{Reference Type}: Journal Article {Title}: A synergistic two-drug therapy specifically targets a DNA repair dysregulation that occurs in p53-deficient colorectal and pancreatic cancers. {Author}: Alruwaili MM;Zonneville J;Naranjo MN;Serio H;Melendy T;Straubinger RM;Gillard B;Foster BA;Rajan P;Attwood K;Chatley S;Iyer R;Fountzilas C;Bakin AV; {Journal}: Cell Rep Med {Volume}: 5 {Issue}: 3 {Year}: 2024 Mar 19 {Factor}: 16.988 {DOI}: 10.1016/j.xcrm.2024.101434 {Abstract}: The tumor-suppressor p53 is commonly inactivated in colorectal cancer and pancreatic ductal adenocarcinoma, but existing treatment options for p53-mutant (p53Mut) cancer are largely ineffective. Here, we report a therapeutic strategy for p53Mut tumors based on abnormalities in the DNA repair response. Investigation of DNA repair upon challenge with thymidine analogs reveals a dysregulation in DNA repair response in p53Mut cells that leads to accumulation of DNA breaks. Thymidine analogs do not interrupt DNA synthesis but induce DNA repair that involves a p53-dependent checkpoint. Inhibitors of poly(ADP-ribose) polymerase (PARPis) markedly enhance DNA double-strand breaks and cell death induced by thymidine analogs in p53Mut cells, whereas p53 wild-type cells respond with p53-dependent inhibition of the cell cycle. Combinations of trifluorothymidine and PARPi agents demonstrate superior anti-neoplastic activity in p53Mut cancer models. These findings support a two-drug combination strategy to improve outcomes for patients with p53Mut cancer.