Abstract

The DNA damage response (DDR) fulfils essential roles to preserve genome integrity. Targeting the DDR in tumors has had remarkable success over the last decade, exemplified by the licensing of PARP inhibitors for cancer therapy. Recent studies suggest that the application of DDR inhibitors impacts on cellular innate and adaptive immune responses, wherein key DNA repair factors have roles in limiting chronic inflammatory signaling. Antitumor immunity plays an emerging part in cancer therapy, and extensive efforts have led to the development of immune checkpoint inhibitors overcoming immune suppressive signals in tumors. Here, we review the current understanding of the molecular mechanisms underlying DNA damage-triggered immune responses, including cytosolic DNA sensing via the cGAS/STING pathway. We highlight the implications of DDR components for therapeutic outcomes of immune checkpoint inhibitors or their use as biomarkers. Finally, we discuss the rationale for novel combinations of DDR inhibitors with antagonists of immune checkpoints and current hindrances limiting their broader therapeutic applications.

Highlights

  • The genome of every cell is constantly exposed to endogenously-arising and exogenous sources of DNA damage

  • Interfaces between DNA damage response (DDR) and cancer immunotherapy tion is dispensable for cellular survival in homologous recombination (HR)-proficient cells, it becomes extremely toxic in the context of BRCA1/2 deficiency, highlighting the key role of HR in repairing poly-(ADP-ribose) polymerase (PARP) inhibitor-induced damage (Lord and Ashworth 2016)

  • Defects in DNA repair pathways such as HR as well as DNA replication stress and concomitant aberrant processing of DNA replication forks can trigger cytosolic DNA sensing via cGAS/STING, leading to robust interferon responses

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Summary

Interfaces between cellular responses to DNA damage and cancer immunotherapy

The DNA damage response (DDR) fulfils essential roles to preserve genome integrity. Targeting the DDR in tumors has had remarkable success over the last decade, exemplified by the licensing of PARP inhibitors for cancer therapy. Recent studies suggest that the application of DDR inhibitors impacts on cellular innate and adaptive immune responses, wherein key DNA repair factors have roles in limiting chronic inflammatory signaling. Antitumor immunity plays an emerging part in cancer therapy, and extensive efforts have led to the development of immune checkpoint inhibitors overcoming immune suppressive signals in tumors. We highlight the implications of DDR components for therapeutic outcomes of immune checkpoint inhibitors or their use as biomarkers. We discuss the rationale for novel combinations of DDR inhibitors with antagonists of immune checkpoints and current hindrances limiting their broader therapeutic applications

Targeting DNA damage response factors for cancer therapy
FDA approved FDA approved
Sensing damaged DNA by components of the innate immune system
Impacting cellular immune responses through DDR inhibitors
Consequences of DDR defects for immune responses
Mismatch repair deficiency and adaptive immunity
Combined targeting of DDR and immune checkpoints in cancer therapy
Synergy of PARP inhibitors with immune checkpoint inhibition
Clinical trial Phase
Ovarian cancer
Potentiating immune checkpoint inhibitor efficacy via DDR inhibitors
Concluding remarks
Competing interest statement
Creative Commons
Full Text
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