Fig. 2. Mutant KRAS mediates resistance to PARPi and sensitivity to PARPi and MEKi Mutant KRAS mediates resistance to PARPi and sensitivity to PARPi and.

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Fig. 2. Mutant KRAS mediates resistance to PARPi and sensitivity to PARPi and MEKi Mutant KRAS mediates resistance to PARPi and sensitivity to PARPi and MEKi (A) Drug response curves for BMN673 combined with AZD6244 in 24 well-characterized ovarian cancer cell lines treated with varying concentrations of the two compounds for 96 hours. CI was calculated using CalcuSyn software with the Chou-Talalay equation. CI values reflect the sign and magnitude of drug-drug interaction: synergy, <0.5; additivity, 0.5 to 1; antagonism, >1. Red cell line name: synergy (CI, <0.5); blue cell line name: cells intrinsically sensitive to PARPi; black cell line name: cells exhibited modest to no response to either single or combination treatment. (B) Top: Percentage of cell viability at 10 μM BMN673 from (A). Bottom: Selected mutations in cell lines. KRAS and BRCA2 correlations with BMN673 response were significant (P = 4.7 × 10−5 and P = 0.023, respectively). (C) Top: Percentage of cell growth inhibition by AZD6244 from (A). Bottom: Selected mutations in cell lines. KRAS correlation with AZD6244 response was significant (P = 0.026). (D) Correlation between IC50 of BMN673 and AZD6244 (Pearson’s r = −0.412; P = 0.049). (E) Top: CI values; cells were arranged by CI into synergistic (green) and nonsynergistic (red) (cutoff, 0.5) based on (A). Bottom: Selected mutations in cell lines. KRAS mutation is correlated with synergistic effect between PARPi and MEKi (P = 3 × 10−6). (F) Interactions between BMN673 and AZD6244 (MEKi), GSK1120212B (MEKi), SCH772984 (ERKi), GSK2118436A (BRAFi), SP600125 (JNKi), PD0332991 (CDK4/6 inhibitor), and BKM120 [PI3K inhibitor (PI3Ki)] were examined across a panel of 10 cell lines including 8 RAS mutant lines and 2 RAS wild-type lines (cell line data in fig. S3, A and B). (G) Response of Ba/F3 cells rendered interleukin-3–independent with KRAS_WT, KRASG12D, KRASG12V, or PIK3CAH1047R to BMN673 and AZD6244/SCH772984. (H) Heat map of CI of combinations of BMN673 with AZD6244 and SCH772984 from (G). Combinations with BMN673 and GSK2118436A (BRAFi) and SP600125 (JNKi) are also presented. Chaoyang Sun et al., Sci Transl Med 2017;9:eaal5148 Published by AAAS