Protein arginine methyltransferase 5 (PRMT5) is overexpressed in many cancer types and is a promising therapeutic target for several of them, including leukemia and lymphoma. However, we and others have reported that PRMT5 is essential for normal physiology. This dependence may become dose limiting in a therapeutic setting, warranting the search for combinatorial approaches. Here, we report that PRMT5 depletion or inhibition impairs homologous recombination (HR) DNA repair, leading to DNA-damage accumulation, p53 activation, cell-cycle arrest, and cell death. PRMT5 symmetrically dimethylates histone and non-histone substrates, including several components of the RNA splicing machinery. We find that PRMT5 depletion or inhibition induces aberrant splicing of the multifunctional histone-modifying and DNA-repair factor TIP60/KAT5, which selectively affects its lysine acetyltransferase activity and leads to impaired HR. As HR deficiency sensitizes cells to PARP inhibitors, we demonstrate here that PRMT5 and PARP inhibitors have synergistic effects on acute myeloid leukemia cells.

Background & Aims A single nucleotide polymorphism 61*G (rs4444903) in the Epidermal Growth Factor (EGF) gene has been associated, in 2 case-control studies, with hepatocellular carcinoma (HCC). We tested associations between demographic, clinical, and genetic data and development of HCC, and developed a simple predictive model in a cohort of patients with chronic hepatitis C and advanced fibrosis. Methods Black and white subjects from the HALT-C trial (n=816) were followed prospectively for development of a definite or presumed case of HCC for a median time period of 6.1 years. We used the Cox proportional hazards regression model to determine the hazard ratio for risk of HCC and to develop prediction models. Results Subjects with EGF genotype G/G had a higher adjusted risk for HCC than those with genotype A/A (hazard ratio, 2.10; 95% confidence interval, 1.05–4.23; P=0.03). After adjusting for EGF genotype, blacks had no increased risk of HCC risk, compared with whites. Higher serum levels of EGF were observed among subjects with at least one G allele (P=0.08); the subset of subjects with EGF G/G genotype and above-median serum levels of EGF had the highest risk of HCC. We developed a simple prediction model that included the EGF genotype to identify patients at low, intermediate, and high risk for HCC; 6-year cumulative HCC incidences were 2.3%, 10.4%, and 26%, respectively. Conclusions We associated the EGF genotype G/G with increased risk for HCC; differences in its frequency among black and white subjects might account for differences in HCC incidence between these groups. We developed a model that incorporates EGF genotype and demographic and clinical variables to identify patients at low, intermediate, and high risk for HCC.

Purpose Numerous preclinical studies demonstrate that angiogenesis inhibitors can increase the efficacy of radiation therapy (RT). We sought to examine safety and efficacy of bevacizumab (BV) and RT in soft tissue sarcomas (STS) and explore biomarkers for treatment response. Methods and Materials Patients (pts) with ≥5 cm, intermediate- or high-grade STS at significant risk of local recurrence (LR) received neoadjuvant BV alone followed by BV plus RT prior to surgical resection. Correlative science studies included analysis of serial blood and tumor samples as well as serial perfusion CT scans. Results The 20 pts had a median tumor size of 8.25 cm, with 13 extremity, 1 trunk, and 6 retroperitoneal/pelvis tumors. Neoadjuvant treatment was well tolerated with only 4 pts having grade 3 toxicities (hypertension, LFT elevation). BV plus RT resulted in ≥80% pathologic necrosis in 9 of 20 tumors (45%), which is over double the historical rate seen with RT alone. 3 pts had a complete pathologic response. Median microvessel density (MVD) decreased 53% after BV alone (p<0.05), and following combination therapy, median tumor cell proliferation decreased by 73%, apoptosis increased 10.4 fold, and blood flow, blood volume, and permeability surface area decreased by 62–72% (p<0.05). Analysis of gene expression microarrays of untreated tumors identified a 24-gene signature for treatment response. MVD and circulating progenitor cells at baseline and reduction in MVD and plasma soluble c-KIT with BV also correlated with good pathologic response (p<0.05). After a median follow-up of 20 months, only 1 patient had a LR. Conclusions This exploratory study indicates that BV increases the efficacy of RT against STS and may reduce LR, and thus this regimen warrants further investigation. Gene expression profiles and other tissue and circulating biomarkers show promising correlations with treatment response.