Abstract Distinct oncogenic lesions within components of the Myc or PI3K pathways hijack the translation machinery, to establish an aberrant “cancer proteome”, that drives cancer cell growth and tumor development. Invariably, however, increases in the protein synthesis capacity of cancer cells impose a cellular stress that requires an adaptive or evasive response in order for cancer cells to survive and continue proliferating. One of the key cytoprotective stress response pathways is known as the unfolded protein response (UPR), which is engaged when an excess of unfolded/misfolded proteins accumulate within the lumen of the endoplasmic reticulum. How the specific arms of UPR are coupled to increased protein synthesis in cancer etiology and drug response is still poorly understood. In this study we established a new genetic mouse model to address the role of protein synthesis-dependent activation of the UPR in prostate cancer initiation and maintenance promoted by loss of the PTEN tumor suppressor and overexpression of the Myc oncogene. We show that in this epithelial cancer model, Myc hyperactivation and PTEN loss synergize to dramatically stimulate PERK and IRE-1α activity, two major signaling arms of the UPR pathway. Distinct mechanisms transduce adaptive signals under conditions of ER stress: PERK control of protein synthesis through phosphorylation of the key translation initiation factor eIF2α and IRE1α-mediated splicing of the XBP-1 mRNA to produce an active and stable XBP1 transcription factor (XBP1s). Importantly, we observed that UPR activation is associated with formation of prostatic intraepithelial neoplasia (PIN) and invasive carcinoma. Strikingly, the pharmacologic inhibition of eIF2α phosphorylation leads to tumor inhibition. We have further established patient derived xenograft (PDX) models from primary and metastatic human prostate tumors to extend the role of UPR in specific steps of human tumor development. We have also developed a series of novel mouse and human prostate cancer cell culture systems to define the role of localized translation of ER-associated ribosomes during oncogenic transformation. Together this work provides critical insight into a fundamental mechanism by which the augmented protein synthesis requirement of cancer cells is coupled to an adaptation of ER cellular stress, reflecting a new cancer-specific vulnerability that is targetable. Citation Format: Crystal S. Conn, Hao G. Nguyen, Yae Kye, John T. Cunningham, Charles Truillet, Michael Evans, Tony L. Huynh, Peter Walters, Davide Ruggero. Sensing stress in cancer: a novel therapy targeting protein synthesis through the unfolded protein response in prostate cancer development. [abstract]. In: Proceedings of the AACR Special Conference on Translational Control of Cancer: A New Frontier in Cancer Biology and Therapy; 2016 Oct 27-30; San Francisco, CA. Philadelphia (PA): AACR; Cancer Res 2017;77(6 Suppl):Abstract nr A25.