A Tale of Two Checkpoints: ATR Inhibition and PD-(L)1 Blockade

Innate immunity and the DNA damage response (DDR) pathway are inextricably linked. Within the DDR, ataxia telangiectasia and Rad3-related (ATR) is a key kinase responsible for sensing replication stress and facilitating DNA repair through checkpoint activation, cell cycle arrest, and promotion of fo...

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Veröffentlicht in:Annual review of medicine 2022-01, Vol.73 (1), p.231-250
Hauptverfasser: Ngoi, Natalie Y.L, Peng, Guang, Yap, Timothy A
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creator Ngoi, Natalie Y.L
Peng, Guang
Yap, Timothy A
description Innate immunity and the DNA damage response (DDR) pathway are inextricably linked. Within the DDR, ataxia telangiectasia and Rad3-related (ATR) is a key kinase responsible for sensing replication stress and facilitating DNA repair through checkpoint activation, cell cycle arrest, and promotion of fork recovery. Recent studies have shed light on the immunomodulatory role of the ATR-CHK1 pathway in the tumor microenvironment and the specific effects of ATR inhibition in stimulating an innate immune response. With several potent and selective ATR inhibitors in developmental pipelines, the combination of dual ATR and PD-(L)1 blockade has attracted increasing interest in cancer therapy. In this review, we summarize the clinical and preclinical data supporting the combined inhibition of ATR and PD-(L)1, discuss the potential challenges surrounding this approach, and highlight biomarkers relevant for selected patients who are most likely to benefit from the blockade of these two checkpoints.
doi_str_mv 10.1146/annurev-med-042320-025136
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subjects Ataxia telangiectasia
ATR inhibitors
cancer therapy
Cell activation
Cell cycle
CHK1 protein
Deoxyribonucleic acid
DNA
DNA biosynthesis
DNA damage
DNA repair
drug development
immune checkpoint blockade
immune modulation
Immune response
Immunomodulation
Innate immunity
Tumor microenvironment
Tumors
title A Tale of Two Checkpoints: ATR Inhibition and PD-(L)1 Blockade
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