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Targeting Replication Fork Processing Synergizes with PARP Inhibition to Potentiate Lethality in Homologous
Ganesh Pai Bellare1,2, Kshama Kundu1, Papiya Dey1
1Bio-Organic Division, Bhabha Atomic Research Centre, Mumbai, 400085, India.
Abstract:
Synthetic lethality in homologous recombination (HR)-deficient cancers caused by Poly (ADP-ribose) polymerase inhibitors (PARPi) has been classically attributed to its role in DNA repair. The mode of action of PARPi and resistance thereof are now believed to be predominantly replication associated. Therefore, effective combinatorial approaches of targeting replication fork processing along with HR-downregulation to target HR-proficient and possibly PARPi-resistant tumors are warranted. Stilbenes are a privileged class of molecules, which include resveratrol, pterostilbene, piceatannol, etc, that modulate both replication processes and RAD51-expression. In this investigation, by screening a small library of stilbenes, including in-house synthesized molecules, trans-4,4'-dihydroxystilbene (DHS) was discovered as a potent natural agent, which downregulates RAD51 expression and HR repair (GFP-reporter assay). DHS induces extensive synergistic cell death in ovarian cancers when combined with talazoparib (PARPi). Mechanistically, DHS elicits replication-stress through severely impeding replication fork progress, speed, and inducing fork-asymmetry. This leads to robust induction of single stranded DNA (ssDNA) gaps and poly-ADP-ribosylation (PARylation) in S-phase cells, signifying issues related to lagging (Okazaki) strand synthesis. PARPi, which abrogates PARylation, potentiates DHS induced ssDNA gaps, and their conversion into lethal double strand breaks through MRE11 action. Furthermore, the combination is highly effective in mitigating ovarian tumor xenograft growth in SCID mice and exhibited a good therapeutic-index with no/minimal tissue-toxicity.
Insights
Trans-4,4'-dihydroxystilbene (DHS) combined with Poly (ADP-ribose) polymerase inhibitors (PARPi) shows promise for treating ovarian cancers by targeting replication stress and homologous recombination repair. This combination effectively reduces tumor growth with minimal toxicity.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Synthetic lethality in homologous recombination (HR)-deficient cancers treated with Poly (ADP-ribose) polymerase inhibitors (PARPi) is increasingly linked to replication processes rather than solely DNA repair.
- Targeting replication fork processing alongside HR-downregulation offers a strategy for HR-proficient and PARPi-resistant tumors.
- Stilbenes, like resveratrol, are known to modulate replication and RAD51 expression.
Purpose of the Study:
- To identify novel agents that downregulate RAD51 expression and homologous recombination (HR) repair.
- To evaluate the efficacy of combining a novel stilbene, trans-4,4 -dihydroxystilbene (DHS), with a PARPi in ovarian cancer models.
- To elucidate the underlying mechanisms of action for the combination therapy.
Main Methods:
- Screening of a stilbene library to identify compounds affecting RAD51 expression and HR repair using a GFP-reporter assay.
- Combination treatment of ovarian cancer cells with DHS and talazoparib (PARPi).
- Assessment of replication stress, single-stranded DNA (ssDNA) gaps, poly-ADP-ribosylation (PARylation), and DNA double-strand breaks.
- In vivo studies using ovarian tumor xenografts in SCID mice to evaluate therapeutic efficacy and toxicity.
Main Results:
- Trans-4,4 -dihydroxystilbene (DHS) was identified as a potent natural agent that downregulates RAD51 expression and HR repair.
- DHS synergistically enhanced cell death in ovarian cancers when combined with talazoparib (PARPi).
- Mechanistically, DHS induced replication stress by impeding replication fork progression and speed, leading to ssDNA gaps and PARylation, which were potentiated by PARPi to cause lethal double-strand breaks.
- The combination therapy significantly inhibited ovarian tumor xenograft growth with minimal observed tissue toxicity.
Conclusions:
- Trans-4,4 -dihydroxystilbene (DHS) is a potent natural agent that induces replication stress and downregulates HR repair.
- The combination of DHS and talazoparib (PARPi) demonstrates significant synergistic efficacy in ovarian cancer treatment, targeting both HR-proficient and potentially PARPi-resistant tumors.
- This combination therapy warrants further investigation as a novel therapeutic strategy for ovarian cancer, showing promising efficacy and a favorable toxicity profile.
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