Despite the current advances in cancer therapy, most patients with disseminated cancer still die because their tumors become resistant to the available drugs. Thus, drug resistance remains a major challenge in clinical oncology.
Because tumor cells often have alterations in DNA repair mechanisms, therapies that target DNA are usually effective and quite selective for this type of cells. Examples of these malignancies are ovarian and breast cancer with deficiency in the repair of DNA double strand breaks due to mutations in BRCA1 or BRCA2 genes. They are especially sensitive to PARP inhibitors (PARPi), a recently approved targeted therapy that leads to DNA double strand breaks in BRCA mutated cells. However, resistance is an inevitable fact also in the context of those type of cancers. The precise mechanisms underlying resistance to novel targeted drugs such as PARPi are poorly understood.
The overall goal of the DREMATURE project was to identify new mechanisms by which BRCA2-deficient breast cancer cells develop drug resistance to PARPi and thereby gain novel insights into the basic DNA damage response processes. Based on the results of this action, I expect that, eventually, new tools can be implemented in the clinic to predict and explain patient resistance to PARPi. Moreover in the case of patients who do not respond to PARPi, I predict that based on these results, that a personalized strategy can be developed to increase the sensitivity of the cancer cells to this treatment.