Journal
CLINICAL CANCER RESEARCH
Volume 25, Issue 22, Pages 6788-6800Publisher
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1078-0432.CCR-19-0126
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Funding
- Societe Francaise de Lutte contre lesCancers et les leucemies de l'Enfant et de l'Adolescent, Federations Enfants Et Sante, INCa [PLBIO-14-253]
- Course of Excellence in Oncology -Fondation Philanthropia, C.C.S.
- National Council for Scientific and Technological Development (CNPq) Program Science without borders in Brazil
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Purpose: Diffuse intrinsic pontine gliomas (DIPG) are the most severe pediatric brain tumors. Although accepted as the standard therapeutic, radiotherapy is only efficient transiently and not even in every patient. The goal of the study was to identify the underlying molecular determinants of response to radiotherapy in DIPG. Experimental Design: We assessed in vitro response to ionizing radiations in 13 different DIPG cellular models derived from treatment-naive stereotactic biopsies reflecting the genotype variability encountered in patients at diagnosis and correlated it to their principal molecular alterations. Clinical and radiologic response to radiotherapy of a large cohort of 73 DIPG was analyzed according to their genotype. Using a kinome-wide synthetic lethality RNAi screen, we further identified target genes that can sensitize DIPG cells to ionizing radiations. Results: We uncover TP53 mutation as the main driver of increased radioresistance and validated this finding in four isogenic pairs of TP53(WT) DIPG cells with or without TP53 knockdown. In an integrated clinical, radiological, and molecular study, we show that TP53(MUT) DIPG patients respond less to irradiation, relapse earlier after radiotherapy, and have a worse prognosis than their TP53(WT) counterparts. Finally, a kinome-wide synthetic lethality RNAi screen identifies CHK1 as a potential target, whose inhibition increases response to radiation specifically in TP53(MUT) cells. Conclusions: Here, we demonstrate that TP53 mutations are driving DIPG radioresistance both in patients and corresponding cellular models. We suggest alternative treatment strategies to mitigate radioresistance with CHK1 inhibitors. These findings will allow to consequently refine radiotherapy schedules in DIPG.
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