Abstract

Diffuse intrinsic pontine glioma (DIPG) is an invariably fatal brain tumor occurring predominantly in children. Up to 90% of pediatric DIPGs harbor a somatic heterozygous mutation resulting in the replacement of lysine 27 with methionine (K27M) in genes encoding histone H3.3 (H3F3A, 65%) or H3.1 (HIST1H3B, 25%). Several studies have also identified recurrent truncating mutations in the gene encoding protein phosphatase 1D, PPM1D, in 9%-23% of DIPGs. Here, we sought to investigate the therapeutic potential of targeting PPM1D, alone or in combination with inhibitors targeting specific components of DNA damage response pathways in patient-derived DIPG cell lines. We found that GSK2830371, an allosteric PPM1D inhibitor, suppressed the proliferation of PPM1D-mutant, but not PPM1D wild-type DIPG cells. We further observed that PPM1D inhibition sensitized PPM1D-mutant DIPG cells to PARP inhibitor (PARPi) treatment. Mechanistically, combined PPM1D and PARP inhibition show synergistic effects on suppressing a p53-dependent RAD51 expression and the formation of RAD51 nuclear foci, possibly leading to impaired homologous recombination (HR)-mediated DNA repair in PPM1D-mutant DIPG cells. Collectively, our findings reveal the potential role of the PPM1D-p53 signaling axis in the regulation of HR-mediated DNA repair and provide preclinical evidence demonstrating that combined inhibition of PPM1D and PARP1/2 may be a promising therapeutic combination for targeting PPM1D-mutant DIPG tumors. IMPLICATIONS: The findings support the use of PARPi in combination with PPM1D inhibition against PPM1D-mutant DIPGs.

Highlights

  • Diffuse intrinsic pontine glioma (DIPG) is an invariably fatal pediatric brain tumor for which median survival is

  • The abundance of truncated PPM1D was markedly higher than full-length PPM1D in all six DIPG cell lines examined (Fig. 1B), consistent with previous reports demonstrating that truncated PPM1D is more stable than full-length PPM1D [16, 17, 20]

  • We evaluated the therapeutic efficacy of PPM1D inhibition alone or in combination with inhibitors targeting the DNA damage response (DDR) pathways with the aim to develop a more effective combination therapy for PPM1D-mutant DIPGs

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Summary

Introduction

Diffuse intrinsic pontine glioma (DIPG) is an invariably fatal pediatric brain tumor for which median survival is

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