Developing a Multimodal miR-15a Mimic to Overcome PARP Inhibitor Resistance in Epithelial Ovarian Cancer
Pal, A.; Ojha, A.; Bendale, H.; Chen, L.; Ojima, I.; Ju, J.
Show abstract
Epithelial ovarian cancer (EOC) is characterized by high relapse rates and the development of drug resistance, driven by adaptive DNA repair and survival pathways. Here, we develop a multimodal, chemically engineered miRNA therapeutic, MTX-5-FU-Gem-miR-15a, that integrates tumor-suppressive miR-15a activity with chemotherapeutic modifications and tumor-targeting capability. This modified miRNA exhibits potent nanomolar activity across diverse EOC models, including PARP inhibitor-resistant cells, without requiring delivery vehicles. Mechanistically, MTX-5-FU-Gem-miR-15a induces replication stress while suppressing G2/M checkpoint regulators (WEE1 and CHK1), resulting in genomic instability and apoptotic cell death. Transcriptomic and protein-level analyses revealed coordinated suppression of resistance-associated and oncogenic signaling pathways, alongside activation of DNA damage coupled with checkpoint abrogation and potential innate immune response. MTX-5-FU-Gem-miR-15a also demonstrates strong synergy with olaparib and robust antitumor efficacy in vivo. These findings establish a multimodal miRNA-based therapeutic strategy that targets replication stress and checkpoint dependency to overcome PARPi resistance in ovarian cancer.
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