Abstract

Abstract Breast cancer mortality is primarily due to metastatic lesions rather than primary tumors, yet relatively little is known regarding the mechanisms of metastatic breast cancer, making it difficult to identify patients who are at risk for metastatic disease. Our hypothesis suggests that inherited germline mutations contribute to metastatic disease and that these single nucleotide polymorphisms (SNPs) could be used to predict outcome in breast cancer patients. To investigate the effect of inherited SNPs on metastasis, we used a mouse genetics approach comparing strains with high (FVB) and low (MOLF) metastatic phenotypes and identified Arntl2, a circadian rhythm transcription factor, as a gene whose differential expression predicted outcome in breast cancer patients. To identify SNP differences in Arntl2 between MOLF and FVB, we performed whole genome sequencing of MOLF and compared it to the FVB genome. Overlapping the data with DNase hypersensitivity sites revealed 10 SNPs in the predicted promoter of Arntl2. To test the causative role of the SNPs on Arntl2 expression in vivo, metastatic cell lines were engineered using the CRISPR-Cas9 approach to specifically replace the FVB Arntl2 promoter with that of MOLF. In agreement with our hypothesis, substitution of the MOLF promoter reduced Arntl2 transcript levels and subsequently decreased lung metastases in orthotopic implantation assays. In vitro pulldown experiments with strain-specific promoter probes revealed potential differential binding of chromatin modifier proteins, demonstrating the significance of the SNPs in regulating Arntl2 transcription. Finally, analysis of SNPs associated with Arntl2 expression in a cohort of Chinese breast cancer patients revealed significant correlation of Arntl2 expression with overall survival, validating this gene as a marker in humans. Since Arntl2 is a transcription factor, current studies are focused on identifying Arntl2-regulated genes to investigate downstream pathways involved in metastasis. This study has important implications regarding the role of circadian rhythm in cancer progression and provides a potential mechanism to explain the increased risk of breast cancers in nightshift workers. Furthermore, this provides the first evidence that transcriptional control elements can be engineered using CRISPR-Cas9 to establish the causative role of SNPs in inherited susceptibility to cancer metastasis. Citation Format: Ngoc-Han Ha, Kent Hunter. Polymorphisms in the arntl2 promoter affect breast cancer metastasis susceptibility [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3050. doi:10.1158/1538-7445.AM2017-3050

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