Abstract Background: The zinc-finger homeobox ZFXH3 (also known as ATBF1 for AT motif-binding factor 1) is a transcription factor that is frequently downregulated or deleted in human prostate cancers. In a recent clinical trial (NCT02430480), patients with localized prostate cancer (PCa) received six months of neoadjuvant androgen deprivation therapy (ADT) with 10.8mg of the GnRH agonist goserelin every 12 weeks and 160mg of oral enzalutamide daily before a radical prostatectomy (RP). Throughout the six months, the patients had two multiparametric MRIs (mpMRI) at baseline and prior to surgery, along with targeted biopsies of the tumor extracted. DNA from laser capture microdissection (LCM) biopsy and RP tissues was extracted for whole exome sequencing with somatic mutation calling and copy number analysis. The most common alteration in all residual tumor samples shared a single-copy loss or deletion of chromosome 16q overlapping with ZFHX3. We hypothesized that ZFHX3 is necessary for the proper development of normal human prostates and drives tumor-suppressive activity. Methods: To mimic the reduced expression of ZFHX3 observed in patient samples, we first surveyed ZFHX3 expression by Western blotting and real-time qPCR and then developed shRNA knockdowns in androgen-sensitive (22Rv1 and LNCaP) and insensitive (C4-2) PCa cell lines. These cell lines were challenged by dose-response curve studies utilizing standard fetal bovine serum (FBS) growth media with the androgen receptor (AR) axis inhibitors abiraterone and enzalutamide. Continued treatment conditions included charcoal dextran-stripped fetal calf serum (CSS) to simulate androgen deprivation supplemented with either abiraterone or enzalutamide. Cell proliferation was determined at the end of the five-day dose-response curve treatment studies using the CellTiter Glo 2.0 cell viability assay. Results and Conclusions: In the three PCa cell lines with ZFHX3 knockdown, we observed increased sensitivity to AR-targeting drugs with a lower IC50 dose. In addition, ZFHX3 knockdown cell lines exhibited increased cell proliferation compared to scrambled control and parental cell lines using dose-response time course studies. These preliminary results form the scientific premise for this work and substantiate ongoing efforts to expand these assays to more cell lines and treatments. Our future efforts will provide mechanistic insights into the functions of ZFHX3 through chromatin immunoprecipitation sequencing with antibodies against AR and FOXA1 and the expansion of ZFHX3 knockdown into additional cell lines to investigate the transcriptional activity of multiple hormonal signaling pathways. We will further explore genomic interactions between the effects of ZFHX3 reduction and alterations to commonly-mutated genes in PCa, such as PTEN, TP53, and SPOP. Findings in this study will seek to determine how ZFHX3 exerts its tumor suppressor function and its role in the development and progression of prostate cancer. Citation Format: Isaiah M. King, John R. Bright, Nicholas T. Terrigino, Scott Wilkinson, Adam G. Sowalsky. Investigating the function of ZFHX3 in hormone sensitive prostate cancer initiation and treatment resistance [abstract]. In: Proceedings of the AACR Special Conference: Advances in Prostate Cancer Research; 2023 Mar 15-18; Denver, Colorado. Philadelphia (PA): AACR; Cancer Res 2023;83(11 Suppl):Abstract nr A004.
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