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A novel more effective genotoxic therapy for ovarian cancer

一种新的更有效的卵巢癌基因毒性疗法

基本信息

批准号：
10440098
负责人：
FIONA SIMPKINS
金额：
$ 39.81万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-03-01 至 2025-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10440098
关键词：
ATR gene Address Behavior Bioinformatics CCNE1 gene CRISPR/Cas technology Cancer Patient Candidate Disease Gene Cell Cycle Checkpoint Cessation of life Characteristics Chemoresistance Clinic Clinical Clinical Trials Clustered Regularly Interspaced Short Palindromic Repeats Combined Modality Therapy DNA Double Strand Break DNA replication fork DNA sequencing Data Defect Dependence Double Strand Break Repair Drug resistance Frequencies Future Genes Genetic Genome Stability Genomics Human In Vitro Lead Malignant Female Reproductive System Neoplasm Malignant Neoplasms Malignant neoplasm of ovary Modeling Monitor Mus Mutation Patients Phosphotransferases Platinum Poly(ADP-ribose) Polymerase Inhibitor Poly(ADP-ribose) Polymerases Positioning Attribute Primary Neoplasm Proteins Proteomics Recurrence Relapse Reporting Resistance Role Sampling Serous TP53 gene Testing Therapeutic Tumor Promotion Tumor Suppression Validation biomarker identification brca gene cancer cell cancer genetics cancer therapy combinatorial effectiveness testing efficacy evaluation efficacy testing experimental study genotoxicity homologous recombination improved inhibitor innovation insight knock-down novel novel therapeutics overexpression patient derived xenograft model patient population patient stratification pre-clinical preclinical trial predictive marker prevent relapse prevention resistance mechanism response response biomarker synergism targeted treatment transcriptome transcriptome sequencing transgene expression treatment optimization treatment strategy tumor

项目摘要

PROJECT SUMMARY High-grade serous ovarian cancer (HGSOC) is the most lethal gynecological malignancy. More than 80% of HGSOC patients recur after frontline standard therapy, and complete and durable responses are rare. Therapies that improve compete tumor regression and prevent relapse are needed. Our GOALS are to i) identify which ovarian cancer genetic subsets will benefit from a new more effective genetically targeted therapy using primary tumor cultures, patient-derived xenograft models and human tumor samples from our clinical trial, ii) identify mechanisms of acquired resistance with genetic validation. We have identified a novel and highly active genotoxic therapy by co-inhibiting poly-ADP ribose polymerase (PARP) and ATR checkpoint kinase. Combination PARP inhibition with ATR inhibition (PARPi-ATRi) synergizes to specifically target and kill HGSOCs harboring common HGSOC-associated alterations, e.g. homologous recombination (HR) deficiency and Cyclin E overexpression. Our preliminary studies show that PARPi-ATRi in combination is especially effective in killing HGSOC cells with these alterations and causes regression of HR- deficient and Cyclin E overexpressing HGSOC patient-derived xenografts (PDXs). These results have stimulated a clinical trial of PARPi-ATRi combination in recurrent HGSOC (unselected patient population) to be led by the PI of this proposal. This will be the first trial evaluating PAPRi-ATRi combination in ovarian cancer. Here, we propose to validate in vitro findings and expand the use of our PDX model, a reliable HGSOC surrogate, to test the effectiveness of this novel PARPi-ATRi combination in killing HGSOCs that either overexpress Cyclin E-or have acquired PARPi-resistance, which together cause most deaths from HGSOC. Our clinical trial of PARPi-ATRi for treatment of recurrent HGSOC will be performed in parallel with the expanded preclinical mouse studies. This will allow us to correlate predictive biomarkers (HR-deficiency and Cyclin E overexpression) of response and potential resistance mechanisms (e.g., BRCA reversion mutations). This PARPi-ATRi combination therapy is promising; however, this treatment causes tumor regression initially in chemo-resistant Cyclin E-overexpressing tumors but acquired resistance ultimately develops. Using genomic and proteomics, we will integrate alterations discovered in the PAPRi-ATRi-resistant and sensitive PDXs with patient samples from the clinical trial to develop a candidate pool list. Candidate genes associated with resistance will be refined by prioritizing alterations found at both the gene and protein level and that are druggable. The top candidates will be validated in vitro using a targeted CRISPR knock-down approach. Defining markers of response and resistance will help stratify patient populations, optimize treatment strategies and identify new targets for future therapeutics based on HGSOC cancer genetics.

项目总结