Medical Biology - Research Publications

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Start date: 2020 × End date: 2021 × Author: Chan, Keefe × Author: Hannan, Ross × Type: Journal Article ×

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    CX-5461 activates the DNA damage response and demonstrates therapeutic efficacy in high-grade serous ovarian cancer
    Sanij, E ; Hannan, KM ; Xuan, J ; Yan, S ; Ahern, JE ; Trigos, AS ; Brajanovski, N ; Son, J ; Chan, KT ; Kondrashova, O ; Lieschke, E ; Wakefield, MJ ; Frank, D ; Ellis, S ; Cullinane, C ; Kang, J ; Poortinga, G ; Nag, P ; Deans, AJ ; Khanna, KK ; Mileshkin, L ; McArthur, GA ; Soong, J ; Berns, EMJJ ; Hannan, RD ; Scott, CL ; Sheppard, KE ; Pearson, RB (NATURE PUBLISHING GROUP, 2020-05-26)
    Acquired resistance to PARP inhibitors (PARPi) is a major challenge for the clinical management of high grade serous ovarian cancer (HGSOC). Here, we demonstrate CX-5461, the first-in-class inhibitor of RNA polymerase I transcription of ribosomal RNA genes (rDNA), induces replication stress and activates the DNA damage response. CX-5461 co-operates with PARPi in exacerbating replication stress and enhances therapeutic efficacy against homologous recombination (HR) DNA repair-deficient HGSOC-patient-derived xenograft (PDX) in vivo. We demonstrate CX-5461 has a different sensitivity spectrum to PARPi involving MRE11-dependent degradation of replication forks. Importantly, CX-5461 exhibits in vivo single agent efficacy in a HGSOC-PDX with reduced sensitivity to PARPi by overcoming replication fork protection. Further, we identify CX-5461-sensitivity gene expression signatures in primary and relapsed HGSOC. We propose CX-5461 is a promising therapy in combination with PARPi in HR-deficient HGSOC and also as a single agent for the treatment of relapsed disease.