BRCA1 intronic Alu elements drive gene rearrangements and PARP inhibitor resistance

Yifan Wang1, Andrea J Bernhardy1, Joseph Nacson1,2

  • 1Molecular Therapeutics Program, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA.

Nature Communications
|December 13, 2019
PubMed

Insights

BRCA1 gene rearrangements in intron 15 can lead to resistance against PARP inhibitor (PARPi) therapy by producing functional BRCA1 protein variants. These variants promote DNA repair, enabling cancer cell proliferation despite PARPi treatment.

Area of Science:

  • Oncology
  • Molecular Biology
  • Genetics

Background:

  • BRCA1 mutations confer sensitivity to PARP inhibitors (PARPi) due to impaired DNA repair.
  • Resistance to PARPi therapy is a significant clinical challenge in BRCA1-mutated cancers.
  • Correct folding and stability of BRCA1 protein, particularly the BRCT domain, are crucial for its function.

Purpose of the Study:

  • To investigate the mechanisms underlying PARPi resistance in BRCA1 mutant cancers.
  • To identify genetic alterations in BRCA1 that confer resistance to PARPi therapy.
  • To explore the role of BRCA1 protein isoforms in homology-dependent DNA repair and PARPi resistance.

Main Methods:

  • Analysis of cell lines and patient-derived tumors with BRCA1 BRCT domain mutations.
  • Detection of BRCA1 protein expression in resistant cancer models.
  • Peptide analysis to identify specific protein residues in chemo-resistant cancers.
  • Investigation of BRCA1 gene rearrangements, including Alu element involvement, in intron 15.

Main Results:

  • Highly disruptive BRCA1 BRCT domain mutations did not always lead to protein degradation, with detectable BRCA1 protein expression in resistant cases.
  • Chemo-resistant cancers harbored BRCA1 gene breakpoints within Alu elements in intron 15, causing partial gene duplications, inversions, or translocations.
  • These rearrangements generated BRCA1 isoforms lacking the mutated BRCT domain, which escaped proteasomal degradation.
  • BRCA1 BRCT domain-deficient isoforms supported homology-dependent DNA repair, contributing to PARPi resistance.

Conclusions:

  • Alu-mediated BRCA1 gene rearrangements in intron 15 generate hypomorphic BRCA1 proteins that confer PARPi resistance.
  • These specific BRCA1 gene rearrangements may serve as a predictive biomarker for PARPi resistance.
  • Understanding these resistance mechanisms is crucial for optimizing cancer treatment strategies.

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