BRCA1 or BRCA2 (BRCA)-deficient tumor cells have defects in DNA double strand break repair by homologous recombination (HR) and fork protection (FP) that are thought to underlie the sensitivity to poly(ADP-ribose) polymerase inhibitor (PARPi). Given the recent finding that PARPi accelerates DNA replication, it was proposed that high speed DNA replication leads to DNA double strand breaks (DSBs). Here, we tested the alternative hypothesis that PARPi sensitivity in BRCA deficient cells results from combined replication dysfunction that causes a lethal accumulation of replication-associated single-stranded DNA (ssDNA) gaps. In support of a gap toxicity threshold, PARPi-induced ssDNA gaps accumulate more excessively in BRCA deficient cells and are suppressed in de novo and genetic models of PARPi resistance while defects in HR or FP often lack this correlation.We also uncouple replication speed from lethality. The clear link between PARPi sensitivity and ssDNA gaps provides a new paradigm for understanding synthetic lethal interactions. Schlacher et al., 2012). Consistent with the DSB inducing model of therapy response in BRCA deficient cells, restoration of HR or FP are associated with chemoresistance (Bouwman et al., 2010; Bunting et al., 2010; Chaudhuri et al., 2016; Edwards et al., 2008; Sakai et al., 2008). However, this model of therapy response is challenged by recent reports indicating that chemotoxic agents do not initially induce DSBs or even pause DNA replication forks (Huang et al., 2013; Mutreja et al., 2018; Zellweger et al., 2015). Indeed, PARPi accelerates DNA replication (Maya-Mendoza et al., 2018). To square this finding with the framework that HR and/or FP defects drive PARPi therapy response, it was proposed that high speed DNA replication ultimately induces DSBs (Maya-Mendoza et al., 2018; Quinet and Vindigni, 2018). However, we recently proposed a competing model in which ssDNA gaps underlie the BRCA deficiency phenotype, and not DSBs and we propose are fundamental to the mechanismof-action of genotoxic therapies (Panzarino et al., 2019).
2011;Here, we provide evidence that the genotoxic lesion driving PARPi synthetic lethality in BRCA deficient cancer is wide-spread single-stranded DNA (ssDNA) gaps. Gap induction is associated with PARPi potentially due to its role in the repair of ssDNA breaks, processing Okazaki fragments, or regulating replication-fork reversal -a mechanism by which replication forks reverse direction when confronted with replication obstacles (Berti et al. Sogo et al., 2002). Critically, we demonstrate that PARPi gaps are compounded in BRCA-deficient cells, but suppressed in cell lines and tumors with intrinsic, genetic or de novo mechanisms of PARPi resistance. These findings highlight that a key function of the BRCA-RAD51 proteins is to limit replication gaps (Hashimoto et al., 2010; Kolinjivadi et al., 2017a; Kolinjivadi et al., 2017b; Zellweger et al., 2015, Panzarino et al., 2019 and that loss of this function confers therapy response.
RESULTS
PARPi generates s...