期刊
NATURE CANCER
卷 3, 期 10, 页码 1211-+出版社
NATURE PORTFOLIO
DOI: 10.1038/s43018-022-00438-2
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资金
- National Institutes of Health [CA211615, CA217685]
- Breast Cancer Research Foundation [BCRF-17-069]
- MD Anderson-China Medical University Sister Institution Fund
- American Cancer Society
- Frank McGraw Memorial Chair in Cancer Research
- MD Anderson SPORE in Ovarian Cancer
- MD Anderson Moonshot for Ovarian Cancer
- MD Anderson Moonshot for Breast Cancer
- Ministry of Education in Taiwan
- China Medical University Hospital
- Ministry of Science and Technology in Taiwan [CMUH DMR-108-BC-6, 108-2314-B-039-018, NSTC 111-2639-B-039-001-ASP]
- University of Texas MD Anderson Cancer Center
- Conquer Cancer Development Award
- New Partnership Program for the Connection to the Top Labs in the World (Dragon Gate Program) [107-2911-I-006-519]
This study reveals that anaplastic lymphoma kinase (ALK) phosphorylates CDK9 at tyrosine-19, leading to homologous recombination repair and resistance to PARP inhibitors. Combining ALK and PARP inhibitors shows promising results in reducing tumor growth and improving survival. The expression of phosphorylated ALK is associated with resistance to PARP inhibitors.
Poly(ADP-ribose) polymerase (PARP) inhibitors have demonstrated promising clinical activity in multiple cancers. However, resistance to PARP inhibitors remains a substantial clinical challenge. In the present study, we report that anaplastic lymphoma kinase (ALK) directly phosphorylates CDK9 at tyrosine-19 to promote homologous recombination (HR) repair and PARP inhibitor resistance. Phospho-CDK9-Tyr19 increases its kinase activity and nuclear localization to stabilize positive transcriptional elongation factor b and activate polymerase II-dependent transcription of HR-repair genes. Conversely, ALK inhibition increases ubiquitination and degradation of CDK9 by Skp2, an E3 ligase. Notably, combination of US Food and Drug Administration-approved ALK and PARP inhibitors markedly reduce tumor growth and improve survival of mice in PARP inhibitor-/platinum-resistant tumor xenograft models. Using human tumor biospecimens, we further demonstrate that phosphorylated ALK (p-ALK) expression is associated with resistance to PARP inhibitors and positively correlated with p-Tyr19-CDK9 expression. Together, our findings support a biomarker-driven, combinatorial treatment strategy involving ALK and PARP inhibitors to induce synthetic lethality in PARP inhibitor-/platinum-resistant tumors with high p-ALK-p-Tyr19-CDK9 expression. Hung and colleagues show that ALK-mediated CDK9 activation increases homologous recombination repair and PARP inhibition resistance and propose combinatorial inhibition of ALK and PARP as therapeutically beneficial for treatment-resistant tumors.
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