World Library  
Flag as Inappropriate
Email this Article

PARP inhibitor

Article Id: WHEBN0024369967
Reproduction Date:

Title: PARP inhibitor  
Author: World Heritage Encyclopedia
Language: English
Subject: BioMarin Pharmaceutical, Thymidylate synthase inhibitor, Dihydrofolate reductase inhibitor, Breast cancer management, Oudenone
Publisher: World Heritage Encyclopedia

PARP inhibitor

PARP inhibitors are a group of pharmacological inhibitors of the enzyme poly ADP ribose polymerase (PARP). They are developed for multiple indications; the most important is the treatment of cancer.[1] Several forms of cancer are more dependent on PARP than regular cells, making PARP an attractive target for cancer therapy.[2] [3][4] PARP inhibitors appear to improve progression-free survival in women with recurrent platinum-sensitive ovarian cancer, as evidenced mainly by olaparib added to conventional treatment.[5]

In addition to their use in cancer therapy, PARP inhibitors are considered a potential treatment for acute life-threatening diseases, such as stroke and myocardial infarction, as well as for long-term neurodegenerative diseases.[6]

Mechanism of action

DNA is damaged thousands of times during each cell cycle, and that damage must be repaired.

BRCA1, BRCA2 and PALB2[7] are proteins that are important for the repair of double-strand DNA breaks by the error-free homologous recombinational repair, or HRR, pathway. When the gene for either protein is mutated, the change can lead to errors in DNA repair that can eventually cause breast cancer. When subjected to enough damage at one time, the altered gene can cause the death of the cells.

PARP1 is a protein that is important for repairing single-strand breaks ('nicks' in the DNA). If such nicks persist unrepaired until DNA is replicated (which must precede cell division), then the replication itself can cause double strand breaks to form.[8]

Drugs that inhibit PARP1 cause multiple double strand breaks to form in this way, and in tumours with BRCA1, BRCA2 or PALB2 [7] mutations these double strand breaks cannot be efficiently repaired, leading to the death of the cells. Normal cells that don't replicate their DNA as often as cancer cells, and that lack any mutated BRCA1 or BRCA2 still have homologous repair operating, which allows them to survive the inhibition of PARP.[9][10]

Some cancer cells that lack the tumor suppressor PTEN may be sensitive to PARP inhibitors because of downregulation of Rad51, a critical homologous recombination component, although other data suggest PTEN may not regulate Rad51.[3][11] Hence PARP inhibitors may be effective against many PTEN-defective tumours[4] (e.g. some aggressive prostate cancers).

Cancer cells that are low in oxygen (e.g. in fast growing tumors) are sensitive to PARP inhibitors.[12]

Additional mode of action for PARP inhibitors

2012: Researchers at the National Cancer Institute have discovered a significant new mechanism of action for PARP inhibitors.[13] They have also identified differences in the toxic capabilities of three drugs in this class, which are currently being tested in clinical trials. Prior to this study, PARP inhibitors were thought to work primarily by blocking PARP enzyme activity, thus preventing the repair of DNA damage and ultimately causing cell death. In this study,[14] scientists established that PARP inhibitors have an additional mode of action: localizing PARP proteins at sites of DNA damage, which has relevance to their anti-tumor activity. The trapped PARP protein–DNA complexes are highly toxic to cells because they block DNA replication. When the researchers tested three PARP inhibitors for their differential ability to trap PARP proteins on damaged DNA, they found that the trapping potency of the inhibitors varied widely. The PARP family of proteins in humans includes PARP1 and PARP2, which are DNA binding and repair proteins. When activated by DNA damage, these proteins recruit other proteins that do the actual work of repairing DNA. Under normal conditions, PARP1 and PARP2 are released from DNA once the repair process is underway. However, as this study shows, when they are bound to PARP inhibitors, PARP1 and PARP2 become trapped on DNA. The researchers showed that trapped PARP–DNA complexes are more toxic to cells than the unrepaired single-strand DNA breaks that accumulate in the absence of PARP activity, indicating that PARP inhibitors act as PARP poisons. These findings suggest that there may be two classes of PARP inhibitors, catalytic inhibitors that act mainly to inhibit PARP enzyme activity and do not trap PARP proteins on DNA, and dual inhibitors that both block PARP enzyme activity and act as PARP poison.

Examples in clinical trials

Started Phase III:

  • Iniparib (BSI 201) for breast cancer and squamous cell lung cancer. Failed trial for triple negative breast cancer.[15] In 2012 iniparib was determined not be a true PARP inhibitor and its mechanism of action is believed to be through other means than PARP inhibition.[16][17]
  • Talazoparib (BMN-673) after trials for advanced hematological malignancies and for advanced or recurrent solid tumors.[18] it is now in phase 3 for metastatic germline BRCA mutated breast cancer.[19]

Started Phase II:

  • Olaparib (AZD-2281) for breast, ovarian and colorectal cancer.[20][21] AZ On December 19, 2014, the FDA approved olaparib as monotherapy (at 400 mg taken twice per day) for patients with germline BRCA mutated (gBRCAm) advanced ovarian cancer who have been treated with three or more prior lines of chemotherapy.
  • Olaparib TOPARP-A trial for use in advanced prostate cancer (published c. April 21, 2015.[22]
  • Rucaparib (AG014699, PF-01367338) for metastatic breast and ovarian cancer.
  • Veliparib (ABT-888) for metastatic melanoma and breast cancer, and as an add on to radiation in patients with Brain Metastases from Non-Small Cell Lung Cancer.
  • CEP 9722[23] for non–small-cell lung cancer (NSCLC)[15]

Started Phase I:


Combination with radiotherapy

The main function of radiotherapy is to produce DNA strand breaks, causing severe DNA damage and leading to cell death. Radiotherapy has the potential to kill 100% of any targeted cells, but the dose required to do so would cause unacceptable side effects to healthy tissue. Radiotherapy therefore can only be given up to a certain level of radiation exposure. Combining radiation therapy with PARP inhibitors offers promise, since the inhibitors would lead to formation of double strand breaks from the single-strand breaks generated by the radiotherapy in tumor tissue with BRCA1/BRCA2 mutations. This combination could therefore lead to either more powerful therapy with the same radiation dose or similarly powerful therapy with a lower radiation dose.[27]

See also


  1. ^
  2. ^
  3. ^ a b
  4. ^ a b
  5. ^
  6. ^
  7. ^ a b
  8. ^ McGlynn, P. and Lloyd, B. "Recombinational Repair and Restart of Damaged Replication Forks." Nature Reviews, 2002, pp.859-870
  9. ^ N Engl J Med 361:123
  10. ^ N Engl J Med 361:189
  11. ^
  12. ^
  13. ^
  14. ^
  15. ^ a b
  16. ^ Liu X, Shi Y, Maag DX, Palma JP, Patterson MJ, Ellis PA, Surber BW, Ready DB, Soni NB, Ladror US, Xu AJ, Iyer R, Harlan JE, Solomon LR, Donawho CK,Penning TD, Johnson EF, Shoemaker AR. Iniparib nonselectively modifies cysteine-containing proteins in tumor cells and is not a bona fide PARP inhibitor.Clin Cancer Res. 2012 Jan 15;18(2):510-23. doi:10.1158/1078-0432.CCR-11-1973
  17. ^ Anand G. Patel, Silvana B. De Lorenzo, Karen S. Flatten1, Guy G. Poirier, andScott H. Kaufmann. Failure of Iniparib to Inhibit Poly(ADP-Ribose) Polymerase In Vitro. Clin Cancer Res. 2012 Mar 15;18(6):1655-62. doi:10.1158/1078-0432.CCR-11-2890
  18. ^
  19. ^
  20. ^
  21. ^
  22. ^
  23. ^
  24. ^
  25. ^
  26. ^
  27. ^

External links

  • Parp Inhibitors information site
  • PARP structure
This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.

Copyright © World Library Foundation. All rights reserved. eBooks from Project Gutenberg are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.