Abstract
<div>Abstract<p>Mutations in <i>ARID1A</i> rank among the most common molecular aberrations in human cancer. However, oncogenic consequences of <i>ARID1A</i> mutation in human cells remain poorly defined due to lack of forward genetic models. Here, CRISPR/Cas9-mediated <i>ARID1A</i> knockout (KO) in primary <i>TP53<sup>−/−</sup></i> human gastric organoids induced morphologic dysplasia, tumorigenicity, and mucinous differentiation. Genetic WNT/β-catenin activation rescued mucinous differentiation, but not hyperproliferation, suggesting alternative pathways of <i>ARID1A</i> KO-mediated transformation. <i>ARID1A</i> mutation induced transcriptional regulatory modules characteristic of microsatellite instability and Epstein–Barr virus–associated subtype human gastric cancer, including <i>FOXM1</i>-associated mitotic genes and <i>BIRC5/</i>survivin. Convergently, high-throughput compound screening indicated selective vulnerability of <i>ARID1A</i>-deficient organoids to inhibition of BIRC5/survivin, functionally implicating this pathway as an essential mediator of <i>ARID1A</i> KO-dependent early-stage gastric tumorigenesis. Overall, we define distinct pathways downstream of oncogenic <i>ARID1A</i> mutation, with nonessential WNT-inhibited mucinous differentiation in parallel with essential transcriptional <i>FOXM1/BIRC5</i>-stimulated proliferation, illustrating the general utility of organoid-based forward genetic cancer analysis in human cells.</p>Significance:<p>We establish the first human forward genetic modeling of a commonly mutated tumor suppressor gene, <i>ARID1A</i>. Our study integrates diverse modalities including CRISPR/Cas9 genome editing, organoid culture, systems biology, and small-molecule screening to derive novel insights into early transformation mechanisms of <i>ARID1A</i>-deficient gastric cancers.</p><p><i>See related commentary by Zafra and Dow, p. 1327</i>.</p><p><i>This article is highlighted in the In This Issue feature, p. 1307</i></p></div>
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