DNA damage tolerance (
DDT) enables replication to continue in the presence of a damaged template and constitutes a key step in
DNA interstrand crosslink repair. In this way
DDT minimizes replication stress inflicted by a wide range of endogenous and exogenous agents, and provides a critical first line defense against alkylating and platinating chemotherapeutics. Effective
DDT strongly depends on damage-induced, site-specific
PCNA-ubiquitination at
Lysine (K) 164 by the E2/E3 complex (RAD6/18). A survey of The
Cancer Genome Atlas (TCGA) revealed a high frequency of
tumors presents RAD6/RAD18 bi-allelic inactivating deletions. For instance, 11% of
renal cell carcinoma and 5% of pancreatic
tumors have inactivating RAD18-deletions and 7% of
malignant peripheral nerve sheath tumors lack RAD6B. To determine the potential benefit for
tumor-specific
DDT defects, we followed a genetic approach by establishing unique sets of
DDT-proficient PcnaK164 and -defective PcnaK164R
lymphoma and
breast cancer cell lines. In the absence of exogenous DNA damage, PcnaK164R
tumors grew comparably to their PcnaK164 controls in vitro and in vivo. However,
DDT-defective
lymphomas and breast
cancers were compared to their
DDT-proficient controls hypersensitive to the chemotherapeutic
drug cisplatin (CsPt), both in vitro and in vivo. CsPt strongly inhibited
tumor growth and the overall survival of
tumor bearing mice greatly improved in the
DDT-defective condition. These insights open new therapeutic possibilities for precision
cancer medicine with
DNA damaging chemotherapeutics and optimize Next-Generation-Sequencing (NGS)-based
cancer-diagnostics, -
therapeutics, and -prognosis.