CNSC-06. TEMOZOLOMIDE-INDUCED GUANINE MUTATIONS CREATE EXPLOITABLE VULNERABILITIES OF GUANINE-RICH DNA AND RNA REGIONS IN DRUG-RESISTANT GLIOMAS

Abstract

Abstract Temozolomide (TMZ) is a chemotherapeutic agent that has been the first-line standard of care for the aggressive braincancer glioblastoma (GBM) since 2005. Although initially beneficial, TMZ resistance is universal and second-lineinterventions are an unmet clinical need. Here, we took advantage of the known mechanism of action of TMZ to targetguanines (G) and investigated G-rich G-quadruplex (G4) and splice site changes that occur upon TMZ resistance. We reportthat TMZ-resistant GBM has guanine mutations that disrupt the G-rich DNA G4s and splice sites that lead to deregulatedalternative splicing. These alterations create vulnerabilities, which are selectively targeted by either the G4-stabilizingdrug TMPyP4 or a novel splicing kinase inhibitor of cdc2-like kinase. Lastly, we show that the G4 and RNA binding proteinEWSR1, member of the FUS, EWSR1, and TAF15 family, aggregates in the cytoplasm in TMZ-resistant GBM cells and patient samples. Together, our findings provide insight into targetable vulnerabilities of TMZ-resistant GBM and present cytoplasmic EWSR1 as a putative biomarker.