L-asparaginase treatment induces a tumor metabolic plasticity and reveals a vulnerability to PARP1/2 inhibitor Olaparib, in B-cell lymphomas.

Abstract

Intrinsic mechanisms driving secondary resistance to L-asparaginase (ASNase) treatment remain poorly understood. Using a preclinical model of B-cell lymphomas (BCL), sensitive to ASNase, we observed tumor relapse during ASNase treatment despite an initial antineoplastic response. Through in vivo metabolic profiling of BCL and stable isotope resolved metabolomics in vitro and in vivo, we show that ASNase induces a flexible metabolic reprogramming marked by increased de novo serine biosynthesis. This adaptive response is driven in part by phosphoglycerate dehydrogenase (PHGDH), which mitigates ASNase-induced reactive oxygen species (ROS) and ROS-mediated DNA damage, enabling tumor cell survival under therapeutic pressure. ASNase-treated malignant B cells exhibit features of replication stress, with activation of the ATR-dependent DNA damage response and increased poly(ADP-ribose) polymerase 1/2 (PARP) activity. Targeting initiation of DNA repair mechanism using the PARP inhibitor Olaparib, enhances the antineoplastic effect of each individual mono-chemotherapy, both in vitro and in vivo. Importantly, we showed that this therapeutic combination was also effective in homologous recombination (HR)-proficient colorectal cancer cells, supporting its broader therapeutic relevance beyond lymphoid malignancies. Altogether, our findings reveal redox- and DNA repair-dependent metabolic vulnerabilities in ASNase-treated B-cell lymphomas and provide proof-of-concept for a rational combination therapy using clinically approved agents, ASNase and Olaparib.