Targeting epigenetic regulators induces transcription-replication conflicts to overcome ATR inhibitor resistance

Samah W Awwad1,2, Holly Barber1,3, Josie Coulthard1

  • 1Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, United Kingdom.

Nucleic Acids Research
|August 20, 2026
PubMed

Insights

Targeting epigenetic regulators like HDAC3 or PRC2 can restore sensitivity to ataxia telangiectasia and Rad3-related (ATR) kinase inhibitors (ATRi) in resistant cancers. This approach induces transcriptional dysregulation and replication stress, offering a new strategy against ATRi resistance.

Area of Science:

  • Cancer Biology
  • Epigenetics
  • Genomic Stability

Background:

  • Cancer cells rely on ATR kinase for survival amid replication stress.
  • Resistance to ATR inhibitors (ATRi) is a major therapeutic challenge.
  • Loss of CDK8/CCNC subunits confers ATRi resistance by reducing transcription-dependent replication stress.

Purpose of the Study:

  • Identify vulnerabilities to restore ATRi sensitivity in resistant cancer cells.
  • Explore the role of epigenetic regulators in ATRi resistance.
  • Validate therapeutic strategies targeting epigenetic pathways.

Main Methods:

  • Genome-wide CRISPR screens in wild-type and CDK8-deficient cells.
  • Assessing ATRi sensitivity upon impairment of epigenetic components.
  • In vivo tumor growth studies following HDAC3 loss.
  • Pharmacological inhibition of HDAC3 and PRC2.

Main Results:

  • Impairment of HDAC3 or PRC2 enhances ATRi sensitivity, especially in CDK8/CCNC-deficient cells.
  • This sensitivity is driven by transcriptional dysregulation, increased transcription-replication collisions, and replication stress.
  • HDAC3 loss significantly limits the growth of ATRi-resistant tumors in vivo.
  • Pharmacological inhibition of HDAC3/PRC2 mimics genetic loss effects.

Conclusions:

  • Targeting epigenetic regulators like HDAC3 and PRC2 is a promising strategy to overcome ATRi resistance.
  • Inducing transcriptional dysregulation and replication stress can re-sensitize resistant cancers to ATRi.
  • Pharmacological targeting of epigenetic pathways offers a viable therapeutic approach for ATRi-resistant cancers.

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