Coactivator networks orchestrating noncanonical AR programs in enzalutamide-resistant CRPC
Ephraim J Gardner1,2, Sasikumar Ponnusamy1, Remi Adelaiye-Ogala1,2,3,4
1Division of Hematology and Oncology, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States.
Abstract:
Resistance to androgen receptor (AR)-targeted therapies remains a major clinical challenge in the treatment of castration-resistant prostate cancer (CRPC). Emerging evidence suggests that Enzalutamide resistance is not solely due to the loss of AR dependency but can also arise from epigenomic reprogramming of the AR cistrome toward noncanonical gene networks. Recent studies have revealed that this reprogramming is mediated by previously unrecognized coactivators, including CXXC5, TET2, and EZH2, which cooperate with AR to establish a transcriptional landscape that supports lineage plasticity and therapeutic evasion. These noncanonical AR transcriptional programs enable CRPC cells to survive under continued AR blockade, acting as a transitional state towards neuroendocrine differentiation. Pharmacologic disruption of these coactivators abrogates noncanonical AR activity and suppresses tumor growth, highlighting a tractable vulnerability. These findings redefine AR signaling in advanced disease, suggesting that targeting noncanonical AR coactivators could offer a novel therapeutic paradigm to overcome resistance. Advances in single-cell and epigenomic profiling are poised to delineate further the heterogeneity and dynamics of AR cistrome remodeling in treatment-refractory prostate cancer.
Insights
Resistance to androgen receptor (AR)-targeted therapies in prostate cancer can be overcome. New coactivators drive noncanonical AR signaling, enabling cancer cells to evade treatment. Targeting these coactivators offers a novel therapeutic strategy.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Castration-resistant prostate cancer (CRPC) poses significant treatment challenges.
- Resistance to androgen receptor (AR)-targeted therapies is a major clinical hurdle.
- Enzalutamide resistance involves epigenomic reprogramming of AR cistrome towards noncanonical gene networks.
Purpose of the Study:
- To investigate the mechanisms of Enzalutamide resistance in CRPC.
- To identify novel coactivators mediating AR-dependent therapeutic evasion.
- To explore therapeutic strategies targeting noncanonical AR signaling.
Main Methods:
- Analysis of AR cistrome reprogramming in CRPC.
- Identification and characterization of novel AR coactivators (CXXC5, TET2, EZH2).
- Pharmacologic disruption of identified coactivators in preclinical models.
Main Results:
- AR resistance is driven by epigenomic reprogramming and noncanonical AR transcriptional programs.
- CXXC5, TET2, and EZH2 cooperate with AR to promote lineage plasticity and therapeutic evasion.
- Pharmacologic inhibition of these coactivators abrogates noncanonical AR activity and suppresses tumor growth.
Conclusions:
- Noncanonical AR coactivators represent a novel therapeutic target for overcoming Enzalutamide resistance in CRPC.
- Targeting these coactivators offers a new paradigm for treating advanced prostate cancer.
- Further research using single-cell and epigenomic profiling will elucidate AR cistrome remodeling dynamics.
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