Sequential therapeutic targeting of ovarian Cancer harboring dysfunctional BRCA1

SKOV3 (#HTB-77), UWB1.289 (#CRL-2945), SNU-251 (#CVCL-5040) and OVCAR8 (#CVCL-1629) were purchased from ATCC. UWB1.289-BRCA1 (#CRL-2946) was provided by Dr. Ramandeep (University of Detroit) [29]. A2780PAR (parental) and A2780CR (cisplatin resistant) cells were provided by Dr. Seftor (Northwestern University, Chicago, purchased from the European collection of cell cultures, ECACC via Sigma). All the cells lines were authenticated by short tandem repeat (STR) profiling by the DNA sequencing and analysis core of the University of Colorado which has extensive experience in evaluation of gynecological cell lines [30]. All cell lines were frequently tested for mycoplasma infection using MycoAlert Detection Kit (Lonza #LT07–710).

SKOV3, A2780PAR and A2780CR contain wild-type BRCA1 genes, while OVCAR8 contains methylated BRCA1 genes. UWB1.289-BRCA1 is homozygous for the 2594delC BRCA1 mutation and SNU-251 is homozygous for the 5564G > A BRCA1 mutation. SKOV3 and OVCAR8 cells were cultured in RPMI-1640 supplemented with 10% fetal bovine serum (FBS), 2 mM glutamine, and1% Penicillin/Streptomycin. UWB1.289 and UWB1.289-BRCA1 cells were cultured in 50% MEGM medium (supplemented with hEGF, BPE, insulin, hydrocortisone), 50% RPMI-1640 (supplemented with 10% FBS, 2 mM glutamine) and 1% Penicillin/Streptomycin. SNU-251 cells were cultured in DMEM supplemented with 10% FBS, and 1% Penicillin/Streptomycin. A2780PAR and A2780CR were cultured in RPMI-1640 medium supplemented with 10% FBS, 1% HEPES and 1% Penicillin/Streptomycin. Each cell line was passaged every 4 to 6 days depending on its growth. All cells were maintained at 37 °C in a 5% CO2, 95% atmosphere incubator. All assays were performed in their respective medium.

Olaparib (AZD2281 #A10111), rucaparib (AG014699 #A10045) and niraparib (MK4827 #A11026) were purchased from AdooQ Bioscience. The drugs were diluted in DMSO (10 mM stocks) and stored at − 20 °C. To avoid drug degradation, new aliquots were prepared directly from stocks every 5–10 uses. The concentration used in the present study ranged between 0.01–10 μM for all PARPi which are considered to be at the lower range of that used in the clinical trials based on blood plasma concentrations. Cisplatin was ordered from the Jewish General Hospital Satellite Pharmacy.

SKOV3, SNU-251 and OVCAR8 cells were used to generate stable cell lines for experiments with knockdown or restored BRCA1. Cells were seeded in 6 well flat bottom cell culture plates. Lipofectamine (Invitrogen, Burlington, Ontario, Canada) (1:1) was mixed with control shRNA, BRCAshRNA, pcDNA3 and pcDNA3-BRCA1 separately with their respective media with no FBS. Following 30 min of incubation at room temperature, both control and plasmids were added to their respective wells. The cells were incubated at 37 °C for 5 h. Pools of stable transfected cells were selected using 2 mg/ml puromycin for up to a week, as previously described [31].

Cells were lysed using RIPA buffer (25 mM Tris.HCl, pH 7.6, 150 mM NaCl, 1% NP-40.0.25% sodium deoxycholate 0.1% SDS) supplemented with protease and phosphate inhibitor (PhosphoSTOP, Roche Diagnostics, Mannheim, Germany). Total Protein concentration was determined using a BCA assay kit (Ref 23,227, Pierce Thermo-Scientific, Rockford, IL, USA) and a spectrophotometer at 570 nm. Proteins were run on SDS-PAGE and transferred to nitrocellulose membrane for western blot analysis, using the appropriate antibodies. Primary antibodies: BRCA1 antibody (#9010 Cell Signaling), PARP1 (#9542 Cell Signaling), MDR1 (#12683 Cell Signaling), Bad Ser473 (#9271S Cell Signaling), Cleaved Caspase 3 (#9661 Cell Signaling), Bcl2 (#2876 Cell Signaling), p-Bad (#06–853 upstate Cell signaling), p-Bcl-2 (# 2875 Cell signaling) and β-actin (#4967 Cell Signaling). Secondary antibodies: anti-rabbit-HRP (L170–6515 Bio-Rad), anti-mouse HRP (L170–6516 Bio-Rad). Immunoblot proteins were visualized using horseradish peroxidase (HRP) conjugated secondary antibodies, and antigen-antibody complexes were detected using the ECL system.

Cell survival was assessed by clonogenic assays. 800–1000 cells were seeded into 6-well plates and grown in culture media with Cisplatin and/or PARPi (olaparib, rucaparib and niraparib). DMSO was used as a control. After treatments cells were washed, trypsinized, counted and plated in 60 mm dishes in triplicate and incubated for 7–14 days. Colonies were stained with 6.0% glutaraldehyde and 0.5% crystal violet and counted. Each experiment was repeated five times. Cell colonies were counted by using a Gel Count (Oxford optronix, UK). The surviving fraction (SF) of cells was calculated as follows: number of colonies formed after treatment/number of cells seeded x plating efficacy. The plating efficacy was calculated as follows: number of colonies formed in control/number of cell seeded. Drug interaction was assessed using the multiple drug effects analysis method of Chou and Talalay [32]. This method quantitatively describes the interaction between two drugs or a combination of two drugs together, with values of less than 1 indicating synergistic interactions, value greater than 1 indicating antagonistic interactions, and the values equal to 1 additive interactions. Calculations of the combination index were performed with CompuSyn Software (ComboSyn, Inc., Paramus, NJ. 07652 USA).

For annexin V/PI assay, cells were stained with annexin V and PI (propidium iodide), and evaluated for apoptosis and necrosis by flow cytometry, according to the manufacturer’s protocol (eBioscience™ Annexin V Apoptosis Detection Kit eFluor™ 450). Treated cells were collected using trypsin, collected by centrifugation, washed twice with PBS and stained with 5 μL of annexin V in 250 μL binding buffer for 10 min at room temperature. Cells were again washed with PBS, re-suspended in 250 μL binding buffer and stained with 10 μL of PI. Apoptotic cells were determined using the FACSFortessa (BD BioSciences, CA) [33].

Cell cycle analysis was performed by PI staining for DNA content and flow cytometric analysis. Briefly, after treatment, adherent cells were collected using trypsin-EDTA by centrifugation at 10000 rpm for 5 min, and washed twice with ice cold PBS. During the last spin, 5ul PI was added for every ml of hypotonic buffer (0.1% Sodium Citrate, 0.1% Triton X-100), and incubated on ice in the dark (at least 20 min). Stained cells were analyzed (at least 20,000 events per sample) with a FACSFortessa flow cytometer (BD BioSciences, CA).

BRCA1 protein expression was observed in SKOV3, A2780PAR and A2780CR cells as compared to UWB1.289, SNU-251 and OVCAR8 cells showed no expression. Furthermore, stable SKOV3-shBRCA1 knockdown was developed, and 70–80% down regulation of BRCA was observed (Fig. 1a). In addition, after stable restoration of BRCA1 in mutated and methylated cells BRCA1 protein expression was increased (Fig. 1a).

Moreover, we have evaluated the PARP1 protein expression levels in these OC cell lines and we have found different expression levels in the cell lines. Interestingly chemo-treated A2780CR as compared to chemo-naive A2780PAR have showed low expression of PARP1 (Fig. 1b), similarly as described by our group [28].

Furthermore, BRCA1-mutated and methylated cells expressed reduced levels of RAD51 as compared with BRCA1 wild-type, suggesting a deficiency in HR function and also corroborated with previous results [34]. Finally, multidrug resistance protein (MDR1), involved in drug resistance, was also evaluated. The development of MDR1 could lead to a treatment failure in patients with ovarian cancer, and this severely limits the ultimate success of chemotherapy in the clinic in patients [35]. We have found that chemo naive cells have showed low levels of MDR1 as compared to chemo-treated (Fig. 1b).

Cell lines with different HR status were exposed to different doses of PARPi (0.5 μM to 4 μM). OC cells with BRCA1-mutated and HR-deficient genes display higher sensitivity to PARPi compared to cells with wild-type, methylated or restored BRCA1 (Fig. 2). In contrast, OC cells that harbour a functional HR needed to be expossed to higher doses of olaparib (Fig. 2a), rucaparib (Fig. 2b) and niraparib (Fig. 2c) to achieve growth inhibition (Additional file 1: Table S1). Altogether, these results confirmed that OC cells with mutated BRCA1 and deficient HR-related genes are more sensitive to PARPi similarly to other studies [36, 37].

Currently, olaparib is used as a maintenance therapy in patients after response to cisplatin therapy [38]. We evaluated whether olaparib prior to chemotherapy might be more effective treatment. SKOV3, SKOV3-shBRCA1, SNU-251 and SNU-251-BRCA1 cells were plated for clonogenic assays and cell colonies were counted to determine cell growth. Cells were treated with increasing concentrations of olaparib follow by cisplatin (2μg) or increasing dose of cisplatin follows by olaparib (0.1 μM and 0.5 μM).

Cells pre-treated with olaparib or rucaparib followed by cisplatin had significantly decreased cell growth compared to the inverse sequence (Fig. 3a and b, Additional file 2: Figure S2). To further determine the nature of the interaction we used the multiple drug effects analysis method by Chou and Talalay. In both cell lines the combination of olaparib followed cisplatin was synergistic, with a CI between 0.1–0.6. In contrast, cells pre-treated with cisplatin followed by olaparib display additive effect (CI > 1) (Fig. 3c, d). Similar results were observed in UWB1.289, UWB1.289-BRCA1, OVCAR8, OVCAR8-BRCA1, A2780PAR and A2780CR (Additional file 3: Figure S1).

We further investigated the effect of these sequence treatments on regulating apoptosis and cell cycle. First, we studied the effects of these treatments by quantifying the apoptotic cells using Annexin V/PI double staining assay (Fig. 4a). As presented in Fig. 4a, b and c, we found that olaparib or cisplatin monotherapy induced cell death in ~ 23–30% of SKOV3 cells, and ~ 30–40% of SNU-251 cells in comparison with control cells. Pre-treatment with cisplatin followed by olaparib induced cell death up to ~ 35% in SKOV3 and ~ 42% in SNU-251 cells. On the other hand, pre-treatment with olaparib followed by cisplatin increased cell death to ~ 52% (p = 0.02) of SKOV3 cells and ~ 70% (p = 0.002) of SNU-251 cells (Fig. 4b and c). Moreover, these results were similar in A2780 PAR, A2780CR, OVCAR8 and UWB1.289 cell lines (data not shown). Furthermore, we evaluated the pro-survival proteins Bcl2, p-Bcl2 and Bcl-XL. Our results showed that these proteins were all significantly down regulated in SKOV3 and SNU-251 cells, while pro-apoptotic proteins Bad, p-Bad and cleaved caspase-3 were up regulated, and this was more pronounced in cells after pre-treatment with olaparib (Fig. 4d).

Next, we analyzed the effect of these treatment combinations on cell cycle progression. Olaparib pre-treatment followed by cisplatin resulted in G2/M arrest in up to ~ 60% (p < 0.01) of SKOV3 and ~ 73% (p < 0.001) of SNU-251 cells (Fig. 5a-c) compared to ~ 25–40% using the inverse sequence. Moreover, the arrest at this phase was also confirmed by evaluating cyclins (Fig. 5d). While we did not observe any change in cyclin D1, a significant increase in cyclin A and cyclin B was observed after olaparib pre-treatment in SKOV3 and SNU-251 cells, consistent with the G2/M arrest observed in the cell cycle analysis. Taken together these results highlight the increased inhibitory effect of olaparib pre-treatment followed by Cisplatin in cell proliferation and cell growth, correlated to cell cycle arrest and induction of apoptosis.