Abstract

Targeting of steroidogenic enzymes (e.g., abiraterone acetate targeting CYP17A1) has been developed as a novel therapeutic strategy against metastatic castration-resistant prostate cancer (CRPC). However, resistance to steroidal inhibitors inevitably develops in patients, the mechanisms of which remain largely unknown. Liver receptor homolog-1 (LRH-1, NR5A2) is a nuclear receptor, originally characterized as an important regulator of some liver-specific metabolic genes. Here, we report that LRH-1, which exhibited an increased expression pattern in high-grade prostate cancer and CRPC xenograft models, functions to promote de novo androgen biosynthesis via its direct transactivation of several key steroidogenic enzyme genes, elevating intratumoral androgen levels and reactivating AR signaling in CRPC xenografts as well as abiraterone-treated CRPC tumors. Pharmacologic inhibition of LRH-1 activity attenuated LRH-1-mediated androgen deprivation and anti-androgen resistance of prostate cancer cells. Our findings not only demonstrate the significant role of LRH-1 in the promotion of intratumoral androgen biosynthesis in CRPC via its direct transcriptional control of steroidogenesis, but also suggest targeting LRH-1 could be a potential therapeutic strategy for CRPC management.Significance: These findings not only demonstrate the significant role of the nuclear receptor LRH-1 in the promotion of intratumoral androgen biosynthesis in CRPC via its direct transcriptional control of steroidogenesis, but also suggest targeting LRH-1 could be a potential therapeutic strategy for CRPC management. Cancer Res; 78(9); 2205-18. ©2018 AACR.

Highlights

  • Hormone therapy is still the mainstay medical treatment option for most prostate cancer patients relapsed from prostatectomy or with metastasis, largely based on its androgen-dependent characteristic

  • Persistent intratumoral androgen biosynthesis is regarded as one key factor responsible for the hormone-refractory growth of prostate cancer and the reactivation of androgen receptor (AR) signaling in castration-resistant prostate cancer (CRPC)

  • Inhibition of steroidogenic enzymes has been developed as a novel therapeutic strategy in the hormone therapy of metastatic CRPC and clinically proved that the CYP17A1targeting abiraterone acetate can markedly lower serum and intratumoral androgens and improve the overall survival of CRPC patients [31]

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Summary

Introduction

Hormone therapy is still the mainstay medical treatment option for most prostate cancer patients relapsed from prostatectomy or with metastasis, largely based on its androgen-dependent characteristic. This treatment is only effective temporarily, as many patients will inevitably fail in this therapy and progress to a fatal hormone-refractory (or androgen-insensitive) castration-resistant (CRPC) stage within 2–3 years. Accumulated evidences suggest that this advanced disease progression involves multiple but interconnected molecular mechanisms related to. Note: Supplementary data for this article are available at Cancer Research Online (http://cancerres.aacrjournals.org/).

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