Senescence Is the Main Trait Induced by Temozolomide in Glioblastoma Cells

Simple Summary Temozolomide (TMZ) is the first-line drug in the treatment of glioblastoma. Due to the formation of the DNA damage O-6-methylguanine, it is toxic to cancer cells, resulting in the induction of apoptosis. However, the damage also induces cellular senescence. Here, we show that not apoptosis, but cellular senescence is the main response triggered by TMZ-induced DNA damage. We analyzed the senescent cells in detail and show that they are characterized by a high level of non-repaired DNA double-strand breaks that trigger the DNA damage response. The primary damage, O-6-methylguanine, is the upstream trigger, but it is not required for maintaining the senescent state. Cells which acquired temozolomide resistance also became resistant to the induction of senescence. Comparing specimens from primary and recurrent glioblastoma, we show that recurrences contain a higher proportion of senescent cells than the primary tumor, indicating that induction of senescence also occurs upon treatment in vivo, which likely plays a role in therapy resistance. First-line drug in the treatment of glioblastoma, the most severe brain cancer, is temozolomide (TMZ), a DNA-methylating agent that induces the critical damage O-6-methylguanine (O(6)MeG). This lesion is cytotoxic through the generation of mismatch repair-mediated DNA double-strand breaks (DSBs), which trigger apoptotic pathways. Previously, we showed that O(6)MeG also induces cellular senescence (CSEN). Here, we show that TMZ-induced CSEN is a late response which has similar kinetics to apoptosis, but at a fourfold higher level. CSEN cells show a high amount of DSBs, which are located outside of telomeres, a high level of ROS and oxidized DNA damage (8-oxo-guanine), and sustained activation of the DNA damage response and histone methylation. Despite the presence of DSBs, CSEN cells are capable of repairing radiation-induced DSBs. Glioblastoma cells that acquired resistance to TMZ became simultaneously resistant to TMZ-induced CSEN. Using a Tet-On glioblastoma cell system, we show that upregulation of MGMT immediately after TMZ completely abrogated apoptosis and CSEN, while induction of MGMT long-term (>72 h) after TMZ did not reduce apoptosis and CSEN. Furthermore, upregulation of MGMT in the senescent cell population had no impact on the survival of senescent cells, indicating that O(6)MeG is required for induction, but not for maintenance of the senescent state. We further show that, in recurrent GBM specimens, a significantly higher level of DSBs and CSEN-associated histone H3K27me3 was observed than in the corresponding primary tumors. Overall, the data indicate that CSEN is a key node induced in GBM following chemotherapy.