Abstract

Abstract Therapeutics have been developed to target castration-resistant prostate cancer (CRPC) classified as adenocarcinoma (CRPC-Adeno). However, an increasing frequency of CRPC-Adeno tumors progress to the highly aggressive and lethal neuroendocrine prostate cancer (NEPC) by acquiring a neuroendocrine (NE) phenotype as a mechanism of therapeutic resistance. This transformation from CRPC-Adeno to NEPC requires distinct epigenetic reprogramming by lysine-specific demethylase 1 (LSD1), which can be exploited for development of novel therapies to target NEPC. LSD1 is upregulated in NEPC and promotes a stem-like transition state through lineage plasticity which enables the cancer cell to undergo NE differentiation. We have shown that LSD1 inhibition reduces the NE program, driving NEPC towards a non-neuroendocrine state through ASCL1 suppression and YAP1 re-expression. This less aggressive non-neuroendocrine state exposes unique vulnerabilities for the development of novel combination therapies to treat this lethal disease. Citation Format: Sumer M. Jasmine, Adel Mandl, Susan L. Dalrymple, Sunghyun Kim, Jennifer Dias, Maria Kleppe, Cassandra Celatka, Amy Tapper, Ilsa Coleman, Peter Nelson, Hugh Rienhoff, Samuel R. Denmeade, W. Nathaniel Brennen. LSD1 inhibition transcriptionally reprograms neuroendocrine prostate cancer exposing unique therapeutic vulnerabilities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3232.

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