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Abstract Head and neck squamous cell carcinoma (HNSCC) presents a challenging clinical scenario due to its recurrence propensity despite existing treatments. Altered intrinsic signaling pathways significantly contribute to therapeutic resistance, demanding exploration of novel strategies to induce tumor cell demise. Dysregulated cell cycle and DNA damage repair constitute pivotal events driving HNSCC progression, offering potential therapeutic targets. CHK1 and CHK2, pivotal regulators of the DNA replication checkpoint, are promising targets in HNSCC. The convergence of DNA-damaging agents with DNA checkpoint inhibitors represents a burgeoning paradigm in cancer management. Our study delves into elucidating the intrinsic signaling mechanisms triggered by the synergistic action of the CHK1/2 dual inhibitor (Prexasertib) and the nucleoside analog (Gemcitabine) in HNSCC. Our study unveiled a robust synergistic effect between Prexasertib and Gemcitabine, inducing substantial cell death in multiple HNSCC cell lines and mouse model. Remarkably, the combination rapidly induced DNA damage and reduced tumor growth in vivo. To unravel the underlying intrinsic signaling mechanism provoked by the Prexasertib/Gemcitabine combination, we conducted comprehensive molecular analyses. Proteomic profiling uncovered distinct alterations in key signaling pathways upon combination treatment. We identified unique overexpression of an embryonic stem cell-specific transcription factor pivotal in genomic stability regulation, solely induced by single-agent Prexasertib. Specifically, the combination therapy showcased unique modulation of critical genes involved in DNA repair, replication, and cell cycle regulation. These alterations included overexpression or suppression of key genes associated with DNA stability and cell proliferation pathways, accompanied by evidence of CHK1/2 inhibition-mediated DNA damage response accompanied by cleavage of CHK-2 and caspase-3 proteins, validated through Western blots. Additionally, functional assays including the colony formation assays demonstrated markedly reduced survival rates with the combination treatment compared to single-agent therapy. Cell cycle analysis revealed a replication catastrophe and increased pH2AX across multiple HNSCC cell lines following combination treatment. Our findings highlight the significance of CHK1/2 inhibition coupled with nucleoside analog-induced DNA damage in unveiling novel intrinsic signaling mechanisms in HNSCC. These insights offer a promising avenue for targeted therapeutic strategies to enhance treatment efficacy and outcomes in HNSCC. This work has been supported by the MGC, FC, P Part 1 (Regular Abstracts) ; 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84 (6Suppl): Abstract nr 3368.
Palve et al. (Fri,) studied this question.