Acquisition of taxane resistance by p53 inactivation in ovarian cancer cells

Changfa Shu1,2, Xi Zheng1,3, Alafate Wuhafu1,4, Danielle Cicka1, Sean Doyle1, Qiankun Niu1, Dacheng Fan1, Kun Qian1, Andrey A. Ivanov1,5, Yuhong Du1,5, Xiulei Mo1, Haian Fu1,5,6
1 Department of Pharmacology and Chemical Biology, Emory University School of Medicine, Atlanta, GA 30322, USA
2 Department of Gynecology and Obstetrics, The Third Xiangya Hospital of Central South University, Changsha 410013, China
3 Cancer Institute, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
4 The First Affiliated Hospital, Medical School of Xi’an Jiaotong University, Xi’an 710061, China
5 Emory Chemical Biology Discovery Center, Emory University School of Medicine, Atlanta, GA 30322, USA
6 Department of Hematology and Medical Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA
Correspondence to: Haian Fu:,
DOI: 10.1038/s41401-021-00847-6
Received: 7 September 2021
Accepted: 20 December 2021
Advance online: 14 January 2022


Ovarian cancer is one of the most common gynecologic malignancies in women and has a poor prognosis. Taxanes are a class of standard first-line chemotherapeutic agents for the treatment of ovarian cancer. However, tumor-intrinsic and acquired resistance to taxanes poses major challenges to improving clinical outcomes. Hence, there is an urgent clinical need to understand the mechanisms of resistance in order to discover potential biomarkers and therapeutic strategies to increase taxane sensitivity in ovarian cancer. Here, we report the identification of an association between the TP53 status and taxane sensitivity in ovarian cancer cells through complementary experimental and informatics approaches. We found that TP53 inactivation is associated with taxane resistance in ovarian cancer cells, supported by the evidence from (i) drug sensitivity profiling with bioinformatic analysis of large- scale cancer therapeutic response and genomic datasets and (ii) gene signature identification based on experimental isogenic cell line models. Further, our studies revealed TP53-dependent gene expression patterns, such as overexpression of ACSM3, as potential predictive biomarkers of taxane resistance in ovarian cancer. The TP53-dependent hyperactivation of the WNT/β-catenin pathway discovered herein revealed a potential vulnerability to exploit in developing combination therapeutic strategies. Identification of this genotype-phenotype relationship between the TP53 status and taxane sensitivity sheds light on TP53-directed patient stratification and therapeutic discoveries for ovarian cancer treatment.
Keywords: Paclitaxel; Docetaxel; Ovarian cancer; TP53; ACSM3; WNT signaling

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