Abstract
<div>AbstractPurpose:<p>Previous sequencing studies revealed that alterations of genes associated with DNA damage response (DDR) are enriched in men with metastatic castration-resistant prostate cancer (mCRPC). <i>BRCA2</i>, a DDR and cancer susceptibility gene, is frequently deleted (homozygous and heterozygous) in men with aggressive prostate cancer. Here we show that patients with prostate cancer who have lost a copy of <i>BRCA2</i> frequently lose a copy of tumor suppressor gene <i>RB1</i>; importantly, for the first time, we demonstrate that co-loss of both genes in early prostate cancer is sufficient to induce a distinct biology that is likely associated with worse prognosis.</p>Experimental Design:<p>We prospectively investigated underlying molecular mechanisms and genomic consequences of co-loss of <i>BRCA2</i> and <i>RB1</i> in prostate cancer. We used CRISPR-Cas9 and RNAi-based methods to eliminate these two genes in prostate cancer cell lines and subjected them to <i>in vitro</i> studies and transcriptomic analyses. We developed a 3-color FISH assay to detect genomic deletions of <i>BRCA2</i> and <i>RB1</i> in prostate cancer cells and patient-derived mCRPC organoids.</p>Results:<p>In human prostate cancer cell lines (LNCaP and LAPC4), loss of <i>BRCA2</i> leads to the castration-resistant phenotype. Co-loss of <i>BRCA2</i>-<i>RB1</i> in human prostate cancer cells induces an epithelial-to-mesenchymal transition, which is associated with invasiveness and a more aggressive disease phenotype. Importantly, PARP inhibitors attenuate cell growth in human mCRPC-derived organoids and human CRPC cells harboring single-copy loss of both genes.</p>Conclusions:<p>Our findings suggest that early identification of this aggressive form of prostate cancer offers potential for improved outcomes with early introduction of PARP inhibitor–based therapy.</p><p><i>See related commentary by Mandigo and Knudsen, p. 1784</i></p></div>
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