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A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
Targeting Bromodomain and Extra-Terminal (BET) Family Proteins in Castration-Resistant Prostate Cancer (CRPC)
Jonathan Welti1, Adam Sharp1,2, Wei Yuan1
1The Institute for Cancer Research, London, United Kingdom.
Abstract:
Purpose: Persistent androgen receptor (AR) signaling drives castration-resistant prostate cancer (CRPC) and confers resistance to AR-targeting therapies. Novel therapeutic strategies to overcome this are urgently required. We evaluated how bromodomain and extra-terminal (BET) protein inhibitors (BETi) abrogate aberrant AR signaling in CRPC.Experimental Design: We determined associations between BET expression, AR-driven transcription, and patient outcome; and the effect and mechanism by which chemical BETi (JQ1 and GSK1210151A; I-BET151) and BET family protein knockdown regulates AR-V7 expression and AR signaling in prostate cancer models.Results: Nuclear BRD4 protein expression increases significantly (P ≤ 0.01) with castration resistance in same patient treatment-naïve (median H-score; interquartile range: 100; 100-170) and CRPC (150; 110-200) biopsies, with higher expression at diagnosis associating with worse outcome (HR, 3.25; 95% CI, 1.50-7.01; P ≤ 0.001). BRD2, BRD3, and BRD4 RNA expression in CRPC biopsies correlates with AR-driven transcription (all P ≤ 0.001). Chemical BETi, and combined BET family protein knockdown, reduce AR-V7 expression and AR signaling. This was not recapitulated by C-MYC knockdown. In addition, we show that BETi regulates RNA processing thereby reducing alternative splicing and AR-V7 expression. Furthermore, BETi reduce growth of prostate cancer cells and patient-derived organoids with known AR mutations, AR amplification and AR-V7 expression. Finally, BETi, unlike enzalutamide, decreases persistent AR signaling and growth (P ≤ 0.001) of a patient-derived xenograft model of CRPC with AR amplification and AR-V7 expression.Conclusions: BETi merit clinical evaluation as inhibitors of AR splicing and function, with trials demonstrating their blockade in proof-of-mechanism pharmacodynamic studies. Clin Cancer Res; 24(13); 3149-62. ©2018 AACR.
Insights
Bromodomain and extra-terminal (BET) protein inhibitors can overcome resistance to prostate cancer therapies by blocking androgen receptor (AR) signaling. These BET inhibitors reduce AR-V7 expression and tumor growth, showing promise for clinical evaluation.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Persistent androgen receptor (AR) signaling is a key driver of castration-resistant prostate cancer (CRPC).
- This persistent signaling confers resistance to current AR-targeting therapies, necessitating novel treatment strategies.
- Bromodomain and extra-terminal (BET) proteins play a role in regulating gene transcription, including AR-driven genes.
Purpose of the Study:
- To evaluate the efficacy of BET protein inhibitors (BETi) in abrogating aberrant AR signaling in CRPC.
- To determine the association between BET expression, AR-driven transcription, and patient outcomes in prostate cancer.
- To elucidate the mechanism by which BETi regulate AR signaling, specifically AR-V7 expression.
Main Methods:
- Analysis of BET expression in patient biopsies (treatment-naïve and CRPC) and correlation with patient outcomes.
- Assessment of RNA expression of BET family proteins (BRD2, BRD3, BRD4) and their correlation with AR-driven transcription.
- In vitro and in vivo studies using chemical BETi (JQ1, GSK1210151A; I-BET151) and BET protein knockdown to assess effects on AR-V7 expression and AR signaling in prostate cancer models.
Main Results:
- Nuclear BRD4 protein expression was significantly increased in CRPC biopsies and associated with worse patient outcomes.
- BET family RNA expression correlated with AR-driven transcription in CRPC.
- Chemical BETi and BET protein knockdown reduced AR-V7 expression and AR signaling, decreased prostate cancer cell and organoid growth, and inhibited tumor growth in a patient-derived xenograft model, outperforming enzalutamide in specific contexts.
Conclusions:
- BET inhibitors effectively reduce AR splicing and function by regulating RNA processing, leading to decreased AR-V7 expression.
- BETi demonstrate significant anti-tumor activity against prostate cancer models with AR amplification and AR-V7 expression.
- BET inhibitors warrant clinical evaluation for their potential to overcome resistance in CRPC by targeting AR signaling.
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