - Jessica A Neal
- Department of Microbiology & Molecular Genetics, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan. Department of Pathobiology & Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Zhengqiang Bao
- Department of Pharmacology, Zhejiang University School of Medicine, Hangzhou, China
| | - Oliver Mortusewicz
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Joanna McGouran
- Nuffield Department of Medicine, Henry Wellcome Building for Molecular Physiology, University of Oxford, Oxford, United Kingdom
| | - Xinming Song
- Department of Gastrointestinal and Pancreatic Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huahao Shen
- Department of Respiratory and Critical Care Medicine of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. State Key Laboratory for Respiratory Diseases, Guangzhou, China
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Benedikt M Kessler
- Nuffield Department of Medicine, Henry Wellcome Building for Molecular Physiology, University of Oxford, Oxford, United Kingdom
| | - Katheryn Meek
- Department of Microbiology & Molecular Genetics, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan. Department of Pathobiology & Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Thomas Helleday
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden.
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136
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Yu H, Hendrikx JJMA, Rottenberg S, Schellens JHM, Beijnen JH, Huitema ADR. Development of a Tumour Growth Inhibition Model to Elucidate the Effects of Ritonavir on Intratumoural Metabolism and Anti-tumour Effect of Docetaxel in a Mouse Model for Hereditary Breast Cancer. AAPS JOURNAL 2015; 18:362-71. [PMID: 26603889 DOI: 10.1208/s12248-015-9838-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 10/17/2015] [Indexed: 12/31/2022]
Abstract
In a mouse tumour model for hereditary breast cancer, we previously explored the anti-cancer effects of docetaxel, ritonavir and the combination of both and studied the effect of ritonavir on the intratumoural concentration of docetaxel. The objective of the current study was to apply pharmacokinetic (PK)-pharmacodynamic (PD) modelling on this previous study to further elucidate and quantify the effects of docetaxel when co-administered with ritonavir. PK models of docetaxel and ritonavir in plasma and in tumour were developed. The effect of ritonavir on docetaxel concentration in the systemic circulation of Cyp3a knock-out mice and in the implanted tumour (with inherent Cyp3a expression) was studied, respectively. Subsequently, we designed a tumour growth inhibition model that included the inhibitory effects of both docetaxel and ritonavir. Ritonavir decreased docetaxel systemic clearance with 8% (relative standard error 0.4%) in the co-treated group compared to that in the docetaxel only-treated group. The docetaxel concentration in tumour tissues was significantly increased by ritonavir with mean area under the concentration-time curve 2.5-fold higher when combined with ritonavir. Observed tumour volume profiles in mice could be properly described by the PK/PD model. In the co-treated group, the enhanced anti-tumour effect was mainly due to increased docetaxel tumour concentration; however, we demonstrated a small but significant anti-tumour effect of ritonavir addition (p value <0.001). In conclusion, we showed that the increased anti-tumour effect observed when docetaxel is combined with ritonavir is mainly caused by enhanced docetaxel tumour concentration and to a minor extent by a direct anti-tumour effect of ritonavir.
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Affiliation(s)
- Huixin Yu
- Department of Pharmacy & Pharmacology, Netherlands Cancer Institute-Antoni van Leeuwenhoek/Slotervaart Hospital, Louwesweg 6, PO Box 90440, 1006 BK, Amsterdam, The Netherlands.
| | - Jeroen J M A Hendrikx
- Department of Pharmacy & Pharmacology, Netherlands Cancer Institute-Antoni van Leeuwenhoek/Slotervaart Hospital, Louwesweg 6, PO Box 90440, 1006 BK, Amsterdam, The Netherlands.,Division of Molecular Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Sven Rottenberg
- Division of Molecular Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Jan H M Schellens
- Division of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jos H Beijnen
- Department of Pharmacy & Pharmacology, Netherlands Cancer Institute-Antoni van Leeuwenhoek/Slotervaart Hospital, Louwesweg 6, PO Box 90440, 1006 BK, Amsterdam, The Netherlands.,Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Alwin D R Huitema
- Department of Pharmacy & Pharmacology, Netherlands Cancer Institute-Antoni van Leeuwenhoek/Slotervaart Hospital, Louwesweg 6, PO Box 90440, 1006 BK, Amsterdam, The Netherlands
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137
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Gunderson CC, Moore KN. Olaparib: an oral PARP-1 and PARP-2 inhibitor with promising activity in ovarian cancer. Future Oncol 2015; 11:747-57. [PMID: 25757679 DOI: 10.2217/fon.14.313] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Olaparib (Lynparza™; AZD2281) is a potent PARP-1 and PARP-2 inhibitor with biologic activity in ovarian cancer as well as other solid tumors. It has been tested in Phase I and II trials and has single-agent activity in both germline BRCA mutated and sporadic ovarian cancer. Phase III trials assessing the efficacy of olaparib in the maintenance setting following first line and platinum-sensitive recurrence are underway for patients with a germline BRCA mutation, given the inherent molecular compatibility with the drug's mechanism of action.
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Affiliation(s)
- Camille C Gunderson
- University of Oklahoma Health Sciences Center, Stephenson Oklahoma Cancer Center, 800 NE 10th Street, Suite 5040, Oklahoma City, OK 73104, USA
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138
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Zhu Q, Wang X, Hu Y, He X, Gong G, Xu Y. Discovery and SAR study of 2-(1-propylpiperidin-4-yl)-3H-imidazo[4,5-c]pyridine-7-carboxamide: A potent inhibitor of poly(ADP-ribose) polymerase-1 (PARP-1) for the treatment of cancer. Bioorg Med Chem 2015; 23:6551-9. [DOI: 10.1016/j.bmc.2015.09.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 09/14/2015] [Accepted: 09/15/2015] [Indexed: 11/16/2022]
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139
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Cheng H, Zou Y, Ross JS, Wang K, Liu X, Halmos B, Ali SM, Liu H, Verma A, Montagna C, Chachoua A, Goel S, Schwartz EL, Zhu C, Shan J, Yu Y, Gritsman K, Yelensky R, Lipson D, Otto G, Hawryluk M, Stephens PJ, Miller VA, Piperdi B, Perez-Soler R. RICTOR Amplification Defines a Novel Subset of Patients with Lung Cancer Who May Benefit from Treatment with mTORC1/2 Inhibitors. Cancer Discov 2015; 5:1262-70. [PMID: 26370156 DOI: 10.1158/2159-8290.cd-14-0971] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 09/10/2015] [Indexed: 01/09/2023]
Abstract
UNLABELLED We identified amplification of RICTOR, a key component of the mTOR complex 2 (mTORC2), as the sole actionable genomic alteration in an 18-year-old never-smoker with lung adenocarcinoma. Amplification of RICTOR occurs in 13% of lung cancers (1,016 cases) in The Cancer Genome Atlas and at a similar frequency in an independent cohort of 1,070 patients identified by genomic profiling. In the latter series, 11% of cases harbored RICTOR amplification as the only relevant genomic alteration. Its oncogenic roles were suggested by decreased lung cancer cell growth both in vitro and in vivo with RICTOR ablation, and the transforming capacity of RICTOR in a Ba/F3-cell system. The mTORC1/2 inhibitors were significantly more active against RICTOR-amplified lung cancer cells as compared with other agents targeting the PI3K-AKT-mTOR pathway. Moreover, an association between RICTOR amplification and sensitivities to mTORC1/2 inhibitors was observed. The index patient has been treated with mTORC1/2 inhibitors that led to tumor stabilization for more than 18 months. SIGNIFICANCE RICTOR amplification may define a novel and unique molecular subset of patients with lung cancer who may benefit from treatment with mTORC1/2 inhibitors.
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Affiliation(s)
- Haiying Cheng
- Division of Medical Oncology, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center, Bronx, New York.
| | - Yiyu Zou
- Division of Medical Oncology, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center, Bronx, New York
| | | | - Kai Wang
- Foundation Medicine, Inc., Cambridge, Massachusetts
| | - Xuewen Liu
- Division of Hematology/Oncology, Herbert Irving Comprehensive Cancer Center, New York Presbyterian Hospital-Columbia University Medical Center, New York, New York. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Balazs Halmos
- Division of Medical Oncology, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center, Bronx, New York. Division of Hematology/Oncology, Herbert Irving Comprehensive Cancer Center, New York Presbyterian Hospital-Columbia University Medical Center, New York, New York
| | - Siraj M Ali
- Foundation Medicine, Inc., Cambridge, Massachusetts
| | - Huijie Liu
- Division of Medical Oncology, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center, Bronx, New York
| | - Amit Verma
- Division of Medical Oncology, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center, Bronx, New York
| | - Cristina Montagna
- Departments of Genetics and Pathology, Molecular Cytogenetic Core, Albert Einstein College of Medicine, Bronx, New York
| | - Abraham Chachoua
- Division of Medical Oncology, NYU Langone Medical Center, New York, New York
| | - Sanjay Goel
- Division of Medical Oncology, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center, Bronx, New York
| | - Edward L Schwartz
- Division of Medical Oncology, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center, Bronx, New York
| | - Changcheng Zhu
- Department of Pathology, Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center, Bronx, New York
| | - Jidong Shan
- Departments of Genetics and Pathology, Molecular Cytogenetic Core, Albert Einstein College of Medicine, Bronx, New York
| | - Yiting Yu
- Division of Medical Oncology, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center, Bronx, New York
| | - Kira Gritsman
- Division of Medical Oncology, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center, Bronx, New York
| | | | - Doron Lipson
- Foundation Medicine, Inc., Cambridge, Massachusetts
| | - Geoff Otto
- Foundation Medicine, Inc., Cambridge, Massachusetts
| | | | | | | | - Bilal Piperdi
- Division of Medical Oncology, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center, Bronx, New York
| | - Roman Perez-Soler
- Division of Medical Oncology, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center, Bronx, New York
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140
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Olaparib tablet formulation: effect of food on the pharmacokinetics after oral dosing in patients with advanced solid tumours. Cancer Chemother Pharmacol 2015; 76:723-9. [DOI: 10.1007/s00280-015-2836-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 07/21/2015] [Indexed: 10/23/2022]
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Yardley DA, Shipley DL, Peacock NW, Shastry M, Midha R, Priego VM, Hainsworth JD. Phase I/II trial of neoadjuvant sunitinib administered with weekly paclitaxel/carboplatin in patients with locally advanced triple-negative breast cancer. Breast Cancer Res Treat 2015; 152:557-67. [PMID: 26155975 DOI: 10.1007/s10549-015-3482-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 06/18/2015] [Indexed: 10/23/2022]
Abstract
The purpose of the study is to evaluate the feasibility and efficacy of adding sunitinib to paclitaxel/carboplatin in the neoadjuvant therapy of patients with triple-negative breast cancer (TNBC). Patients had histologically proven, previously untreated, triple-negative adenocarcinoma, with disease limited to the breast and axilla (clinical T1-T3, N0-N2, M0; T1N1M0 excluded). Following determination of the maximum tolerated doses in the phase I portion, patients in the phase II study received paclitaxel 70 mg/m(2) IV days 1, 8, and 15; carboplatin AUC 5.0 IV day 1; sunitinib 25 mg orally daily; treatment was administered for six 28-day cycles followed by definitive surgery. Sunitinib was resumed postoperatively to complete a 52-week course. Pathologic complete response (pCR) rate was the primary endpoint. Fifty-four patients enrolled; 41 received treatment in the phase II study. Sixteen patients (39 %) were able to complete six cycles of neoadjuvant therapy; 18 additional patients had surgery after completing 2-5 cycles of treatment. The pCR rate in these 34 evaluable patients was 35 %. The toxicity of the regimen was considerable, with myelosuppression resulting in numerous dose reductions and/or omissions of paclitaxel and carboplatin. Eleven patients (27 %) discontinued sunitinib during neoadjuvant therapy, and six patients (14 %) completed 52 weeks of single-agent sunitinib. In the neoadjuvant treatment of patients with TNBC, the combination of paclitaxel, carboplatin, and sunitinib was difficult to administer, and produced a pCR rate comparable to other less toxic regimens. This combination is not recommended for further evaluation. At present, sunitinib has no defined role in the treatment of breast cancer.
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Francis JC, Melchor L, Campbell J, Kendrick H, Wei W, Armisen-Garrido J, Assiotis I, Chen L, Kozarewa I, Fenwick K, Swain A, Smalley MJ, Lord CJ, Ashworth A. Whole-exome DNA sequence analysis of Brca2- and Trp53-deficient mouse mammary gland tumours. J Pathol 2015; 236:186-200. [PMID: 25692405 DOI: 10.1002/path.4517] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 02/03/2015] [Accepted: 02/11/2015] [Indexed: 01/08/2023]
Abstract
Germline mutations in the tumour suppressor BRCA2 predispose to breast, ovarian and a number of other human cancers. Brca2-deficient mouse models are used for preclinical studies but the pattern of genomic alterations in these tumours has not yet been described in detail. We have performed whole-exome DNA sequencing analysis of mouse mammary tumours from Blg-Cre Brca2(f/f) Trp53(f/f) animals, a model of BRCA2-deficient human cancer. We also used the sequencing data to estimate DNA copy number alterations in these tumours and identified a recurrent copy number gain in Met, which has been found amplified in other mouse mammary cancer models. Through a comparative genomic analysis, we identified several mouse Blg-Cre Brca2(f/f) Trp53(f/f) mammary tumour somatic mutations in genes that are also mutated in human cancer, but few of these genes have been found frequently mutated in human breast cancer. A more detailed analysis of these somatic mutations revealed a set of genes that are mutated in human BRCA2 mutant breast and ovarian tumours and that are also mutated in mouse Brca2-null, Trp53-null mammary tumours. Finally, a DNA deletion surrounded by microhomology signature found in human BRCA1/2-deficient cancers was not common in the genome of these mouse tumours. Although a useful model, there are some differences in the genomic landscape of tumours arising in Blg-Cre Brca2(f/f) Trp53(f/f) mice compared to human BRCA-mutated breast cancers. Therefore, this needs to be taken into account in the use of this model.
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MESH Headings
- Animals
- Antigens, CD/genetics
- Breast Neoplasms/genetics
- Chromosomal Proteins, Non-Histone/genetics
- DNA Copy Number Variations/genetics
- DNA, Neoplasm/genetics
- Disease Models, Animal
- Female
- Gene Knockout Techniques
- Genes, BRCA2/physiology
- Germ-Line Mutation/genetics
- Humans
- Mammary Neoplasms, Experimental/genetics
- Mice, Transgenic
- Mutation, Missense/genetics
- Ovarian Neoplasms/genetics
- Protein Serine-Threonine Kinases/genetics
- Receptors, Immunologic/genetics
- Sequence Analysis, DNA
- Signaling Lymphocytic Activation Molecule Family
- Tumor Suppressor Protein p53/deficiency
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Affiliation(s)
- Jeffrey C Francis
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK
- The CRUK Gene Function Laboratory, Institute of Cancer Research, London, UK
| | - Lorenzo Melchor
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK
| | - James Campbell
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK
- The CRUK Gene Function Laboratory, Institute of Cancer Research, London, UK
| | - Howard Kendrick
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK
| | - Wenbin Wei
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK
- The CRUK Gene Function Laboratory, Institute of Cancer Research, London, UK
| | | | | | - Lina Chen
- Tumour Profiling Unit, Institute of Cancer Research, London, UK
| | - Iwanka Kozarewa
- Tumour Profiling Unit, Institute of Cancer Research, London, UK
| | - Kerry Fenwick
- Tumour Profiling Unit, Institute of Cancer Research, London, UK
| | - Amanda Swain
- Tumour Profiling Unit, Institute of Cancer Research, London, UK
| | - Matthew J Smalley
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK
| | - Christopher J Lord
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK
- The CRUK Gene Function Laboratory, Institute of Cancer Research, London, UK
| | - Alan Ashworth
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK
- The CRUK Gene Function Laboratory, Institute of Cancer Research, London, UK
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143
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Xu G, Chapman JR, Brandsma I, Yuan J, Mistrik M, Bouwman P, Bartkova J, Gogola E, Warmerdam D, Barazas M, Jaspers JE, Watanabe K, Pieterse M, Kersbergen A, Sol W, Celie PHN, Schouten PC, van den Broek B, Salman A, Nieuwland M, de Rink I, de Ronde J, Jalink K, Boulton SJ, Chen J, van Gent DC, Bartek J, Jonkers J, Borst P, Rottenberg S. REV7 counteracts DNA double-strand break resection and affects PARP inhibition. Nature 2015; 521:541-544. [PMID: 25799992 PMCID: PMC4671316 DOI: 10.1038/nature14328] [Citation(s) in RCA: 435] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 02/13/2015] [Indexed: 01/01/2023]
Abstract
Error-free repair of DNA double-strand breaks (DSBs) is achieved by homologous recombination (HR), and BRCA1 is an important factor for this repair pathway. In the absence of BRCA1-mediated HR, the administration of PARP inhibitors induces synthetic lethality of tumour cells of patients with breast or ovarian cancers. Despite the benefit of this tailored therapy, drug resistance can occur by HR restoration. Genetic reversion of BRCA1-inactivating mutations can be the underlying mechanism of drug resistance, but this does not explain resistance in all cases. In particular, little is known about BRCA1-independent restoration of HR. Here we show that loss of REV7 (also known as MAD2L2) in mouse and human cell lines re-establishes CTIP-dependent end resection of DSBs in BRCA1-deficient cells, leading to HR restoration and PARP inhibitor resistance, which is reversed by ATM kinase inhibition. REV7 is recruited to DSBs in a manner dependent on the H2AX-MDC1-RNF8-RNF168-53BP1 chromatin pathway, and seems to block HR and promote end joining in addition to its regulatory role in DNA damage tolerance. Finally, we establish that REV7 blocks DSB resection to promote non-homologous end-joining during immunoglobulin class switch recombination. Our results reveal an unexpected crucial function of REV7 downstream of 53BP1 in coordinating pathological DSB repair pathway choices in BRCA1-deficient cells.
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Affiliation(s)
- Guotai Xu
- Division of Molecular Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - J Ross Chapman
- The Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford, OX3 7BN, United Kingdom
| | - Inger Brandsma
- Department of Genetics, Erasmus, University Medical Center, Rotterdam, The Netherlands
| | - Jingsong Yuan
- Department of Experimental Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Martin Mistrik
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Peter Bouwman
- Division of Molecular Pathology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | | | - Ewa Gogola
- Division of Molecular Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Daniël Warmerdam
- Division of Cell Biology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Marco Barazas
- Division of Molecular Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Janneke E Jaspers
- Division of Molecular Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Kenji Watanabe
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mark Pieterse
- Department of Experimental Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Ariena Kersbergen
- Division of Molecular Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Wendy Sol
- Division of Molecular Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Patrick H N Celie
- Protein Facility, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Philip C Schouten
- Division of Molecular Pathology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Bram van den Broek
- Division of Cell Biology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Ahmed Salman
- The Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford, OX3 7BN, United Kingdom
| | - Marja Nieuwland
- Deep Sequencing Core Facility, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Iris de Rink
- Deep Sequencing Core Facility, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Jorma de Ronde
- Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Kees Jalink
- Division of Cell Biology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Simon J Boulton
- DNA Damage Response Laboratory, London Research Institute, Cancer Research UK, Clare Hall, South Mimms EN6 3LD, UK
| | - Junjie Chen
- Department of Experimental Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Dik C van Gent
- Department of Genetics, Erasmus, University Medical Center, Rotterdam, The Netherlands
| | - Jiri Bartek
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jos Jonkers
- Division of Molecular Pathology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Piet Borst
- Division of Molecular Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Sven Rottenberg
- Division of Molecular Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
- Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Laengassstrasse 122, 3012 Bern, Switzerland
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144
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Yang KS, Kohler RH, Landon M, Giedt R, Weissleder R. Single cell resolution in vivo imaging of DNA damage following PARP inhibition. Sci Rep 2015; 5:10129. [PMID: 25984718 PMCID: PMC4434991 DOI: 10.1038/srep10129] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 03/24/2015] [Indexed: 11/17/2022] Open
Abstract
Targeting DNA repair pathways is a powerful strategy to treat cancers. To gauge efficacy in vivo, typical response markers include late stage effects such as tumor shrinkage, progression free survival, or invasive repeat biopsies. These approaches are often difficult to answer critical questions such as how a given drug affects single cell populations as a function of dose and time, distance from microvessels or how drug concentration (pharmacokinetics) correlates with DNA damage (pharmacodynamics). Here, we established a single-cell in vivo pharmacodynamic imaging read-out based on a truncated 53BP1 double-strand break reporter to determine whether or not poly(ADP-ribose) polymerase (PARP) inhibitor treatment leads to accumulation of DNA damage. Using this reporter, we show that not all PARP inhibitor treated tumors incur an increase in DNA damage. The method provides a framework for single cell analysis of cancer therapeutics in vivo.
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Affiliation(s)
- Katherine S Yang
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA 02114
| | - Rainer H Kohler
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA 02114
| | - Matthieu Landon
- 1] Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA 02114 [2] Department of Systems Biology, Harvard Medical School, 200 Longwood Ave, Boston, MA 02115
| | - Randy Giedt
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA 02114
| | - Ralph Weissleder
- 1] Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA 02114 [2] Department of Systems Biology, Harvard Medical School, 200 Longwood Ave, Boston, MA 02115
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145
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Extent of radiosensitization by the PARP inhibitor olaparib depends on its dose, the radiation dose and the integrity of the homologous recombination pathway of tumor cells. Radiother Oncol 2015; 116:358-65. [PMID: 25981132 DOI: 10.1016/j.radonc.2015.03.028] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/19/2015] [Accepted: 03/26/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND PURPOSE The PARP inhibitor olaparib is currently tested in clinical phase 1 trials to define safe dose levels in combination with RT. However, certain clinically relevant insights are still lacking. Here we test, while comparing to single agent activity, the olaparib dose and genetic background dependence of olaparib-mediated radiosensitization. MATERIALS AND METHODS Long-term growth inhibition and clonogenic assays were used to assess radiosensitization in BRCA2-deficient and BRCA2-complemented cells and in a panel of human head and neck squamous cell carcinoma cell lines. RESULTS The extent of radiosensitization greatly depended on the olaparib dose, the radiation dose and the homologous recombination status of cells. Olaparib concentrations that resulted in radiosensitization prevented PAR induction by irradiation. Seven hours olaparib exposures were sufficient for radiosensitization. Importantly, the radiosensitizing effects can be observed at much lower olaparib doses than the single agent effects. CONCLUSION Extrapolation of these data to the clinic suggests that low olaparib doses are sufficient to cause radiosensitization, underlining the potential of the treatment. Here we show that drug doses achieving radiosensitization can greatly differ from those achieving single agent activities, an important consideration when developing combined radiotherapy strategies with novel targeted agents.
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146
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Activity of CEP-9722, a poly (ADP-ribose) polymerase inhibitor, in urothelial carcinoma correlates inversely with homologous recombination repair response to DNA damage. Anticancer Drugs 2015; 25:878-86. [PMID: 24714082 DOI: 10.1097/cad.0000000000000114] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
As loss of DNA-repair proteins is common in urothelial carcinoma (UC), a rationale can be made to evaluate the activity of poly (ADP-ribose) polymerase (PARP) inhibitors to exploit synthetic lethality. We aimed to preclinically evaluate a PARP inhibitor, CEP-9722, and its active metabolite, CEP-8983, in UC. The activity of CEP-8983 was evaluated using a 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay against human UC cell lines. Flow cytometry, COMET assay, and western blot were performed to assess apoptosis, DNA damage, and DNA-repair proteins, respectively. RT4 xenografts received placebo or CEP-9722 (100 or 200 mg/kg/day) orally. Xenografts were subjected to immunohistochemistry for apoptosis [cleaved caspase (cc)-3] and angiogenesis (CD31). CEP-8983 (1 μmol/l) reduced the viability of RT4 and T24 cells by 20%, but did not reduce the viability of 5637 and TCC-SUP cells. Apoptosis and necrosis occurred in 9.7 and 9.1% of RT4 and 5637 cells, respectively. RT4 cells showed greater DNA damage compared with 5637 cells. Increased DNA damage occurred with combination versus CEP-8983 or cisplatin alone in RT4 and 5637 cells. T24 and RT4 showed the least RAD51 foci 8 h following radiation, whereas TCC-SUP and 5637 robustly induced RAD51 foci. CEP-9722 showed dose-dependent antitumor activity in RT4 xenografts; 200 mg/kg daily was better than control (P=0.04) and 100 mg/kg was not (P=0.26). Immunohistochemistry of xenografts showed a significant increase in cc-3 and decrease in CD31 with both doses (P<0.05). Biomarker-driven evaluation of PARP inhibitors in UC is justified as the activity of CEP-9722 correlated inversely with homologous recombination repair response to DNA damage.
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147
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Ataxia-telangiectasia-mutated protein kinase levels stratify patients with pancreatic adenocarcinoma into prognostic subgroups with loss being a strong indicator of poor survival. Pancreas 2015; 44:296-301. [PMID: 25423555 DOI: 10.1097/mpa.0000000000000248] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Recently, aberrations in the gene encoding for ataxia-telangiectasia-mutated (ATM) protein kinase have been reported for pancreatic ductal adenocarcinomas (PDAC). These findings argue that ATM deficiency may play a role during carcinogenesis. Therefore, in this study, we investigated the clinical relevance of ATM expression and ATM activation in PDAC. METHODS Both ATM expression and nuclear phosphoSer1981-ATM levels were assessed by immunohistochemistry in a cohort of 133 PDAC and correlated with clinicopathological parameters. RESULTS We found stratification in prognostic subgroups. Complete loss of Ser1981-ATM was indicative of the worst prognosis (median survival, 10.8 vs 14.3 months [low expression] vs 31.1 months [high expression], P < 0.001). Similarly, analysis of ATM expression demonstrated absent expression levels of ATM to be associated with dismal prognosis (median survival, 9.6 months), whereas expression of ATM in general was associated with increased survival (17.7 months, P = 0.001). CONCLUSIONS Our analysis shows that both ATM expression and activated ATM are prognostic markers in PDAC with respect to standard clinicopathological parameters. These results suggest that ATM should be further explored as prognostic as well as predictive factor with respect to conventional chemotherapies and for putative synthetic lethal approaches.
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148
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Abstract
The development of poly (adenosine diphosphate [ADP]) ribose polymerase (PARP) inhibitors (PARPi) has progressed greatly over the last few years and has shown encouraging results in the BRCA1/2 mutation–related cancers. This article attempts to summarize the rationale and theory behind PARPi, the clinical trials already reported, as well as ongoing studies designed to determine the role of PARPi in patients with and without germline mutations of BRCA genes. Future plans for PARPi both as monotherapy and in combination with standard cytotoxics, other biological agents, and as radiosensitizers are also covered. The widening scope of PARPi adds another important targeted agent to the growing list of molecular inhibitors; future and ongoing trials will identify the most effective role for PARPi, including for patients other than BRCA germline mutation carriers.
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Affiliation(s)
- Sarah Benafif
- Mount Vernon Cancer Centre, Northwood, Middlesex, UK
| | - Marcia Hall
- Mount Vernon Cancer Centre, Northwood, Middlesex, UK
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149
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Coward JIG, Middleton K, Murphy F. New perspectives on targeted therapy in ovarian cancer. Int J Womens Health 2015; 7:189-203. [PMID: 25678824 PMCID: PMC4324539 DOI: 10.2147/ijwh.s52379] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Epithelial ovarian cancer remains the most lethal gynecologic malignancy. During the last 15 years, there has been only marginal improvement in 5 year overall survival. These daunting statistics are compounded by the fact that despite all subtypes exhibiting striking heterogeneity, their systemic management remains identical. Although changes to the scheduling and administration of chemotherapy have improved outcomes to a degree, a therapeutic ceiling is being reached with this approach, resulting in a number of trials investigating the efficacy of targeted therapies alongside standard treatment algorithms. Furthermore, there is an urge to develop subtype-specific studies in an attempt to improve outcomes, which currently remain poor. This review summarizes the key studies with antiangiogenic agents, poly(adenosine diphosphate [ADP]-ribose) inhibitors, and epidermal growth factor receptor/human epidermal growth factor receptor family targeting, in addition to folate receptor antagonists and insulin growth factor receptor inhibitors. The efficacy of treatment paradigms used in non-ovarian malignancies for type I tumors is also highlighted, in addition to recent advances in appropriate patient stratification for targeted therapies in epithelial ovarian cancer.
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Affiliation(s)
- Jermaine IG Coward
- Mater Health Services, Raymond Terrace, South Brisbane, QLD, Australia
- Inflammtion and Cancer Therapeutics Group, Mater Research, University of Queensland, Translational Research Institute, Woolloongabba, Brisbane, QLD, Australia
- School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Kathryn Middleton
- Mater Health Services, Raymond Terrace, South Brisbane, QLD, Australia
| | - Felicity Murphy
- Mater Health Services, Raymond Terrace, South Brisbane, QLD, Australia
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150
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