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Chromosomal instability determines taxane response
Authors:Charles Swanton  Barbara Nicke  Marion Schuett  Aron C. Eklund  Charlotte Ng  Qiyuan Li  Thomas Hardcastle  Alvin Lee  Rajat Roy  Philip East  Maik Kschischo  David Endesfelder  Paul Wylie  Se Nyun Kim  Jie-Guang Chen  Michael Howell  Thomas Ried  Jens K. Habermann  Gert Auer  James D. Brenton  Zoltan Szallasi  Julian Downward
Abstract:Microtubule-stabilizing (MTS) agents, such as taxanes, are important chemotherapeutics with a poorly understood mechanism of action. We identified a set of genes repressed in multiple cell lines in response to MTS agents and observed that these genes are overexpressed in tumors exhibiting chromosomal instability (CIN). Silencing 22/50 of these genes, many of which are involved in DNA repair, caused cancer cell death, suggesting that these genes are involved in the survival of aneuploid cells. Overexpression of these “CIN-survival” genes is associated with poor outcome in estrogen receptor–positive breast cancer and occurs frequently in basal-like and Her2-positive cases. In diploid cells, but not in chromosomally unstable cells, paclitaxel causes repression of CIN-survival genes, followed by cell death. In the OV01 ovarian cancer clinical trial, a high level of CIN was associated with taxane resistance but carboplatin sensitivity, indicating that CIN may determine MTS response in vivo. Thus, pretherapeutic assessment of CIN may optimize treatment stratification and clinical trial design using these agents.
Keywords:chemotherapy   drug resistance
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