AURKA blockage as a strategy to overcome resistance to olaparib and platinum in high-grade ovarian cancer (HGOC).

Abstract

e15198 Background: PARP inhibitors (PARPi) as olaparib (OLA) have become the new standard in maintenance treatment in high grade ovarian carcinoma (HGOC). Thus, there is an important need to identify the mechanisms for PARPi resistance and the strategies to overcome them. Our aim is to assess if in vitro inhibition of AURKA, a protein that plays a relevant role in centrosome spindle formation and mitotic regulation, might overcome olaparib resistance mechanisms in HGOC. Methods: Three HGOC cell lines (PEO1, Kuramochi and SKOV3) were selected, and isogenic resistant pairs generated in vitro, by pulsed exposure to OLA (PEO1-R) or by exposure to growing concentrations of OLA (Kuramochi-R and SKOV-R). AURKA expression was assessed by PCR and Western blot (WB). Cells were OLA-treated before and after the downregulation of AURKA expression by a specific small inhibitor RNA (siRNA) and by pharmacologic inhibition with alisertib. Cell viability was assessed by MTT assay and DNA damage by the evaluation of markers by WB. Combination index of the combo OLA+alisertib was assessed by Chou-Talalay method. Results: AURKA expression was lower at gene and protein levels in resistant cell lines compared to parental. Upon AURKA silencing (Si) of parental (OLA-sensitive) cell lines, no differences in the OLA IC50 values between AURKA-Si and control cells were seen. However AURKA-Si of the OLA-resistant cell lines was associated with a decreased in OLA IC50 as follows: 1) In PEO1R control scramble siRNA (sc) was 226 mM vs SI 128 mM, p < 0.0001; 2) In Kuramochi-R scRNA 268.4 mM vs si 130.2 mM p < 0.0001 and 3) in SKOV3-R scRNA 187 mM vs si 74.7 mM, p < 0.0001 suggesting a role of AURKA-si in overcoming OLA-resistance. Pharmacologic AURKA targeting with the inhibitor alisertib in all 3 sensitive and resistant cell lines showed an increase of DNA damage measured by the expression of H2AX protein by WB. Combination index of the OLA+alisertib in all resistant cell lines showed a synergistic effect of the combination with PEO1-R FA50 = 0.25 (FA25-75 0.2-0.31), Kuramochi-R FA50 = 0.29 (0.19-9.36) and SKOV3-R FA50 = 0.24 (0.19-0.36). Conclusions: AURKA targeting either by silencing or pharmacologic inhibition increased OLA-induced apoptosis or had a synergistic effect in OLA-resistant cell lines suggesting AURKA as a potential target for overcoming OLA resistance.