OnCo
ideasIdea

A synthetic lethality map for every cancer driver in every tissue context

For each cancer-causing mutation, find every gene the cancer cell newly depends on, in every tissue, so that even undruggable drivers get druggable partners.

PARP inhibitors in BRCA-mutant cancers proved synthetic lethality can be turned into medicine; DepMap has screened around two thousand cell lines but coverage of driver-context combinations, in vivo dependencies and combination interactions is incomplete. The proposal is a systematic programme: isogenic and patient-derived models for each of the roughly 100 recurrent drivers across major tissue contexts, genome-wide CRISPR knockout, activation and base-editing screens in vitro and in vivo (including immune-competent settings), and drug-combination anchor screens, released openly with a standardised dependency confidence score.

Hypothesis
The map yields at least twenty validated context-specific dependencies for drivers currently considered undruggable (MYC, mutant TP53 loss, SMARCA4, ARID1A) that translate into clinical programmes within a decade.
Rationale
Dependencies are context-dependent and rarely visible in a single model; systematic coverage is what made the BRCA-PARP relationship exploitable, and screening cost has fallen by orders of magnitude.
What would test it
Fund the first 20 driver-context pairs; success is prospective validation of at least three new dependencies in patient-derived models with drug-like inhibitors.
Maturity
preclinical evidence
Who has to act
research
Cost to try
Large (over $50M)
Years to first evidence
5
Bottlenecks it attacks

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