Abstract
Abstract Mutations in isocitrate dehydrogenase (IDH) identified across cancer types lead to global changes to the epigenome that drive tumorigenesis. Yet, effectiveness of targeted therapies against mutant IDH remains unclear. Here we demonstrate that IDH-mutant glioma and cholangiocarcinoma patient specimens display elevated overall DNA damage responses. With tissue culture and multiple preclinical animal models of glioma and cholangiocarcinoma, we report that the reduced efficiency of DNA damage repair conferred by mutant IDH can be exploited by PARP inhibitors. Moreover, pharmacological effects of PARP inhibitors are dramatically enhanced by introducing concurrent, local ionizing radiation treatment to the animals. Thus, our study characterized the synergy of PARPi and radiation specifically towards IDH-mutant tumors, pointing out that in addition to ongoing trials using PARPi as mono agent, clinical trials that combine PARPi and radiation should be specifically considered. Furthermore, PARPi + RT may represent a readily translatable approach that is selective for tumor cells, transcends histologic origin, and has potential to improve outcomes in multiple diseases.
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