# Project 3: Credentialing CDK 4/6 inhibitors used with radiation as an effective treatment strategy in locally advanced ER+ and TNBC

> **NIH NIH P50** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2024 · $250,596

## Abstract

PROJECT SUMMARY/ABSTRACT
Radiation (RT) therapy remains a mainstay in the treatment of women with breast cancer (BC), but locoregional
disease recurrence remains a significant clinical issue that compromises survival, with locoregional recurrence
rates ~20-25% at 10 years in women with >3 lymph nodes (LNs) ER+ BC or TNBC. As over 280,000 women are
diagnosed with breast cancer in the US each year and 37% have N+ breast cancer at diagnosis, this population
includes >100,000 women in the US each year who have either >3 LN or have TNBC each year. A 25% risk of
recurrence in this number of potentially curable women represents a greater mortality risk than many other
cancers and underscores the potential impact of these studies. Evaluation of clinical agents that function as
radiosensitizers is an area of active yet understudied interest. Cyclin-dependent kinase 4 and 6 inhibitors (CDK
4/6i) are used as frontline therapy to treat women with metastatic estrogen receptor positive (ER+) breast
cancers and ongoing studies continue to refine their utility in the upfront, non-metastatic setting for women with
high-risk ER+ breast cancers. Despite these promising studies, CDK4/6 inhibitors are not yet given in
combination with the radiation therapy that patients receive as part of the standard of care, and there currently
is no indication for women with triple-negative breast cancer (TNBC) which disproportionately affects African
American women.
We previously showed that CDK4/6 inhibition leads to the radiosensitization of multiple Rb-intact ER+ breast
cancer cell lines as well as TNBC models. This radiosensitization occurs to a similar degree with palbociclib,
ribociclib, and abemaciclib, the three clinically approved CDK4/6 inhibitors. Our data suggests a novel
association between CDK 4/6 inhibition and the DNA damage response. Indeed, we have demonstrated that
short term CDK4/6 inhibition leads to a decrease in expression of DNA repair proteins like CHK1 and RAD51
that play a role in homologous recombination and leads to radiosensitization in ER+ breast cancer models. This
has not, however, ever been demonstrated in TNBC. Although we have demonstrated that all three CDK4/6
inhibitors lead to the radiosensitization of ER+, the mechanism of this radiosensitization remains unclear as does
the utility of this approach in women with TNBC. We hypothesize that women with locally advanced multiple
node positive Rb intact breast cancer (including most ER+ and up to 70% of TNBC) will benefit from combination
treatment with CDK4/6 inhibitor with radiation. Furthermore, we hypothesize that the combination of CDK 4/6i
with RT is safe, tolerable, and effective in women at high risk of local recurrence of BC.
In this proposal, we will 1) determine the mechanism of CDK4/6 inhibitor-mediated radiosensitization in ER+ and
TNBC models; 2) determine the sequencing and efficacy of CDK4/6 inhibitor-mediated radiosensitization in in
vivo models of ER+ and TNBC and 3) determine t...

## Key facts

- **NIH application ID:** 10917032
- **Project number:** 5P50CA269022-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Corey W. Speers
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $250,596
- **Award type:** 5
- **Project period:** 2023-08-14 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10917032

## Citation

> US National Institutes of Health, RePORTER application 10917032, Project 3: Credentialing CDK 4/6 inhibitors used with radiation as an effective treatment strategy in locally advanced ER+ and TNBC (5P50CA269022-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10917032. Licensed CC0.

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