Abstract

In this study, we hypothesized that androgen-deprivation therapy (ADT) in prostate cancer, although initially efficient, induces changes in the tumor kinome, which subsequently promote development of castration-resistant (CR) disease. Recognizing the correlation between tumor hypoxia and poor prognosis in prostate cancer, we further hypothesized that such changes might be influenced by hypoxia. Microarrays with 144 kinase peptide substrates were applied to analyze CWR22 prostate carcinoma xenograft samples from ADT-naïve, androgen-deprived (AD), long-term AD (ADL), and CR disease stages. The impact of hypoxia was assessed by matching the xenograft kinase activity profiles with those acquired from hypoxic and normoxic prostate carcinoma cell cultures, whereas the clinical relevance was evaluated by analyzing prostatectomy tumor samples from patients with locally advanced disease, either in ADT-naïve or early CR disease stages. By using this novel peptide substrate microarray method we revealed high kinase activity mediated by signal transducer and activator of transcription 5A (STAT5A) in CR prostate cancer. Additionally, we uncovered high STAT5A kinase activity already in regressing ADL xenografts, before renewed CR growth was evidenced. Finally, since increased STAT5A kinase activity also was detected after exposing prostate carcinoma cells to hypoxia, we propose long-term ADT to induce tumor hypoxia and stimulate STAT5A kinase activity, subsequently leading to renewed CR tumor growth. Hence, the study detected STAT5A as a candidate to be further investigated for its potential as marker of advanced prostate cancer and as possible therapeutic target protein.

Highlights

  • The initial growth of a malignant prostate tumor is stimulated by androgens [1], and standard first-line treatment of patients with advanced prostate cancer includes androgen-deprivation therapy (ADT) [2]

  • The current study identified increased phosphorylation level of the signal transducer and activator of transcription 5A (STAT5A) peptide substrate by ADL and CR prostate carcinoma xenografts, compared to by ADT-naıve xenografts

  • In a limited population of prostate cancer patients studied, low phosphorylation levels of the STAT5A substrate by tumors from ADT-naıve patients’ were revealed, whereas the STAT5A phosphorylation level generated by the tumor from an early CR disease case was substantially higher

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Summary

Introduction

The initial growth of a malignant prostate tumor is stimulated by androgens [1], and standard first-line treatment of patients with advanced prostate cancer includes androgen-deprivation therapy (ADT) [2]. Tumors inevitably recur in a castration-resistant (CR) state. Metastatic, CR prostate cancer is still remaining the most apprehensive aspect in prostate cancer management, defying prolonged treatment effects. Hypoxia is a common microenvironmental factor of solid tumors, promoting tumor growth as well as angiogenesis, metastasis, and therapy resistance [3,4]. Tumor hypoxia has been correlated to poor prognosis [5,6,7], skepticism remains as to its role and routine clinical importance. In vitro studies have shown that hypoxia increases the activity and sensitivity of the androgen receptor [8], which in many CR tumors may lead to a selection of adapted phenotypes [9]

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