Abstract

Although potent androgen receptor pathway inhibitors (ARPI) improve overall survival of metastatic prostate cancer patients, treatment-induced neuroendocrine prostate cancer (t-NEPC) as a consequence of the selection pressures of ARPI is becoming a more common clinical issue. Improved understanding of the molecular biology of t-NEPC is essential for the development of new effective management approaches for t-NEPC. In this study, we identify a splice variant of the MYST/Esa1-associated factor 6 (MEAF6) gene, MEAF6-1, that is highly expressed in both t-NEPC tumor biopsies and neuroendocrine cell lines of prostate and lung cancers. We show that MEAF6-1 splicing is stimulated by neuronal RNA splicing factor SRRM4. Rather than inducing neuroendocrine trans-differentiation of cells in prostate adenocarcinoma, MEAF6-1 upregulation stimulates cell proliferation, anchorage-independent cell growth, invasion and xenograft tumor growth. Gene microarray identifies that these MEAF6-1 actions are in part mediated by the ID1 and ID3 genes. These findings suggest that the MEAF6-1 variant does not induce neuroendocrine differentiation of prostate cancer cells, but rather facilitates t-NEPC progression by increasing the proliferation rate of cells that have acquired neuroendocrine phenotypes.

Highlights

  • Generation androgen receptor (AR) pathway inhibitors (ARPIs) prolong survival of patients with metastatic castrate resistant prostate cancer (CRPC) [1, 2]

  • These results indicate that up-regulation of the expression of MYST/Esa1associated factor 6 (MEAF6)-1 splice variant is closely associated with NEPC progression

  • This study reports that a functionally reprogrammed MEAF6 gene alternatively spliced by neuronal splicing factor SRRM4 facilitates NEPC progression

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Summary

Introduction

Generation androgen receptor (AR) pathway inhibitors (ARPIs) prolong survival of patients with metastatic castrate resistant prostate cancer (CRPC) [1, 2]. A consequence of the selection pressures exerted by the more potent ARPIs is that they can promote the emergence of AR-independent CRPC, one variant of which is treatment-induced neuroendocrine prostate cancer (t-NEPC) [3,4,5,6]. T-NEPC is reported in 25–30% of post-ARPI CRPC patients and the rate of occurrence is predicted to rise with the widespread use of ARPIs [7]. The average survival of t-NEPC patients is only ~7 months [8]. There is accumulating evidence indicating that t-NEPC is clonally derived from adenocarcinoma (AdPC) precursors [3, 9]. Whole exome sequencing has shown similar mutational landscapes between t-NEPC and

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