Faculty, Staff and Student Publications

Publication Date

10-1-2024

Journal

Proceedings of the National Academy of Sciences of the United States of America

Abstract

Cancers develop resistance to inhibitors of oncogenes mainly due to target-centric mechanisms such as mutations and splicing. While inhibitors or antagonists force targets to unnatural conformation contributing to protein instability and resistance, activating tumor suppressors may maintain the protein in an agonistic conformation to elicit sustainable growth inhibition. Due to the lack of tumor suppressor agonists, this hypothesis and the mechanisms underlying resistance are not understood. In estrogen receptor (ER)-positive breast cancer (BC), androgen receptor (AR) is a druggable tumor suppressor offering a promising avenue for this investigation. Spatial genomics suggests that the molecular portrait of AR-expressing BC cells in tumor microenvironment corresponds to better overall patient survival, clinically confirming AR's role as a tumor suppressor. Ligand activation of AR in ER-positive BC xenografts reprograms cistromes, inhibits oncogenic pathways, and promotes cellular elasticity toward a more differentiated state. Sustained AR activation results in cistrome rearrangement toward transcription factor PROP paired-like homeobox 1, transformation of AR into oncogene, and activation of the Janus kinase/signal transducer (JAK/STAT) pathway, all culminating in lineage plasticity to an aggressive resistant subtype. While the molecular profile of AR agonist-sensitive tumors corresponds to better patient survival, the profile represented in the resistant phenotype corresponds to shorter survival. Inhibition of activated oncogenes in resistant tumors reduces growth and resensitizes them to AR agonists. These findings indicate that persistent activation of a context-dependent tumor suppressor may lead to resistance through lineage plasticity-driven tumor metamorphosis. Our work provides a framework to explore the above phenomenon across multiple cancer types and underscores the importance of factoring sensitization of tumor suppressor targets while developing agonist-like drugs.

Keywords

Humans, Receptors, Androgen, Breast Neoplasms, Female, STAT Transcription Factors, Animals, Receptors, Estrogen, Oncogenes, Janus Kinases, Mice, Signal Transduction, Cell Line, Tumor, Tumor Microenvironment, Gene Expression Regulation, Neoplastic, androgen receptor, estrogen receptor, breast cancer, JAK STAT, tumor suppressor

DOI

10.1073/pnas.2406837121

PMID

39312663

PMCID

PMC11459127

PubMedCentral® Posted Date

9-23-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

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