Secondary Somatic Mutations Restoring RAD51C and RAD51D Associated with Acquired Resistance to the PARP Inhibitor Rucaparib in High-Grade Ovarian Carcinoma
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Accepted version
Author(s)
Type
Journal Article
Abstract
High-grade epithelial ovarian carcinomas containing mutated BRCA1 or BRCA2 (BRCA1/2) homologous recombination (HR) genes are sensitive to platinum-based chemotherapy and PARP inhibitors (PARPi), while restoration of HR function due to secondary mutations in BRCA1/2 has been recognized as an important resistance mechanism. We sequenced core HR pathway genes in 12 pairs of pretreatment and postprogression tumor biopsy samples collected from patients in ARIEL2 Part 1, a phase II study of the PARPi rucaparib as treatment for platinum-sensitive, relapsed ovarian carcinoma. In 6 of 12 pretreatment biopsies, a truncation mutation in BRCA1, RAD51C, or RAD51D was identified. In five of six paired postprogression biopsies, one or more secondary mutations restored the open reading frame. Four distinct secondary mutations and spatial heterogeneity were observed for RAD51C. In vitro complementation assays and a patient-derived xenograft, as well as predictive molecular modeling, confirmed that resistance to rucaparib was associated with secondary mutations.
Date Issued
2017-06-06
Date Acceptance
2017-06-02
Citation
Cancer Discovery, 2017, 7 (9), pp.984-998
ISSN
2159-8290
Publisher
American Association for Cancer Research
Start Page
984
End Page
998
Journal / Book Title
Cancer Discovery
Volume
7
Issue
9
Copyright Statement
©2017 American Association for Cancer Research.
Subjects
Science & Technology
Life Sciences & Biomedicine
Oncology
HOMOLOGOUS RECOMBINATION REPAIR
GERMLINE MUTATIONS
POLYMERASE INHIBITORS
MAINTENANCE THERAPY
MOLECULAR-DYNAMICS
PLATINUM RESPONSE
FALLOPIAN-TUBE
PHASE-2 TRIAL
DNA-DAMAGE
CANCER
Publication Status
Published