Ovarian Cancers with Low CIP2A Tumor Expression Constitute an APR-246-Sensitive Disease Subtype
: Cvrljevic Anna N., Butt Umar, Huhtinen Kaisa, Grönroos Tove J., Böckelman Camilla, Lassus Heini, Butzow Ralf, Haglund Caj, Kaipio Katja, Arsiola Tiina, Laajala Teemu D., Connolly Denise C, Ristimäki Ari, Carpen Olli, Pouwels Jeroen, Westermarck Jukka
Publisher: American Association for Cancer Research
: 2022
: Molecular Cancer Therapeutics
: 21
: 7
: 1236
: 1245
: 1538-8514
DOI: https://doi.org/10.1158/1535-7163.MCT-21-0622
: https://doi.org/10.1158/1535-7163.MCT-21-0622
: https://www.biorxiv.org/content/10.1101/2021.03.31.437804v1
Identification of ovarian cancer patient subpopulations with increased sensitivity to targeted therapies could offer significant clinical benefit. We report that 22% of the high-grade ovarian cancer tumors at diagnosis express CIP2A oncoprotein at low levels. Furthermore, regardless of their significantly lower likelihood of disease relapse after standard chemotherapy, a portion of relapsed tumors retain their CIP2A-deficient phenotype. Through a screen for therapeutics that would preferentially kill CIP2A-deficient ovarian cancer cells, we identified reactive oxygen species inducer APR-246, tested previously in ovarian cancer clinical trials. Consistent with CIP2A-deficient ovarian cancer subtype in humans, CIP2A is dispensable for development of MISIIR-Tag-driven mouse ovarian cancer tumors. Nevertheless, CIP2A-null ovarian cancer tumor cells from MISIIR-Tag mice displayed APR-246 hypersensitivity both in vitro and in vivo. Mechanistically, the lack of CIP2A expression hypersensitizes the ovarian cancer cells to APR-246 by inhibition of NF-κB activity. Accordingly, combination of APR-246 and NF-κB inhibitor compounds strongly synergized in killing of CIP2A-positive ovarian cancer cells. Collectively, the results warrant consideration of clinical testing of APR-246 for CIP2A-deficient ovarian cancer tumor subtype patients. Results also reveal CIP2A as a candidate APR-246 combination therapy target for ovarian cancer.