PROJECT SUMMARY
Whole-genome duplication (WGD) is increasingly appreciated as a defining moment for enabling chromosome
instability in solid tumors. This proposal investigates chemotherapy-induced WGD that promotes the formation
of polyploid cancer cells that appear senescent but in the absence of functional p53 are able to escape the
senescent state and generate heterogenous daughter cells. The focus on high-grade serous ovarian carcinoma
(HGSOC) derives from the urgent clinical need to improve therapy outcomes and the fact that p53 mutations are
the most prevalent genetic abnormality (≥90%) associated with aneuploidy in this malignancy. Polyploid cancer
cells exhibit a high level of plasticity and are thought to be a driving force in repopulating a tumor with highly
aggressive, therapy-resistant, metastasis-prone progeny. Currently, there is a gap in knowledge that connects
clinical descriptions of polyploid cells in tumor specimen with laboratory observations on the formation of
polyploid cancer cells. We hypothesize to close this gap through a CRISPR-Cas9 screen to identify genes that
are functionally necessary for formation of polyploid cancer cells and their daughter cells. We further hypothesize
that polyploid cancer cells in clinical specimen can be identified by their large polynuclear morphology and one
or more putative markers (cytoplasmic p21, acid ceramidase, VEGF-R2) resulting from an unbiased RNAseq
analysis. Our specific aims are to (1) Define essential genes for the polyploid lifecycle critical transition stages
and (2) to determine expression of putative markers of polyploid cancer cells in archived HGSOC samples. The
proposed studies will serve as the foundation for future larger mechanistic, drug development, or prognostic
studies with the potential to improve outcomes in ovarian cancer patients. An immediate impact will include
prioritizing patients for the angiogenesis inhibitor Bevacizumab, a common HGSOC option, which may work
better in VEGF-R2 expressing PGCC tumors. Of particular interest will also be therapeutic targeting of the
polyploid population through re-purposing of existing drugs that would be combined with neo-adjuvant
chemotherapy or used as a maintenance strategy following surgical debulking. Results obtained in HGSOC likely
have broader relevance, since polyploid cells are observed in many other solid malignancies.