Abstract
Poly (ADP-ribose) polymerase (PARP) inhibitors have attracted much attention as one of the major molecular-targeted therapeutics for inhibiting DNA damage response. The PARP inhibitor, olaparib, has been clinically applied for treating certain recurrent ovarian cancer patients with BRCA1/2 mutations in Europe and the United States. It was also designated on 24 March 2017 as an orphan drug in Japan for similar clinical indications. In this review, we discuss (i) the prevalence of BRCA1/2 mutations in ovarian cancer, (ii) clinical trials of PARP inhibitors in ovarian cancer, (iii) genetic counseling for hereditary breast and ovarian cancer patients, and (iv) non-BRCA genes that may be associated with homologous recombination deficiency.
Similar content being viewed by others
References
Tomkinson AE, Chen L, Dong Z et al (2001) Completion of base excision repair by mammalian DNA ligases. Prog Nucleic Acid Res Mol Biol 68:151–164
Jasin M (2002) Homologous repair of DNA damage and tumorigenesis: the BRCA connection. Oncogene 21:8981–8993
Ashworth A (2008) A synthetic lethal therapeutic approach: poly(ADP) ribose polymerase inhibitors for the treatment of cancers deficient in DNA double-strand break repair. J Clin Oncol 26:3785–3790
Martin SA, Lord CJ, Ashworth A (2008) DNA repair deficiency as a therapeutic target in cancer. Curr Opin Genet Dev 18:80–86
Yap TA, Sandhu SK, Carden CP et al (2011) Poly(ADP-ribose) polymerase (PARP) inhibitors: exploiting a synthetic lethal strategy in the clinic. CA Cancer J Clin 61:31–49
Helleday T (2011) The underlying mechanism for the PARP and BRCA synthetic lethality: clearing up the misunderstandings. Mol Oncol 5:387–393
Pal T, Permuth-Wey J, Betts JA et al (2005) BRCA1 and BRCA2 mutations account for a large proportion of ovarian carcinoma cases. Cancer 104:2807–2816
Walsh T, Casadei S, Lee MK et al (2011) Mutations in 12 genes for inherited ovarian, fallopian tube, and peritoneal carcinoma identified by massively parallel sequencing. Proc Natl Acad Sci USA 108:18032–18037
Cancer Genome Atlas Research Network (2011) Integrated genomic analyses of ovarian carcinoma. Nature 474:609–615
Pennington KP, Walsh T, Harrell MI et al (2014) Germline and somatic mutations in homologous recombination genes predict platinum response and survival in ovarian, fallopian tube, and peritoneal carcinomas. Clin Cancer Res 20:764–775
Kim G, Ison G, McKee AE et al (2015) FDA approval summary: olaparib monotherapy in patients with deleterious Germline BRCA-mutated advanced ovarian cancer treated with three or more lines of chemotherapy. Clin Cancer Res 21:4257–4261
George A, Kaye S, Banerjee S (2017) Delivering widespread BRCA testing and PARP inhibition to patients with ovarian cancer. Nat Rev Clin Oncol. 14(5): 284−296
Alsop K, Fereday S, Meldrum C et al (2012) BRCA mutation frequency and patterns of treatment response in BRCA mutation-positive women with ovarian cancer: a report from the Australian Ovarian Cancer Study Group. J Clin Oncol 30:2654–2663
Norquist BM, Harrell MI, Brady MF et al (2016) Inherited mutations in women with ovarian carcinoma. JAMA Oncol 2:482–490
Moslehi R, Chu W, Karlan B et al (2000) BRCA1 and BRCA2 mutation analysis of 208 Ashkenazi Jewish women with ovarian cancer. Am J Hum Genet 66:1259–1272
Satagopan JM, Boyd J, Kauff ND et al (2002) Ovarian cancer risk in Ashkenazi Jewish carriers of BRCA1 and BRCA2 mutations. Clin Cancer Res 8:3776–3781
Moller P, Hagen AI, Apold J et al (2007) Genetic epidemiology of BRCA mutations–family history detects less than 50% of the mutation carriers. Eur J Cancer 43:1713–1717
Soegaard M, Kjaer SK, Cox M et al (2008) BRCA1 and BRCA2 mutation prevalence and clinical characteristics of a population-based series of ovarian cancer cases from Denmark. Clin Cancer Res 14:3761–3767
Norquist BM, Pennington KP, Agnew KJ et al (2013) Characteristics of women with ovarian carcinoma who have BRCA1 and BRCA2 mutations not identified by clinical testing. Gynecol Oncol 128:483–487
Sakamoto I, Hirotsu Y, Nakagomi H et al (2016) BRCA1 and BRCA2 mutations in Japanese patients with ovarian, fallopian tube, and primary peritoneal cancer. Cancer 122:84–90
Farmer H, McCabe N, Lord CJ et al (2005) Targeting the DNA repair defect in BRCA mutant cells as a therapeutic strategy. Nature 434:917–921
Bryant HE, Schultz N, Thomas HD et al (2005) Specific killing of BRCA2-deficient tumours with inhibitors of poly(ADP-ribose) polymerase. Nature 434:913–917
Fong PC, Boss DS, Yap TA et al (2009) Inhibition of poly(ADP-ribose) polymerase in tumors from BRCA mutation carriers. N Engl J Med 361:123–134
Audeh MW, Carmichael J, Penson RT et al (2010) Oral poly(ADP-ribose) polymerase inhibitor olaparib in patients with BRCA1 or BRCA2 mutations and recurrent ovarian cancer: a proof-of-concept trial. Lancet 376:245–251
Kaufman B, Shapira-Frommer R, Schmutzler RK et al (2015) Olaparib monotherapy in patients with advanced cancer and a germline BRCA1/2 mutation. J Clin Oncol 33:244–250
Ledermann J, Harter P, Gourley C et al (2012) Olaparib maintenance therapy in platinum-sensitive relapsed ovarian cancer. N Engl J Med 366:1382–1392
Ledermann J, Harter P, Gourley C et al (2014) Olaparib maintenance therapy in patients with platinum-sensitive relapsed serous ovarian cancer: a preplanned retrospective analysis of outcomes by BRCA status in a randomised phase 2 trial. Lancet Oncol 15:852–861
Ledermann JA, Harter P, Gourley C et al (2016) Overall survival in patients with platinum-sensitive recurrent serous ovarian cancer receiving olaparib maintenance monotherapy: an updated analysis from a randomised, placebo-controlled, double-blind, phase 2 trial. Lancet Oncol 17:1579–1589
Domchek SM, Aghajanian C, Shapira-Frommer R et al (2016) Efficacy and safety of olaparib monotherapy in germline BRCA1/2 mutation carriers with advanced ovarian cancer and three or more lines of prior therapy. Gynecol Oncol 140:199–203
Pujade-Lauraine E, Ledermann JA, Penson RT et al (2017) Treatment with olaparib monotherapy in the maintenance setting significantly improves progression-free survival in patients with platinum-sensitive relapsed ovarian cancer: Results from the phase III SOLO2 study. In: SGO Annual Meeting (Late-Breaking Abstract-2). March 14
Donawho CK, Luo Y, Luo Y et al (2007) ABT-888, an orally active poly(ADP-ribose) polymerase inhibitor that potentiates DNA-damaging agents in preclinical tumor models. Clin Cancer Res 13:2728–2737
Rottenberg S, Jaspers JE, Kersbergen A et al (2008) High sensitivity of BRCA1-deficient mammary tumors to the PARP inhibitor AZD2281 alone and in combination with platinum drugs. Proc Natl Acad Sci USA 105:17079–17084
Oza AM, Cibula D, Benzaquen AO et al (2015) Olaparib combined with chemotherapy for recurrent platinum-sensitive ovarian cancer: a randomised phase 2 trial. Lancet Oncol 16:87–97
Yadav A, Kumar B, Teknos TN et al (2011) Sorafenib enhances the antitumor effects of chemoradiation treatment by downregulating ERCC-1 and XRCC-1 DNA repair proteins. Mol Cancer Ther 10:1241–1251
Liu JF, Barry WT, Birrer M et al (2014) Combination cediranib and olaparib versus olaparib alone for women with recurrent platinum-sensitive ovarian cancer: a randomised phase 2 study. Lancet Oncol 15:1207–1214
Coleman RL, Sill MW, Bell-McGuinn K et al (2015) A phase II evaluation of the potent, highly selective PARP inhibitor veliparib in the treatment of persistent or recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer in patients who carry a germline BRCA1 or BRCA2 mutation − An NRG Oncology/Gynecologic Oncology Group study. Gynecol Oncol 137:386–391
McNeish I, A.M. O, Coleman RL et al (2015) Results of ARIEL2: a phase 2 trial to prospectively identify ovarian cancer patients likely to respond to rucaparib using tumor genetic analysis. J Clin Oncol 33(suppl): abstract 5508
Swisher EM, Lin KK, Oza AM et al (2017) Rucaparib in relapsed, platinum-sensitive high-grade ovarian carcinoma (ARIEL2 Part 1): an international, multicentre, open-label, phase 2 trial. Lancet Oncol 18:75–87
Jones P, Wilcoxen K, Rowley M et al (2015) Niraparib: a poly(ADP-ribose) polymerase (PARP) inhibitor for the treatment of tumors with defective homologous recombination. J Med Chem 58:3302–3314
Mirza MR, Monk BJ, Herrstedt J et al (2016) Niraparib maintenance therapy in platinum-sensitive, recurrent ovarian cancer. N Engl J Med 375:2154–2164
Telli ML, Timms KM, Reid J et al (2016) Homologous recombination deficiency (HRD) score predicts response to platinum-containing neoadjuvant chemotherapy in patients with triple-negative breast cancer. Clin Cancer Res 22:3764–3773
Yang D, Khan S, Sun Y et al (2011) Association of BRCA1 and BRCA2 mutations with survival, chemotherapy sensitivity, and gene mutator phenotype in patients with ovarian cancer. JAMA 306:1557–1565
Bolton KL, Chenevix-Trench G, Goh C et al (2012) Association between BRCA1 and BRCA2 mutations and survival in women with invasive epithelial ovarian cancer. JAMA 307:382–390
Liu J, Cristea MC, Frankel P et al (2012) Clinical characteristics and outcomes of BRCA-associated ovarian cancer: genotype and survival. Cancer Genet 205:34–41
Candido-dos-Reis FJ, Song H, Goode EL et al (2015) Germline mutation in BRCA1 or BRCA2 and ten-year survival for women diagnosed with epithelial ovarian cancer. Clin Cancer Res 21:652–657
Gourley C, Michie CO, Roxburgh P et al (2010) Increased incidence of visceral metastases in scottish patients with BRCA1/2-defective ovarian cancer: an extension of the ovarian BRCAness phenotype. J Clin Oncol 28:2505–2511
Daly MB, Pilarski R, Axilbund JE et al (2014) NCCN clinical practice guidelines in oncology (NCCN Guidelines®). Genetic/familial high-risk assessment: breast and ovarian V2.2014. www.nccn.org.
Garcia C, Wendt J, Lyon L et al (2014) Risk management options elected by women after testing positive for a BRCA mutation. Gynecol Oncol 132:428–433
Ludwig KK, Neuner J, Butler A et al (2016) Risk reduction and survival benefit of prophylactic surgery in BRCA mutation carriers, a systematic review. Am J Surg 212:660–669
Cousineau I, Belmaaza A (2011) EMSY overexpression disrupts the BRCA2/RAD51 pathway in the DNA-damage response: implications for chromosomal instability/recombination syndromes as checkpoint diseases. Mol Genet Genomics 285:325–340
Wilkerson PM, Dedes KJ, Wetterskog D et al (2011) Functional characterization of EMSY gene amplification in human cancers. J Pathol 225:29–42
Campeau PM, Foulkes WD, Tischkowitz MD (2008) Hereditary breast cancer: new genetic developments, new therapeutic avenues. Hum Genet 124:31–42
Kast K, Rhiem K, Wappenschmidt B et al (2016) Prevalence of BRCA1/2 germline mutations in 21 401 families with breast and ovarian cancer. J Med Genet 53:465–471
Nielsen FC, van Overeem Hansen T, Sorensen CS (2016) Hereditary breast and ovarian cancer: new genes in confined pathways. Nat Rev Cancer 16:599–612
Loveday C, Turnbull C, Ruark E et al (2012) Germline RAD51C mutations confer susceptibility to ovarian cancer. Nat Genet 44:475–476 author reply 476
Meindl A, Hellebrand H, Wiek C et al (2010) Germline mutations in breast and ovarian cancer pedigrees establish RAD51C as a human cancer susceptibility gene. Nat Genet 42:410–414
Coulet F, Fajac A, Colas C et al (2013) Germline RAD51C mutations in ovarian cancer susceptibility. Clin Genet 83:332–336
Rafnar T, Gudbjartsson DF, Sulem P et al (2011) Mutations in BRIP1 confer high risk of ovarian cancer. Nat Genet 43:1104–1107
Loveday C, Turnbull C, Ramsay E et al (2011) Germline mutations in RAD51D confer susceptibility to ovarian cancer. Nat Genet 43:879–882
Judkins T, Leclair B, Bowles K et al (2015) Development and analytical validation of a 25-gene next generation sequencing panel that includes the BRCA1 and BRCA2 genes to assess hereditary cancer risk. BMC Cancer 15:215
Schroeder C, Faust U, Sturm M et al (2015) HBOC multi-gene panel testing: comparison of two sequencing centers. Breast Cancer Res Treat 152:129–136
Eliade M, Skrzypski J, Baurand A et al (2017) The transfer of multigene panel testing for hereditary breast and ovarian cancer to healthcare: what are the implications for the management of patients and families? Oncotarget 8:1957–1971
Hunt CR, Gupta A, Horikoshi N et al (2012) Does PTEN loss impair DNA double-strand break repair by homologous recombination? Clin Cancer Res 18:920–922
Miyasaka A, Oda K, Ikeda Y et al (2014) Anti-tumor activity of olaparib, a poly (ADP-ribose) polymerase (PARP) inhibitor, in cultured endometrial carcinoma cells. BMC Cancer 14:179
Uehara Y, Oda K, Ikeda Y et al (2015) Integrated copy number and expression analysis identifies profiles of whole-arm chromosomal alterations and subgroups with favorable outcome in ovarian clear cell carcinomas. PLoS One 10:e0128066
Oda K, Ikeda Y, Kashiyama T et al (2016) Characterization of TP53 and PI3K signaling pathways as molecular targets in gynecologic malignancies. J Obstet Gynaecol Res 42:757–762
Khanna KK (2000) Cancer risk and the ATM gene: a continuing debate. J Natl Cancer Inst 92:795–802
Khanna KK, Jackson SP (2001) DNA double-strand breaks: signaling, repair and the cancer connection. Nat Genet 27:247–254
Bolderson E, Richard DJ, Zhou BB et al (2009) Recent advances in cancer therapy targeting proteins involved in DNA double-strand break repair. Clin Cancer Res 15:6314–6320
Acknowledgements
This work was financially supported by a research program of the Project for Cancer Research and Therapeutic Evolution (P-CREATE) (to K Oda) from the Japan Agency for Medical Research and development (AMED). We thank Editage for their English editing service (www.editage.com).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no competing interests to disclose.
About this article
Cite this article
Oda, K., Tanikawa, M., Sone, K. et al. Recent advances in targeting DNA repair pathways for the treatment of ovarian cancer and their clinical relevance. Int J Clin Oncol 22, 611–618 (2017). https://doi.org/10.1007/s10147-017-1137-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10147-017-1137-7