RT Journal Article SR Electronic T1 WRN Helicase is a Synthetic Lethal Target in Microsatellite Unstable Cancers JF bioRxiv FD Cold Spring Harbor Laboratory SP 502070 DO 10.1101/502070 A1 Edmond M. Chan A1 Tsukasa Shibue A1 James McFarland A1 Benjamin Gaeta A1 Justine S. McPartlan A1 Mahmoud Ghandi A1 Jie Bin Liu A1 Jean-Bernard Lazaro A1 Nancy Dumont A1 Alfredo Gonzalez A1 Annie Apffel A1 Syed O. Ali A1 Lisa Leung A1 Emma A. Roberts A1 Elizaveta Reznichenko A1 Mirazul Islam A1 Maria Alimova A1 Monica Schenone A1 Yosef Maruvka A1 Yang Liu A1 Alan D’Andrea A1 David E. Root A1 Jesse S. Boehm A1 Gad Getz A1 Todd R. Golub A1 Aviad Tsherniak A1 Francisca Vazquez A1 Adam J. Bass YR 2018 UL http://biorxiv.org/content/early/2018/12/20/502070.abstract AB Synthetic lethality, an interaction whereby the co-occurrence of two or more genetic events lead to cell death but one event alone does not, can be exploited to develop novel cancer therapeutics1. DNA repair processes represent attractive synthetic lethal targets since many cancers exhibit an impaired DNA repair pathway, which can lead these cells to become dependent on specific repair proteins2. The success of poly (ADP-ribose) polymerase 1 (PARP-1) inhibitors in homologous recombination-deficient cancers highlights the potential of this approach in clinical oncology3,4. Hypothesizing that other DNA repair defects would give rise to alternative synthetic lethal relationships, we asked if there are specific dependencies in cancers with microsatellite instability (MSI), which results from impaired DNA mismatch repair (MMR). Here we analyzed data from large-scale CRISPR/Cas9 knockout and RNA interference (RNAi) silencing screens and found that the RecQ DNA helicase WRN was selectively essential in MSI cell lines, yet dispensable in microsatellite stable (MSS) cell lines. WRN depletion induced double-strand DNA breaks and promoted apoptosis and cell cycle arrest selectively in MSI models. MSI cancer models specifically required the helicase activity, but not the exonuclease activity of WRN. These findings expose WRN as a synthetic lethal vulnerability and promising drug target in MSI cancers.