The cyclin-dependent kinase inhibitor p21^WAF1/CIP1 (p21) is a cell-cycle checkpoint effector and inducer of senescence, regulated by p53. Yet, evidence suggests that p21 could also be oncogenic, through a mechanism that has so far remained obscure. We report that a subset of atypical cancerous cells strongly expressing p21 showed proliferation features. This occurred predominantly in p53-mutant human cancers, suggesting p53-independent upregulation of p21 selectively in more aggressive tumour cells. Multifaceted phenotypic and genomic analyses of p21-inducible, p53-null, cancerous and near-normal cellular models showed that after an initial senescence-like phase, a subpopulation of p21-expressing proliferating cells emerged, featuring increased genomic instability, aggressiveness and chemoresistance. Mechanistically, sustained p21 accumulation inhibited mainly the CRL4–CDT2 ubiquitin ligase, leading to deregulated origin licensing and replication stress. Collectively, our data reveal the tumour-promoting ability of p21 through deregulation of DNA replication licensing machinery—an unorthodox role to be considered in cancer treatment, since p21 responds to various stimuli including some chemotherapy drugs.

Human malignancies overcome replicative senescence either by activating the reverse‐transcriptase telomerase or by utilizing a homologous recombination‐based mechanism, referred to as alternative lengthening of telomeres (ALT). In budding yeast, ALT exhibits features of break‐induced replication (BIR), a repair pathway for one‐ended DNA double‐strand breaks (DSBs) that requires the non‐essential subunit Pol32 of DNA polymerase delta and leads to conservative DNA replication. Here, we examined whether ALT in human cancers also exhibits features of BIR. A telomeric fluorescence in situ hybridization protocol involving three consecutive staining steps revealed the presence of conservatively replicated telomeric DNA in telomerase‐negative cancer cells. Furthermore, depletion of PolD3 or PolD4, two subunits of human DNA polymerase delta that are essential for BIR, reduced the frequency of conservatively replicated telomeric DNA ends and led to shorter telomeres and chromosome end‐to‐end fusions. Taken together, these results suggest that BIR is associated with conservative DNA replication in human cells and mediates ALT in cancer. Synopsis Human cells that rely on ALT to maintain telomere length use break‐induced replication, a DNA repair pathway associated with conservative rather than semiconservative DNA replication. Telomeres of human ALT cells are replicated conservatively. PolD3 and PolD4, two subunits of DNA polymerase delta that function in break‐induced replication, are needed for the maintenance of telomere length and function in human ALT cells.

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