1. The neuroendocrine transition in prostate cancer is dynamic and dependent on ASCL1.
- Author
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Romero R, Chu T, González Robles TJ, Smith P, Xie Y, Kaur H, Yoder S, Zhao H, Mao C, Kang W, Pulina MV, Lawrence KE, Gopalan A, Zaidi S, Yoo K, Choi J, Fan N, Gerstner O, Karthaus WR, DeStanchina E, Ruggles KV, Westcott PMK, Chaligné R, Pe'er D, and Sawyers CL
- Subjects
- Male, Animals, Mice, Humans, Organoids, Carcinoma, Neuroendocrine genetics, Carcinoma, Neuroendocrine pathology, Adenocarcinoma genetics, Adenocarcinoma pathology, Neuroendocrine Tumors genetics, Neuroendocrine Tumors pathology, Tumor Microenvironment, Neuroendocrine Cells pathology, Neuroendocrine Cells metabolism, Cell Lineage, Retinoblastoma Binding Proteins genetics, Basic Helix-Loop-Helix Transcription Factors genetics, Basic Helix-Loop-Helix Transcription Factors metabolism, Prostatic Neoplasms pathology, Prostatic Neoplasms genetics
- Abstract
Lineage plasticity is a hallmark of cancer progression that impacts therapy outcomes, yet the mechanisms mediating this process remain unclear. Here, we introduce a versatile in vivo platform to interrogate neuroendocrine lineage transformation throughout prostate cancer progression. Transplanted mouse prostate organoids with human-relevant driver mutations (Rb1
-/- ; Trp53-/- ; cMyc+ or Pten-/- ; Trp53-/- ; cMyc+ ) develop adenocarcinomas, but only those with Rb1 deletion advance to aggressive, ASCL1+ neuroendocrine prostate cancer (NEPC) resistant to androgen receptor signaling inhibitors. Notably, this transition requires an in vivo microenvironment not replicated by conventional organoid culture. Using multiplexed immunofluorescence and spatial transcriptomics, we reveal that ASCL1+ cells arise from KRT8+ luminal cells, progressing into transcriptionally heterogeneous ASCL1+ ;KRT8- NEPC. Ascl1 loss in established NEPC causes transient regression followed by recurrence, but its deletion before transplantation abrogates lineage plasticity, resulting in castration-sensitive adenocarcinomas. This dynamic model highlights the importance of therapy timing and offers a platform to identify additional lineage plasticity drivers., Competing Interests: Competing interests: C.L.S. is on the board of directors of Novartis, is a cofounder of ORIC Pharmaceuticals and is a co-inventor of the prostate cancer drugs enzalutamide and apalutamide, covered by US patents 7,709,517; 8,183,274; 9,126,941; 8,445,507; 8,802,689; and 9,388,159 filed by the University of California. C.L.S. is on the scientific advisory boards for the following biotechnology companies: Beigene, Blueprint Medicines, Column Group, Foghorn, Housey Pharma, Nextech, PMV Pharma and ORIC. D.P. is on the scientific advisory board of Insitro. The other authors declare no competing interests., (© 2024. The Author(s).)- Published
- 2024
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