DNA Damage Repair Pathways in Prostate Cancer: A Narrative Review of Molecular Mechanisms, Emerging Biomarkers and Therapeutic Targets in Precision Oncology

被引:3
作者
Grypari, Ioanna-Maria [1 ]
Tzelepi, Vasiliki [2 ]
Gyftopoulos, Kostis [3 ]
机构
[1] Natl Kapodistrian Univ Athens, Aretaie Univ Hosp, Cytol Dept, Athens 11528, Greece
[2] Univ Patras, Sch Med, Dept Pathol, Patras 26504, Greece
[3] Univ Patras, Sch Med, Dept Anat, Patras 26504, Greece
关键词
prostate cancer; DNA damage repair; homologous recombination deficiency; mismatch repair pathway; biomarkers; MICROSATELLITE INSTABILITY; INTRADUCTAL CARCINOMA; PROMOTER HYPERMETHYLATION; RADICAL PROSTATECTOMY; PARP; INHIBITORS; THERAPIES; GERMLINE; RISK; PD-1;
D O I
10.3390/ijms241411418
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Prostate cancer (PCa) has a distinct molecular signature, including characteristic chromosomal translocations, gene deletions and defective DNA damage repair mechanisms. One crucial pathway involved is homologous recombination deficiency (HRD) and it is found in almost 20% of metastatic castrate-resistant PCa (mCRPC). Inherited/germline mutations are associated with a hereditary predisposition to early PCa development and aggressive behavior. BRCA2, ATM and CHECK2 are the most frequently HRD-mutated genes. BRCA2-mutated tumors have unfavorable clinical and pathological characteristics, such as intraductal carcinoma. PARP inhibitors, due to the induction of synthetic lethality, have been therapeutically approved for mCRPC with HRD alterations. Mutations are detected in metastatic tissue, while a liquid biopsy is utilized during follow-up, recognizing acquired resistance mechanisms. The mismatch repair (MMR) pathway is another DNA repair mechanism implicated in carcinogenesis, although only 5% of metastatic PCa is affected. It is associated with aggressive disease. PD-1 inhibitors have been used in MMR-deficient tumors; thus, the MMR status should be tested in all metastatic PCa cases. A surrogate marker of defective DNA repair mechanisms is the tumor mutational burden. PDL-1 expression and intratumoral lymphocytes have ambivalent predictive value. Few experimental molecules have been so far proposed as potential biomarkers. Future research may further elucidate the role of DNA damage pathways in PCa, revealing new therapeutic targets and predictive biomarkers.
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页数:26
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