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Synthetic lethality defines an association of two genes, where loss of one gene does not affect viability, but loss of both genes leads to cell death. It was first described in 1946 by Dobzhansky while analyzing various phenotypes of drosophila by breeding homozygous mutants1. Mutants that did not produce viable offspring, although viable themselves, exhibited lethal phenotypes when crossed with certain other mutants, setting ground for the establishment of the theory of synthetic lethality. Hartwell and colleagues suggested that this concept might be applicable for cancer therapy in humans2. Pharmacologically provoked synthetic lethality could rely on just one mutation, given that the mutated gene’s synthetic lethal partner is targetable by a pharmacological compound. The first gene pair to enable pharmacological induction of synthetic lethality was BRCA(1/2) and PARP1. PARP1 functions as a sensor for DNA damage, and is tied to sites of double and single DNA strand-breaks, supercoils and crossovers3. BRCA1 and 2 play major roles in repair of DNA double-strand breaks through homologous recombination4. Farmer and colleagues published findings that cells deficient for BRCA1/2 were susceptible to PARP inhibition, while no cytotoxicity was observed in BRCA wild-type cells5. Ultimately, PARP inhibitors were approved for the treatment of BRCA deficient breast and ovarian cancer6,7. Further, synthetic lethality gene pairs leading to clinical approval of pharmacological compounds are much anticipated and a major area of recent cancer research efforts8.
Synthetic lethal gene interactions were modelled in multiple organisms including fruit flies, C. elegans and yeast2. Using various approaches including RNA-interference- and CRISPR/CAS-library knockouts, novel synthetic lethal gene pairs were discovered in recent years9,10,11. A protocol on the experimental procedures of RNAi in combination with CRISPR/CAS was recently published by Housden and colleagues12. Meanwhile, researchers also conducted large screens in haploid human cells to identify synthetic lethal interactions13,14. In silico methods like biological network analysis and machine learning have also shown promise in the discovery of synthetic lethal interactions15,16.
Conceptionally, one approach to make use of synthetic lethal interactions in the context of anti-tumor therapy is to identify mutated or non-functional proteins in tumor cells, making their synthetic lethal interaction partners promising drug targets for therapeutic intervention. Due to the heterogeneity of most tumor types, researchers have started the search for so-called synthetic lethal hub proteins. These synthetic lethal hubs have a number of synthetic lethal interaction partners that are either mutated and therefore non-functional or significantly downregulated in tumor samples. Addressing such synthetic lethal hubs holds promise in increasing drug efficacy or overcoming drug resistance as could be shown for instance in the context of vincristine resistant neuroblastoma17. A second approach to enhance drug treatment making use of the concept of synthetic lethal interactions is to identify drug combinations targeting synthetic lethal interactions. This could lead to new combinations of already approved single anti-tumor therapies and to the repositioning of drugs from other disease areas to the field of oncology.
In this article, we present a step-by-step procedure to yield a list of drug combinations that target synthetic lethal interaction pairs. In this workflow, we (i) use data on synthetic lethal interactions from BioGRID and (ii) information on homologous genes from Ensembl, (iii) retrieve drug-target pairs from DrugBank, (iv) build disease-drug associations from ClinicalTrials.gov, and (v) hence generate a set of drug combinations addressing synthetic lethal interactions. Lastly, we provide drug combinations in the context of ovarian and breast cancer in the representative results section.