Templated insertions are associated specifically with BRCA2 deficiency and overall survival in advanced ovarian cancer Journal Article


Authors: Moore, G.; Majumdar, R.; Powell, S. N.; Khan, A. J.; Weinhold, N.; Yin, S.; Higginson, D. S.
Article Title: Templated insertions are associated specifically with BRCA2 deficiency and overall survival in advanced ovarian cancer
Abstract: Cancer cells defective in homologous recombination (HR) are responsive to DNA-crosslinking chemotherapies, PARP inhibitors, and inhibitors of polymerase theta (Pol q), a key mediator of the backup pathway alternative end-joining. Such cancers include those with pathogenic biallelic alterations in core HR genes and another cohort of cases that exhibit sensitivity to the same agents and harbor genomic hallmarks of HR deficiency (HRD). These HRD signatures include a single-base substitution pattern, large rearrangements, characteristic tandem duplications, and small deletions. Here, we used what is now known about the backup pathway alternative end-joining (Alt-EJ) through the key factor Pol q to design and test novel signatures of polymerase theta–mediated (TMEJ) repair. We generated two novel signatures; a signature composed of small deletions with microhomology and another consisting of small, templated insertions (TINS). We find that TINS consistent with TMEJ repair are highly specific to tumors with pathogenic biallelic mutations in BRCA2 and that high TINS genomic signature content in advanced ovarian cancers associate with overall survival following treatment with platinum agents. In addition, the combination of TINS with other HRD metrics significantly improves the association of platinum sensitivity with survival compared with current state-of-the-art signatures. Implications: Small, templated insertions indicative of theta-mediated end-joining likely can be used in conjunction with other HRD mutational signatures as a prognostic tool for patient response to therapies targeting HR deficiency. © 2022 American Association for Cancer Research
Keywords: genetics; mutation; ovarian neoplasms; homologous recombination; pathology; brca2 protein; ovary tumor; nicotinamide adenine dinucleotide adenosine diphosphate ribosyltransferase inhibitor; drug therapy; brca2 protein, human; humans; human; female; poly(adp-ribose) polymerase inhibitors; carcinoma, ovarian epithelial
Journal Title: Molecular Cancer Research
Volume: 20
Issue: 7
ISSN: 1541-7786
Publisher: American Association for Cancer Research  
Date Published: 2022-07-01
Start Page: 1061
End Page: 1070
Language: English
DOI: 10.1158/1541-7786.Mcr-21-1012
PUBMED: 35385581
PROVIDER: scopus
PMCID: PMC9372910
DOI/URL:
Notes: Article -- Export Date: 1 August 2022 -- Source: Scopus
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  1. Simon Nicholas Powell
    331 Powell
  2. Atif Jalees Khan
    152 Khan
  3. Grace Mierzwa Moore
    5 Moore
  4. Shen Yin
    11 Yin