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Prostate adenocarcinoma transition to neuroendocrine small cell tumors requires ASCL1

ABSTRACT: Most patients with prostate adenocarcinoma develop resistance to therapies targeting the androgen receptor (AR). Consequently, a portion of these patients develop AR-indifferent neuroendocrine prostate cancer (NEPC), a rapidly progressing cancer with limited therapies and poor survival outcomes. Current research to understand the transition to NEPC suggests a model of lineage plasticity, where AR-dependent luminal tumors progress towards an AR-independent neuroendocrine (NE) lineage. Genetic analysis of human NEPC showed a frequent loss of RB1 and TP53, and in experimental models, loss of both genes facilitates the transition to a NE lineage. Transcriptomics has shown the lineage transcription factors ASCL1 and NEUROD1 are present in NEPC. In this study, we used genetically engineered mouse models harboring Cre induced loss of Rb1 and Trp53 with MycT58A overexpression (RPM), to model prostate adenocarcinoma with NEPC by establishing prostate organoids that are subsequently used to generate subcutaneous allograft tumors. These tumors are heterogeneous and display adenocarcinoma, squamous, and NE features. ASCL1 and NEUROD1 are expressed within the NE defined regions, with ASCL1 being more predominant than NEUROD1. Genetic loss of ASCL1 in this model does not decrease tumor growth or tumor formation, however, there is a notable decrease in NE identity and an increase in cells with basal-like cell identity. This study provides a new in vivo model to study the progression of prostate cancer to NEPC and establishes the requirement for ASCL1 in driving neuroendocrine differentiation.

ORGANISM(S): Mus musculus

PROVIDER: GSE264598 | GEO | 2024/08/28

REPOSITORIES: GEO

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Project description:Histone deacetylation is crucial for the regulation of chromatin structure, gene transcription and the epigenetic state of the cell. With the emergence of the neuroendocrine (NE) phenotype in castration-resistant prostate cancer (CRPC), we hypothesized that the inhibition of HDAC1/2 would disrupt the epigenetic events involved in the conversion of prostate adenocarcinoma to a NE prostate cancer (NEPC) phenotype. Additionally, monotherapies tend to have limited efficacy in cancer treatment and combination treatments show more promise. Since the PI3K/AKT/mTOR pathway is a well-established tumor growth-promoting pathway and a promising target in CRPC and NEPC, we investigated the tumor suppressing activities of fimepinostat, a dual HDAC and PI3K inhibitor, on both prostate adenocarcinoma and NEPC. We evaluated multiple cell lines and patient-derived xenograft (PDX) models of prostate adenocarcinoma and NEPC to determine the roles of HDAC1/2 and AKT inhibition, both individually and in combination, in suppressing CRPC and NEPC tumor growth in vitro and in vivo. HDAC1/2 inhibition in combination with PI3K/AKT inhibition was more efficacious than targeting each pathway alone, induced growth inhibitory effects (in some cases synergistic) through cell cycle inhibition and apoptosis across an array of prostate adenocarcinoma and NEPC patient-derived xenografts (PDX) and cell lines in vitro and in vivo. Molecular profiling revealed on-target effects of combined HDAC1/2 and PI3K/AKT inhibition as well as a common downregulation of Myc, E2F, DNA repair, and G2M checkpoint targets, independent of prostate cancer phenotype. Fimepinostat therapy was also associated with the suppression of lineage transcription factor expression including androgen receptor (AR) in prostate adenocarcinoma and Achaete-scute homolog 1 (ASCL1) in NEPC. Our findings demonstrate that dual HDAC1/2 and PI3K/AKT pathway inhibition leads to robust tumor growth inhibition in both adenocarcinoma and NEPC, suggesting that fimepinostat may represent a novel therapeutic for both prostate adenocarcinoma and NEPC phenotypes of CRPC.

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Prostate adenocarcinoma transition to neuroendocrine small cell tumors requires ASCL1

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