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Poly(ADP-ribose) polymerase inhibitors in Ewing sarcoma
Britta Vormoor1, Nicola J Curtin
1aNewcastle Cancer Centre at the Northern Institute for Cancer Research, Newcastle University bGreat North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Purpose Of Review:
In 2012, two publications revealed a particular sensitivity of Ewing sarcoma cells to the inhibition of poly(ADP-ribose) polymerase (PARP). This review updates the reader on PARP function, the development of PARP inhibitors (PARPi) and the evidence for targeting PARP in Ewing sarcoma. It concludes with a description of ongoing/emerging PARPi clinical trials in patients with Ewing sarcoma.
Recent Findings:
PARP has a major role in DNA repair, and is a transcription regulator. The oncoprotein in Ewing sarcoma, EWS-FLI1, is proposed to interact with PARP-1, driving PARP-1 expression, which further promotes transcriptional activation by EWS-FLI1. Thus, there are two rationales for PARPi in the treatment of Ewing sarcoma: to disrupt the interaction between EWS-FLI1 and PARP, and for chemo-potentiation or radio-potentiation. The first clinical trial with a single agent PARPi failed to show significant responses, but preclinical evidence for combinations of PARPi with chemotherapy or radiotherapy is very promising.
Summary:
Despite initial excitement for the potential of PARPi as single agent therapy in Ewing sarcoma, the emerging preclinical data now strongly support testing PARPi in combination with chemo/radiotherapy clinically.
Insights
Poly(ADP-ribose) polymerase (PARP) inhibitors show promise for Ewing sarcoma treatment. Preclinical data suggest combining PARP inhibitors with chemotherapy or radiotherapy is more effective than single-agent therapy.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Therapeutics
Background:
- Ewing sarcoma cells exhibit sensitivity to poly(ADP-ribose) polymerase (PARP) inhibition.
- PARP plays a crucial role in DNA repair and transcription regulation.
- The Ewing sarcoma oncoprotein EWS-FLI1 may interact with PARP-1, influencing its expression and transcriptional activity.
Purpose of the Study:
- To review PARP function and the development of PARP inhibitors (PARPi).
- To examine the evidence for targeting PARP in Ewing sarcoma treatment.
- To describe ongoing and emerging clinical trials of PARPi in Ewing sarcoma.
Main Methods:
- Literature review of PARP function, PARPi development, and Ewing sarcoma research.
- Analysis of preclinical data on PARPi efficacy in Ewing sarcoma models.
- Overview of current clinical trials involving PARPi for Ewing sarcoma.
Main Results:
- PARP inhibitors offer dual rationales for Ewing sarcoma treatment: disrupting EWS-FLI1 interaction and potentiating chemotherapy/radiotherapy.
- A Phase I clinical trial of single-agent PARPi did not yield significant responses.
- Preclinical studies demonstrate promising results for combining PARPi with chemotherapy or radiotherapy.
Conclusions:
- Initial enthusiasm for single-agent PARPi in Ewing sarcoma is tempered by clinical trial outcomes.
- Emerging preclinical evidence strongly supports the clinical investigation of PARPi in combination therapies for Ewing sarcoma.
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