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ALK signaling primes the DNA damage response sensitizing ALK-driven neuroblastoma to therapeutic ATR inhibition

Borenäs, Marcus ; Umapathy, Ganesh ; Lind, Dan E ; Lai, Wei-Yun ; Guan, Jikui ; Johansson, Joel ; Jennische, Eva ; Schmidt, Alexander ; Kurhe, Yeshwant and Gabre, Jonatan L , et al. (2024) In Proceedings of the National Academy of Sciences of the United States of America 121(1).
Abstract

High-risk neuroblastoma (NB) is a significant clinical challenge. MYCN and Anaplastic Lymphoma Kinase (ALK), which are often involved in high-risk NB, lead to increased replication stress in cancer cells, suggesting therapeutic strategies. We previously identified an ATR (ataxia telangiectasia and Rad3-related)/ALK inhibitor (ATRi/ALKi) combination as such a strategy in two independent genetically modified mouse NB models. Here, we identify an underlying molecular mechanism, in which ALK signaling leads to phosphorylation of ATR and CHK1, supporting an effective DNA damage response. The importance of ALK inhibition is supported by mouse data, in which ATRi monotreatment resulted in a robust initial response, but subsequent relapse, in... (More)

High-risk neuroblastoma (NB) is a significant clinical challenge. MYCN and Anaplastic Lymphoma Kinase (ALK), which are often involved in high-risk NB, lead to increased replication stress in cancer cells, suggesting therapeutic strategies. We previously identified an ATR (ataxia telangiectasia and Rad3-related)/ALK inhibitor (ATRi/ALKi) combination as such a strategy in two independent genetically modified mouse NB models. Here, we identify an underlying molecular mechanism, in which ALK signaling leads to phosphorylation of ATR and CHK1, supporting an effective DNA damage response. The importance of ALK inhibition is supported by mouse data, in which ATRi monotreatment resulted in a robust initial response, but subsequent relapse, in contrast to a 14-d ALKi/ATRi combination treatment that resulted in a robust and sustained response. Finally, we show that the remarkable response to the 14-d combined ATR/ALK inhibition protocol reflects a robust differentiation response, reprogramming tumor cells to a neuronal/Schwann cell lineage identity. Our results identify an ability of ATR inhibition to promote NB differentiation and underscore the importance of further exploring combined ALK/ATR inhibition in NB, particularly in high-risk patient groups with oncogene-induced replication stress.

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publishing date
type
Contribution to journal
publication status
published
subject
in
Proceedings of the National Academy of Sciences of the United States of America
volume
121
issue
1
article number
e2315242121
publisher
National Academy of Sciences
external identifiers
  • scopus:85181376785
  • pmid:38154064
ISSN
1091-6490
DOI
10.1073/pnas.2315242121
language
English
LU publication?
no
id
58961fbf-6ac0-4497-a58b-484b7cd06f0f
date added to LUP
2023-12-29 12:25:42
date last changed
2024-04-20 06:31:13
@article{58961fbf-6ac0-4497-a58b-484b7cd06f0f,
  abstract     = {{<p>High-risk neuroblastoma (NB) is a significant clinical challenge. MYCN and Anaplastic Lymphoma Kinase (ALK), which are often involved in high-risk NB, lead to increased replication stress in cancer cells, suggesting therapeutic strategies. We previously identified an ATR (ataxia telangiectasia and Rad3-related)/ALK inhibitor (ATRi/ALKi) combination as such a strategy in two independent genetically modified mouse NB models. Here, we identify an underlying molecular mechanism, in which ALK signaling leads to phosphorylation of ATR and CHK1, supporting an effective DNA damage response. The importance of ALK inhibition is supported by mouse data, in which ATRi monotreatment resulted in a robust initial response, but subsequent relapse, in contrast to a 14-d ALKi/ATRi combination treatment that resulted in a robust and sustained response. Finally, we show that the remarkable response to the 14-d combined ATR/ALK inhibition protocol reflects a robust differentiation response, reprogramming tumor cells to a neuronal/Schwann cell lineage identity. Our results identify an ability of ATR inhibition to promote NB differentiation and underscore the importance of further exploring combined ALK/ATR inhibition in NB, particularly in high-risk patient groups with oncogene-induced replication stress.</p>}},
  author       = {{Borenäs, Marcus and Umapathy, Ganesh and Lind, Dan E and Lai, Wei-Yun and Guan, Jikui and Johansson, Joel and Jennische, Eva and Schmidt, Alexander and Kurhe, Yeshwant and Gabre, Jonatan L and Aniszewska, Agata and Strömberg, Anneli and Bemark, Mats and Hall, Michael N and Eynden, Jimmy Van den and Hallberg, Bengt and Palmer, Ruth H}},
  issn         = {{1091-6490}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{1}},
  publisher    = {{National Academy of Sciences}},
  series       = {{Proceedings of the National Academy of Sciences of the United States of America}},
  title        = {{ALK signaling primes the DNA damage response sensitizing ALK-driven neuroblastoma to therapeutic ATR inhibition}},
  url          = {{http://dx.doi.org/10.1073/pnas.2315242121}},
  doi          = {{10.1073/pnas.2315242121}},
  volume       = {{121}},
  year         = {{2024}},
}