Abstract
While gemcitabine has been the mainstay therapy for advanced pancreatic cancer, newer combination regimens (e.g. FOLFIRINOX) have extended patient survival, though carry greater toxicity. Biomarkers are needed to better stratify patients for appropriate therapy. Previously, we reported that one-third of pancreatic cancers harbor deletions or deleterious mutations in key subunits of the SWItch/Sucrose NonFermentable (SWI/SNF) chromatin remodeling complex. The SWI/SNF complex mobilizes nucleosomes on DNA, and plays a key role in modulating DNA transcription and repair. Thus, we hypothesized that pancreatic cancers with SWI/SNF aberrations might exhibit compromised DNA repair, and show increased sensitivity to DNA damaging agents. Here, we studied human pancreatic cancer cell lines with deficient (or else exogenously reconstituted) SWI/SNF subunits, as well as normal pancreatic epithelial cells following SWI/SNF subunit knockdown. Cells were challenged with DNA damaging agents, including those used in current combination regimens, and then cell viability assayed. We found that pancreatic cells with SWI/SNF dysfunction showed markedly increased sensitivity to DNA damaging agents, and in particular DNA crosslinking agents (cisplatin and oxaliplatin). Assaying clearance of γH2AX confirmed that SWI/SNF dysfunction impaired DNA damage response/repair. Finally, by analyzing pancreatic cancer patient data from The Cancer Genome Atlas, we found that pancreatic cancers with SWI/SNF deficiency (subunit mutation and/or decreased expression) were associated with extended patient survival specifically when treated with platinum containing regimens. Thus, SWI/SNF dysfunction sensitizes pancreatic cancer cells to DNA crosslinking agents, and SWI/SNF mutation status may provide a useful biomarker to predict which patients are likely to benefit from platinum-containing chemotherapy regimens.
Highlights
Pancreatic ductal adenocarcinoma carries among the worst prognoses of all human cancers, with a 5-year survival rate of about 8% [1]
We found that pancreatic cells with SWI/SWItch/Sucrose NonFermentable (SNF) dysfunction showed markedly increased sensitivity to DNA damaging agents, and in particular DNA crosslinking agents
We found that SWItch/Sucrose NonFermentable (SWI/SNF) dysfunction by engineered subunit depletion in normal human pancreatic epithelial cells, or by somatic mutation in human pancreatic cancer cells, sensitizes those cells to DNA damaging agents, and in particular the DNA crosslinking agents cisplatin and oxaliplatin
Summary
Pancreatic ductal adenocarcinoma (hereafter, pancreatic cancer) carries among the worst prognoses of all human cancers, with a 5-year survival rate of about 8% [1]. Platinumcontaining combination chemotherapiesmost notably FOLFIRINOX (folinic acid, fluorouracil, irinotecan, and oxaliplatin) ̶ have been found to be superior to gemcitabine [4]. Such regimens are more toxic and associated with more side effects, and not tolerated by many patients, those older, www.impactjournals.com/oncotarget sicker or with comorbidities. It is unknown whether some patients’ tumors might respond better to combination chemotherapy regimens, and worth the tradeoff of higher toxicity. There are currently no tumor biomarkers to predict therapy response
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