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2017 ; 109
(11
): ä Nephropedia Template TP
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Drugging the Cancers Addicted to DNA Repair
#MMPMID28521333
Nickoloff JA
; Jones D
; Lee SH
; Williamson EA
; Hromas R
J Natl Cancer Inst
2017[Nov]; 109
(11
): ä PMID28521333
show ga
Defects in DNA repair can result in oncogenic genomic instability. Cancers
occurring from DNA repair defects were once thought to be limited to rare
inherited mutations (such as BRCA1 or 2). It now appears that a clinically
significant fraction of cancers have acquired DNA repair defects. DNA repair
pathways operate in related networks, and cancers arising from loss of one DNA
repair component typically become addicted to other repair pathways to survive
and proliferate. Drug inhibition of the rescue repair pathway prevents the
repair-deficient cancer cell from replicating, causing apoptosis (termed
synthetic lethality). However, the selective pressure of inhibiting the rescue
repair pathway can generate further mutations that confer resistance to the
synthetic lethal drugs. Many such drugs currently in clinical use inhibit PARP1,
a repair component to which cancers arising from inherited BRCA1 or 2 mutations
become addicted. It is now clear that drugs inducing synthetic lethality may also
be therapeutic in cancers with acquired DNA repair defects, which would markedly
broaden their applicability beyond treatment of cancers with inherited DNA repair
defects. Here we review how each DNA repair pathway can be attacked
therapeutically and evaluate DNA repair components as potential drug targets to
induce synthetic lethality. Clinical use of drugs targeting DNA repair will
markedly increase when functional and genetic loss of repair components are
consistently identified. In addition, future therapies will exploit artificial
synthetic lethality, where complementary DNA repair pathways are targeted
simultaneously in cancers without DNA repair defects.
|Antineoplastic Agents/*therapeutic use
[MESH]
|DNA End-Joining Repair/drug effects
[MESH]
|DNA Mismatch Repair/drug effects
[MESH]
|DNA Repair/*drug effects
[MESH]
|Genes, BRCA1
[MESH]
|Genes, BRCA2
[MESH]
|Homologous Recombination/drug effects
[MESH]
|Humans
[MESH]
|Molecular Targeted Therapy
[MESH]
|Neoplasms/*genetics
[MESH]
|Poly(ADP-ribose) Polymerase Inhibitors/*therapeutic use
[MESH]