Abstract BACKGROUND Atypical teratoid/rhabdoid tumors (ATRT) are deadly infantile brain tumors driven by a loss-of-function mutation of SMARCB1, a critical component of the SWI-SNF chromatin remodeling complex. However, residual SWI-SNF activity inhibits EZH2 at all loci except where CoREST colocalizes with these complexes, specifically contributing to ATRT pathogenesis. This results in hypermethylation and subsequent repression of genes coding for neuronal differentiation and tumor suppressors, accounting for ATRTs’ stem-like state, aggressive growth, and therapy resistance. We functionally inhibited the CoREST complex in ATRT cells by targeting its core enzymes LSD1 and HDAC1/2 using a bi-functional inhibitor, corin. METHODS We evaluated the efficacy of corin to target ATRT cells (BT37, CHLA05 and CHLA06) by measuring cell proliferation (BrdU immunofluorescence/IF), apoptosis (CC3 IF, cPARP Western blotting/WB, MUSE Annexin V), histone modifications (WB) and neuronal differentiation (WB, IF). Whole mRNA sequencing and ATAC-Seq were performed to see the global transcriptomic and chromatin changes driven by corin. Further, we examined the long-term survival advantage rendered by corin in an in-vivo orthotopic xenograft model of ATRT. RESULTS Corin reprogrammed the chromatin structure in ATRT cells in favor of pathways related to neuronal differentiation, cell differentiation, and axonal development while downregulating pathways related to proliferation and cell cycle (mRNA Seq, ATAC-Seq). Corin inhibited AT/RT cell growth and proliferation (p<0.05), increased apoptosis (p<0.05), increased H3K4me1 and H3K9Ac levels (p < 0.001), and induced neuronal differentiation (IF: Beta-3-tubulin, MAP2, Synaptophysin). Intratumoral delivery of corin increased the median survival of mice bearing aggressive orthotopic CHLA06 tumors from 14 to 35 days compared to control (p=0.02, Log Rank test). CONCLUSIONS Targeting the CoREST complex with corin disrupts ATRT’s epigenetic abnormalities, reversing their stem-like state and slowing tumor growth, thus presenting a promising new strategy that may translate into the clinical setting to help improve ATRT’s dismal survival.
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