[HTML][HTML] Targeting the ALK–CDK9-Tyr19 kinase cascade sensitizes ovarian and breast tumors to PARP inhibition via destabilization of the P-TEFb complex

YY Chu, MK Chen, Y Wei, HH Lee, W Xia, YN Wang… - Nature Cancer, 2022 - nature.com
YY Chu, MK Chen, Y Wei, HH Lee, W Xia, YN Wang, C Yam, JL Hsu, HL Wang, WC Chang
Nature Cancer, 2022nature.com
Abstract Poly (ADP-ribose) polymerase (PARP) inhibitors have demonstrated promising
clinical activity in multiple cancers. However, resistance to PARP inhibitors remains a
substantial clinical challenge. In the present study, we report that anaplastic lymphoma
kinase (ALK) directly phosphorylates CDK9 at tyrosine-19 to promote homologous
recombination (HR) repair and PARP inhibitor resistance. Phospho-CDK9-Tyr19 increases
its kinase activity and nuclear localization to stabilize positive transcriptional elongation …
Abstract
Poly(ADP-ribose) polymerase (PARP) inhibitors have demonstrated promising clinical activity in multiple cancers. However, resistance to PARP inhibitors remains a substantial clinical challenge. In the present study, we report that anaplastic lymphoma kinase (ALK) directly phosphorylates CDK9 at tyrosine-19 to promote homologous recombination (HR) repair and PARP inhibitor resistance. Phospho-CDK9-Tyr19 increases its kinase activity and nuclear localization to stabilize positive transcriptional elongation factor b and activate polymerase II-dependent transcription of HR-repair genes. Conversely, ALK inhibition increases ubiquitination and degradation of CDK9 by Skp2, an E3 ligase. Notably, combination of US Food and Drug Administration-approved ALK and PARP inhibitors markedly reduce tumor growth and improve survival of mice in PARP inhibitor-/platinum-resistant tumor xenograft models. Using human tumor biospecimens, we further demonstrate that phosphorylated ALK (p-ALK) expression is associated with resistance to PARP inhibitors and positively correlated with p-Tyr19-CDK9 expression. Together, our findings support a biomarker-driven, combinatorial treatment strategy involving ALK and PARP inhibitors to induce synthetic lethality in PARP inhibitor-/platinum-resistant tumors with high p-ALK–p-Tyr19-CDK9 expression.
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