PARP1 and MGMT interaction-based sensitivity to DNA damage in Ewing sarcoma

The Ewing family of sarcomas comprises the fourth most common highly aggressive bone tumor. Four of five Ewing sarcoma chemotherapeutics induce DNA damage, as does radiation therapy. At relapse, two additional DNA-damaging agents are routinely used to re-induce remission, indicating that Ewing sarcoma is intrinsically sensitive to DNA damage. However, current treatment regimens are relatively ineffective, specifically for relapsed or metastatic disease. Several preclinical studies, including our study in the Pediatric Preclinical Testing Program (PPTP), provide evidence for the synthetic lethal combination of PARP1 inhibitor talazoparib with a DNA-methylating agent, temozolomide, for Ewing sarcoma. Nevertheless, in both preclinical studies and clinical trials, doses of temozolomide were significantly reduced because of toxicity of the drug combination. Temozolomide-induced DNA lesions are repaired poly(ADP) ribose polymerase I (PARP1)-dependent base excision repair and by O6-methylguanine-DNA methyltransferase (MGMT) in a single-step adduct removal. Here, we provide evidence that the two DNA repair pathways act in an epistatic manner in lesion removal. Further, we demonstrate that PARP1 and MGMT physically interact, and that this association is stimulated upon DNA damage. Protein co-immunoprecipitation and microscale thermophoresis analyses revealed that PARP1/MGMT complex formation is DNA and PARylation-independent. Collectively, our results show that: 1) DNA damage response pathways mediated by PARP1 and MGMT work epistatically to eliminate temozolomide-induced DNA adducts; 2) PARP1 and MGMT physically interact; and 3) PARP1/MGMT interaction is increased in response to DNA damage. We discuss how our findings may affect therapeutic advancement for Ewing sarcoma and potentially other cancer types.