000294574 001__ 294574 000294574 005__ 20250316015552.0 000294574 0247_ $$2doi$$a10.1093/neuonc/noae228 000294574 0247_ $$2pmid$$apmid:39556024 000294574 0247_ $$2ISSN$$a1522-8517 000294574 0247_ $$2ISSN$$a1523-5866 000294574 0247_ $$2altmetric$$aaltmetric:172118384 000294574 037__ $$aDKFZ-2024-02349 000294574 041__ $$aEnglish 000294574 082__ $$a610 000294574 1001_ $$aLaemmerer, Anna$$b0 000294574 245__ $$aAlternative lengthening of telomere-based immortalization renders H3G34R -mutant diffuse hemispheric glioma hypersensitive to PARP inhibitor combination regimens. 000294574 260__ $$aOxford$$bOxford Univ. Press$$c2025 000294574 3367_ $$2DRIVER$$aarticle 000294574 3367_ $$2DataCite$$aOutput Types/Journal article 000294574 3367_ $$0PUB:(DE-HGF)16$$2PUB:(DE-HGF)$$aJournal Article$$bjournal$$mjournal$$s1741680683_17954 000294574 3367_ $$2BibTeX$$aARTICLE 000294574 3367_ $$2ORCID$$aJOURNAL_ARTICLE 000294574 3367_ $$00$$2EndNote$$aJournal Article 000294574 500__ $$a2025 Mar 7;27(3):811-827 000294574 520__ $$aDiffuse hemispheric glioma, H3G34R/V-mutant (DHG-H3G34) is characterized by poor prognosis and lack of effective treatment options. DHG-H3G34R further harbor deactivation of Alpha-Thalassemia/Mental Retardation Syndrome X-linked protein (ATRX; DHG-H3G34R_ATRX) suggesting a unique interaction of these two oncogenic alterations. In this study, we dissect their cell biological interplay, investigate the impact on telomere stabilization and, consequently, validate a targeted therapy approach.We characterized patient-derived primary pediatric high-grade glioma (pHGG) models for telomere-maintenance mechanisms, DNA damage stress (including protein expression, pH2AX/Rad51 foci, cell-cycle arrest) and their sensitivity towards poly-ADP polymerase inhibitor (PARPi) combinations. Human induced pluripotent stem cells (iPSCs) were used for modelling the disease. The anticancer activity of PARPi combinations in vivo was studied in Chorioallantoic Membrane (CAM) and orthotopic in vivo experiments. Finally, we treated a DHG-H3G34R_ATRX patient with a PARPi combination therapy.We elaborate that alternative lengthening of telomeres (ALT) is a key characteristic of DHG-H3G34R_ATRX. A dominant cooperative effect between H3G34R and ATRX loss in ALT activation also became apparent in iPSCs, which endogenously exert telomerase activity. In both, patient-derived DHG-H3G34R_ATRX models and H3G34R+/ATRX- iPSCs, the ALT phenotype was associated with increased basal DNA damage stress, mediating synergistic susceptibility towards PARPi (talazoparib, niraparib) combinations with topoisomerase-I inhibitors (topotecan, irinotecan). In a first-of-its-kind case, treatment of a DHG-H3G34R_ATRX patient with the brain-penetrant PARP inhibitor niraparib and topotecan resulted in a significant tumor reduction.Our preclinical and clinical data strongly support the further development of PARPis together with DNA damage stress-inducing treatment regimens for DHG-H3G34R_ATRX. 000294574 536__ $$0G:(DE-HGF)POF4-312$$a312 - Funktionelle und strukturelle Genomforschung (POF4-312)$$cPOF4-312$$fPOF IV$$x0 000294574 588__ $$aDataset connected to CrossRef, PubMed, , Journals: inrepo02.dkfz.de 000294574 650_7 $$2Other$$aATRX 000294574 650_7 $$2Other$$aDNA damage 000294574 650_7 $$2Other$$aDiffuse hemispheric glioma 000294574 650_7 $$2Other$$aH3G34R 000294574 650_7 $$2Other$$aPARP inhibitor 000294574 7001_ $$aLehmann, Christian$$b1 000294574 7001_ $$aMayr, Lisa$$b2 000294574 7001_ $$aBruckner, Katharina$$b3 000294574 7001_ $$aGabler, Lisa$$b4 000294574 7001_ $$aSenfter, Daniel$$b5 000294574 7001_ $$aMeyer, Philipp$$b6 000294574 7001_ $$aBalber, Theresa$$b7 000294574 7001_ $$aPirker, Christine$$b8 000294574 7001_ $$aJaunecker, Carola N$$b9 000294574 7001_ $$aKirchhofer, Dominik$$b10 000294574 7001_ $$aVician, Petra$$b11 000294574 7001_ $$aGriesser, Michelle$$b12 000294574 7001_ $$aSpiegl-Kreinecker, Sabine$$b13 000294574 7001_ $$aSchmook, Maria T$$b14 000294574 7001_ $$aTraub-Weidinger, Tatjana$$b15 000294574 7001_ $$aKuess, Peter$$b16 000294574 7001_ $$aEckert, Franziska$$b17 000294574 7001_ $$0P:(DE-He78)32c5110cd42ee8a96b18a3e8909bd0a9$$aFederico, Aniello$$b18$$udkfz 000294574 7001_ $$aMadlener, Sibylle$$b19 000294574 7001_ $$aStepien, Natalia$$b20 000294574 7001_ $$aRobl, Bernhard$$b21 000294574 7001_ $$aBaumgartner, Alicia$$b22 000294574 7001_ $$aHainfellner, Johannes A$$b23 000294574 7001_ $$aDieckmann, Karin$$b24 000294574 7001_ $$00000-0002-1843-7732$$aDorfer, Christian$$b25 000294574 7001_ $$aRoessler, Karl$$b26 000294574 7001_ $$aCorsini, Nina S$$b27 000294574 7001_ $$00000-0003-4077-3377$$aHolzmann, Klaus$$b28 000294574 7001_ $$aSchmidt, Wolfgang M$$b29 000294574 7001_ $$00000-0002-5736-8231$$aPeyrl, Andreas$$b30 000294574 7001_ $$00000-0002-1347-6644$$aAzizi, Amedeo A$$b31 000294574 7001_ $$00000-0003-1016-0545$$aHaberler, Christine$$b32 000294574 7001_ $$aBeck, Alexander$$b33 000294574 7001_ $$0P:(DE-He78)f746aa965c4e1af518b016de3aaff5d9$$aPfister, Stefan M$$b34$$udkfz 000294574 7001_ $$aSchueler, Julia$$b35 000294574 7001_ $$aLoetsch-Gojo, Daniela$$b36 000294574 7001_ $$aKnoblich, Jürgen A$$b37 000294574 7001_ $$aBerger, Walter$$b38 000294574 7001_ $$aGojo, Johannes$$b39 000294574 773__ $$0PERI:(DE-600)2094060-9$$a10.1093/neuonc/noae228$$gp. noae228$$n3$$p811-827$$tNeuro-Oncology$$v27$$x1522-8517$$y2025 000294574 909CO $$ooai:inrepo02.dkfz.de:294574$$pVDB 000294574 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-He78)32c5110cd42ee8a96b18a3e8909bd0a9$$aDeutsches Krebsforschungszentrum$$b18$$kDKFZ 000294574 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-He78)f746aa965c4e1af518b016de3aaff5d9$$aDeutsches Krebsforschungszentrum$$b34$$kDKFZ 000294574 9131_ $$0G:(DE-HGF)POF4-312$$1G:(DE-HGF)POF4-310$$2G:(DE-HGF)POF4-300$$3G:(DE-HGF)POF4$$4G:(DE-HGF)POF$$aDE-HGF$$bGesundheit$$lKrebsforschung$$vFunktionelle und strukturelle Genomforschung$$x0 000294574 9141_ $$y2024 000294574 915__ $$0StatID:(DE-HGF)0420$$2StatID$$aNationallizenz$$d2023-10-24$$wger 000294574 915__ $$0StatID:(DE-HGF)0100$$2StatID$$aJCR$$bNEURO-ONCOLOGY : 2022$$d2023-10-24 000294574 915__ $$0StatID:(DE-HGF)0200$$2StatID$$aDBCoverage$$bSCOPUS$$d2023-10-24 000294574 915__ $$0StatID:(DE-HGF)0300$$2StatID$$aDBCoverage$$bMedline$$d2023-10-24 000294574 915__ $$0StatID:(DE-HGF)0320$$2StatID$$aDBCoverage$$bPubMed Central$$d2023-10-24 000294574 915__ $$0StatID:(DE-HGF)0199$$2StatID$$aDBCoverage$$bClarivate Analytics Master Journal List$$d2023-10-24 000294574 915__ $$0StatID:(DE-HGF)0113$$2StatID$$aWoS$$bScience Citation Index Expanded$$d2023-10-24 000294574 915__ $$0StatID:(DE-HGF)0150$$2StatID$$aDBCoverage$$bWeb of Science Core Collection$$d2023-10-24 000294574 915__ $$0StatID:(DE-HGF)0160$$2StatID$$aDBCoverage$$bEssential Science Indicators$$d2023-10-24 000294574 915__ $$0StatID:(DE-HGF)1110$$2StatID$$aDBCoverage$$bCurrent Contents - Clinical Medicine$$d2023-10-24 000294574 915__ $$0StatID:(DE-HGF)9915$$2StatID$$aIF >= 15$$bNEURO-ONCOLOGY : 2022$$d2023-10-24 000294574 9201_ $$0I:(DE-He78)B062-20160331$$kB062$$lB062 Pädiatrische Neuroonkologie$$x0 000294574 9201_ $$0I:(DE-He78)HD01-20160331$$kHD01$$lDKTK HD zentral$$x1 000294574 980__ $$ajournal 000294574 980__ $$aVDB 000294574 980__ $$aI:(DE-He78)B062-20160331 000294574 980__ $$aI:(DE-He78)HD01-20160331 000294574 980__ $$aUNRESTRICTED