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Uncoupling DNA damage from chromatin damage to detoxify doxorubicin

2020; National Academy of Sciences; Volume: 117; Issue: 26 Linguagem: Inglês

10.1073/pnas.1922072117

1091-6490

Xiaohang Qiao, Sabina Y. van der Zanden, Dennis P. A. Wander, Daniel Borràs, Ji‐Ying Song, Xiaoyang Li, Suzanne van Duikeren, Noortje van Gils, Arjo Rutten, Tessa van Herwaarden, Olaf van Tellingen, Elisa Giacomelli, Milena Bellin, Valeria V. Orlova, Leon G.J. Tertoolen, Sophie Gerhardt, Jimmy J.L.L. Akkermans, Jeroen M. Bakker, Charlotte L. Zuur, Baoxu Pang, Anke M. Smits, Christine L. Mummery, Linda Smit, Ramon Arens, Junmin Li, Herman S. Overkleeft, Jacques Neefjes,

Cancer Treatment and Pharmacology

Significance Anthracyclines like doxorubicin are anticancer drugs, used by over 1 million cancer patients annually. However, they cause severe side effects, most notably, cardiotoxicity and therapy-related malignancies. It is unclear whether these side effects are directly linked to their anticancer activity. Doxorubicin exerts two activities: DNA damage and chromatin damage. Here, we show that both activities conspire in the cardiotoxicity, while doxorubicin variants with only chromatin-damaging activity remain active anticancer drugs devoid of side effects. This challenges the concept that doxorubicin works primarily by inducing DNA double-strand breaks and reveals another major anticancer activity, chromatin damage. Translating these observations will yield anticancer drugs for patients that are currently excluded from doxorubicin treatment and improve the quality of life of cancer survivors.