Abstract 1389: Exploiting inherent DNA damage repair defects in IDH1/2 mutated gliomas with the CNS penetrant PARP inhibitor, pamiparib

Abstract

Abstract Our group recently demonstrated that IDH1/2 mutated gliomas exhibit intrinsic homologous recombination (HR) defects mediated by the oncometabolite, 2HG. These defects render IDH1/2 mutated cells exquisitely sensitive to PARP inhibitors (PARPi's), which suggests a novel therapeutic strategy. Here, we studied the potential in vitro and in vivo efficacy of a CNS penetrant PARPi, pamiparib, in combination with radiation therapy (RT) and temozolomide (TMZ) against IDH1/2 mutated gliomas. Our central hypothesis is that multi-modality therapy using agents that are active against 2HG producing cells will increase efficacy, while allowing lower doses of RT and TMZ as a means to mitigate normal tissue toxicity. We performed a comprehensive series of DNA repair functional studies, short and long term viability assays, as well as in vivo studies, using engineered and patient-derived IDH1/2 mutant glioma models. We tested unique combinations of pamiparib, TMZ and RT in these experiments. In vitro short term viability assays and long-term clonogenic survival assays in model IDH1 wild-type (WT) and R132H mutated glioma cells demonstrated that the mutation confers enhanced TMZ sensitivity (IC50 602 vs. 9.5 uM, respectively). A similar differential sensitivity was observed with RT. We also demonstrated significant, mutant IDH1 selective pamiparib sensitivity in vitro (IC50 0.67 vs. 141 uM). Western blot analysis of PARylation, a functional readout of PARPi activity, confirmed PARylation inhibition by pamiparib in a dose dependent manner. Subsequently, we demonstrated synergistic interactions between TMZ and RT combined with pamiparib, particularly at low doses of both DNA damaging agents, in an IDH1 selective manner. Finally, we demonstrated the activity of PARPi's against IDH1 mutant tumors in vivo, including pharmacodynamic and pharmacokinetic properties of pamiparib on target activity within the brain. Pamiparib is a promising, CNS penetrant PARP inhibitor that may selectively target IDH1/2 mutated gliomas, based on intrinsic HR defects associated with these tumors. Pamiparib appears to act synergistically with TMZ and RT, which are the backbone of GBM therapies. These data lay the groundwork for a future trial testing “trimodality therapy” (i.e., pamiparib, RT and TMZ) against IDH1/2 mutant gliomas. Citation Format: Christopher Hong, Amrita Sule, Jason Beckta, Ranjini Sundaram, Ranjit Bindra. Exploiting inherent DNA damage repair defects in IDH1/2 mutated gliomas with the CNS penetrant PARP inhibitor, pamiparib [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1389.