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Ruxolitinib-induced defects in DNA repair cause sensitivity to PARP inhibitors in myeloproliferative neoplasms

  • Margaret Nieborowska-Skorska
  • , Silvia Maifrede
  • , Yashodhara Dasgupta
  • , Katherine Sullivan
  • , Sylwia Flis
  • , Bac Viet Le
  • , Martyna Solecka
  • , Elizaveta A. Belyaeva
  • , Lucia Kubovcakova
  • , Morgan Nawrocki
  • , Martin Kirschner
  • , Huaqing Zhao
  • , Josef T. Prchal
  • , Katarzyna Piwocka
  • , Alison R. Moliterno
  • , Mariusz Wasik
  • , Steffen Koschmieder
  • , Tony R. Green
  • , Radek C. Skoda
  • , Tomasz Skorski

Research output: Contribution to journalArticlepeer-review

Abstract

Myeloproliferative neoplasms (MPNs) often carry JAK2(V617F), MPL(W515L), or CALR (del52) mutations. Current treatment options for MPNs include cytoreduction by hydroxyurea and JAK1/2 inhibition by ruxolitinib, both of which are not curative. We show here that cell lines expressing JAK2(V617F), MPL(W515L), or CALR(del52) accumulated reactive oxygen species-induced DNA double-strand breaks (DSBs) and were modestly sensitive to poly-ADP-ribose polymerase (PARP) inhibitors olaparib and BMN673. At the same time, primaryMPNcell samples from individual patients displayed a high degree of variability in sensitivity to these drugs. Ruxolitinib inhibited 2 major DSB repair mechanisms, BRCA-mediated homologous recombination and DNA-dependent protein kinase-mediated nonhomologous end-joining, and, when combined with olaparib, caused abundant accumulation of toxic DSBs resulting in enhanced elimination of MPN primary cells, including the disease-initiating cells from the majority of patients. Moreover, the combination of BMN673, ruxolitinib, and hydroxyurea was highly effective in vivo against JAK2(V617F)+ murine MPNlike disease and also against JAK2(V617F)+, CALR(del52)+, and MPL(W515L)+ primary MPN xenografts. In conclusion, we postulate that ruxolitinib-induced deficiencies in DSB repair pathways sensitized MPN cells to synthetic lethality triggered by PARP inhibitors.

Original languageEnglish (US)
Pages (from-to)2848-2859
Number of pages12
JournalBlood
Volume130
Issue number26
DOIs
StatePublished - Dec 28 2017

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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