Evidence map›Paper›PMID 41520142›Full record

ArticleNeuro-oncology2026

SMARCAL1 is a targetable synthetic lethal therapeutic vulnerability in ATRX-deficient gliomas that use alternative lengthening of telomeres.

Alexandrea Brown, Laura M Strickland, Elise N Erman, Christopher J Pirozzi, Justin T Low, Bill H Diplas, Emiley Gibson, Mariah Shobande, Taher Khambati, Marharyta Krylova and 7 more

Abstract read
In one paragraph

Article in Neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Alexandrea BrownThe Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham.
Laura M StricklandThe Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham.
Elise N ErmanThe Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham.
Christopher J PirozziThe Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham.
Justin T LowThe Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham.ORCID 0000-0002-6473-3559
Bill H DiplasThe Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham.
Emiley GibsonThe Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham.
Mariah ShobandeDepartment of Neurosurgery, Duke University Medical Center, Durham.
Taher KhambatiThe Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham.
Marharyta KrylovaThe Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham.
Heng LiuDepartment of Pathology, Duke University Medical Center, Durham.
Roger E McLendonThe Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham.
Zachary J ReitmanThe Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham.ORCID 0000-0002-9122-9550
Stephen T KeirThe Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham.
Lee ZouDepartment of Pharmacology and Cancer Biology, Duke University Medical Center, Durham.
David M AshleyThe Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham.
Matthew S WaitkusThe Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham.ORCID 0000-0002-7116-6978

Funding

Women's Cancer Research ProgramP30CA014236 · NCI · DUKE UNIVERSITY · PI Laura Fish · 1985 to 2026
$174.8M
Targeted Alpha-Particle Radiotheraphy of Brain Tumors with 211At-81C6 AntibodyP50CA190991 · NCI · DUKE UNIVERSITY · PI ALI-OSMAN, FRANCIS, ASHLEY, DAVID M. · 2014 to 2023
$20.8M
TEMODAR RESISTANCE IN CENTRAL NERVOUS SYSTEMP50CA108786 · NCI · DUKE UNIVERSITY · PI BIGNER, DARELL D · 2004 to 2009
$12.3M
Medical Scientist Training Program Training GrantT32GM145449 · NIGMS · DUKE UNIVERSITY · PI Christopher D Kontos · 2022 to 2026
$6.6M
DNA Methylation and GSTP1 Gene Regulation in GliomasR01CA091438 · NCI · UNIVERSITY OF TEXAS MD ANDERSON CAN CTR · PI ALI-OSMAN, FRANCIS · 2002 to 2007
$1.7M
The role of SMARCAL1 in glioma telomere maintenance.K22CA258965 · NCI · DUKE UNIVERSITY · PI WAITKUS, MATTHEW · 2022 to 2024
$454k
The Role of SMARCAL1 Depletion on Increased Immunogenicity in ALT+ GliomasF32CA298007 · NCI · DUKE UNIVERSITY · PI Elise Erman · 2025 to 2026
$155k
Duke Brain Tumor SPORE 5P50CA190991NCI NIH HHS F32 CA298007NCI NIH HHS K22 CA258965NCI NIH HHS P30 CA014236NCI NIH HHS P50 CA108786NCI NIH HHS P50 CA190991NCI NIH HHS R01 CA091438NIGMS NIH HHS T32 GM145449NIH HHS 1F32CA298007-01NIH HHS 1K22CA258965-01A1The Preston Robert Tisch Brain Tumor CenterUncle Kory Foundation Seed
6 · The paper itself

Abstract

backgroundApproximately 10% of cancers achieve replicative immortality through a telomerase-independent mechanism of telomere maintenance, termed Alternative Lengthening of Telomeres (ALT). ALT is particularly prevalent in certain subtypes of malignant gliomas, such as IDH-mutant astrocytoma and pediatric glioblastoma, and frequently co-occurs with ATRX (ATRX chromatin remodeler) inactivating mutations. Although ALT is an adaptive mechanism through which cancer cells achieve proliferative immortality, the elevated levels of replication stress observed in ALT tumors constitute a potential therapeutic vulnerability.

methodsLeveraging CRISPR/Cas9 screening data from the Cancer Dependency Mapping Project, coupled with patient-derived cell lines and xenografts, we identified SMARCAL1 as a novel synthetic lethal vulnerability in ATRX-deficient glioma models that engage ALT. Using complementary molecular assays for DNA damage, telomere maintenance, and telomeric replication stress, we define the mechanisms underlying cytotoxicity induced by SMARCAL1 depletion in ALT-positive glioma cells.

resultsOur data demonstrate the annealing helicase SMARCAL1 is a highly specific synthetical lethal vulnerability in cancers that use ALT. SMARCAL1 localizes to ALT-associated PML (Promyelocytic leukemia protein) bodies in ALT-positive glioma cell lines, including IDH-mutant astrocytomas. SMARCAL1 depletion, via doxycycline-induced RNAi, led to a hyperactivation of the ALT phenotype, high levels of DNA double-strand breaks in G2 phase, and cell death via mitotic catastrophe. In mice bearing intracranial xenografts derived from high-grade IDH-mutant astrocytoma, inducible SMARCAL1 depletion prolonged animal survival.

conclusionsOur findings demonstrate that the molecular processes orchestrating ALT-mediated telomere maintenance constitute a targetable synthetic lethal vulnerability that can be exploited by SMARCAL1 inhibition, thus supporting the future development of small molecule inhibitors of SMARCAL1 as anti-cancer therapeutics.

Indexed as

Brain NeoplasmsDNA HelicasesGliomaSynthetic Lethal MutationsTelomere HomeostasisX-linked Nuclear ProteinAnimalsHumansMiceTelomereXenograft Model Antitumor AssaysATRX protein, humanDNA HelicasesSMARCAL1 protein, humanX-linked Nuclear ProteinALTIDH-mutant astrocytomareplication stresssynthetic lethalitytelomeres

Identifiers

PMID41520142
PMCPMC13003928

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.