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Elucidating acquired PARP inhibitor resistance in advanced prostate cancer.

Title: Elucidating acquired PARP inhibitor resistance in advanced prostate cancer.
Authors: Seed, G; Beije, N; Yuan, W; Bertan, C; Goodall, J; Lundberg, A; Tyler, M; Figueiredo, I; Pereira, R; Baker, C; Bogdan, D; Gallagher, L; Cieslik, J-P; Greening, S; Lambros, M; Neves, R; Magraner-Pardo, L; Fowler, G; Ebbs, B; Miranda, S; Flohr, P; Bianchini, D; Rescigno, P; Porta, N; Hall, E; Gurel, B; Tunariu, N; Sharp, A; Pettit, S; Stoecklein, NH; Sandhu, S; Quigley, D; Lord, CJ; Mateo, J; Carreira, S; de Bono, J
Contributors: Seed, George; Yuan, Wei; Lundberg, Arian; Figueiredo, Ines; Pereira, Ana Rita; Bogdan, Denisa Ioana; Gallagher, Lewis; Miranda, Susana; Porta, Nuria; Hall, Emma; Tunariu, Nina; Sharp, Adam; Lord, Christopher; Carreira, Suzanne; De Bono, Johann
Publisher Information: CELL PRESS
Publication Year: 2024
Collection: The Institute of Cancer Research (ICR): Publications Repository
Subject Terms: DNA repair; PARP inhibition; cfDNA; genomics; prostate cancer; reversion
Subject Geographic: United States
Description: PARP inhibition (PARPi) has anti-tumor activity against castration-resistant prostate cancer (CRPC) with homologous recombination repair (HRR) defects. However, mechanisms underlying PARPi resistance are not fully understood. While acquired mutations restoring BRCA genes are well documented, their clinical relevance, frequency, and mechanism of generation remain unclear. Moreover, how resistance emerges in BRCA2 homozygously deleted (HomDel) CRPC is unknown. Evaluating samples from patients with metastatic CRPC treated in the TOPARP-B trial, we identify reversion mutations in most BRCA2/PALB2-mutated tumors (79%) by end of treatment. Among reversions mediated by frameshift deletions, 60% are flanked by DNA microhomologies, implicating POLQ-mediated repair. The number of reversions and time of their detection associate with radiological progression-free survival and overall survival (p < 0.01). For BRCA2 HomDels, selection for rare subclones without BRCA2-HomDel is observed following PARPi, confirmed by single circulating-tumor-cell genomics, biopsy fluorescence in situ hybridization (FISH), and RNAish. These data support the need for restored HRR function in PARPi resistance.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 1878-3686; 1535-6108
Relation: S1535-6108(24)00403-3; Cancer Cell, 2024; https://repository.icr.ac.uk/handle/internal/6490
DOI: 10.1016/j.ccell.2024.10.015
Availability: https://doi.org/10.1016/j.ccell.2024.10.015; https://repository.icr.ac.uk/handle/internal/6490
Rights: http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.BBB86BCB
Database: BASE