Enhancer profiling identifies epigenetic markers of endocrine resistance and reveals therapeutic options for metastatic castration-resistant prostate cancer patients

Tesa M Severson, Yanyun Zhu, Stefan Prekovic, Karianne Schuurman, Holly M Nguyen, Lisha G Brown, Sini Hakkola, Yongsoo Kim, Jeroen Kneppers, Simon Linder, Suzan Stelloo, Cor Lieftink, Michiel van der Heijden, Matti Nykter, Vincent van der Noort, Joyce Sanders, Ben Morris, Guido Jenster, Geert Jlh van Leenders, Mark PomerantzMatthew L Freedman, Roderick L Beijersbergen, Alfonso Urbanucci, Lodewyk Wessels, Eva Corey, Wilbert Zwart, Andries M Bergman

Research output: Working paperPreprintAcademic

Abstract

Androgen Receptor (AR) signaling inhibitors, including enzalutamide, are treatment options for patients with metastatic castration-resistant prostate cancer (mCRPC), but resistance inevitably develops. Using metastatic samples from a prospective phase II clinical trial, we epigenetically profiled enhancer/promoter activities with H3K27ac chromatin immunoprecipitation followed by sequencing, before and after AR-targeted therapy. We identified a distinct subset of H3K27ac-differentially marked regions that associated with treatment responsiveness. These data were successfully validated in mCRPC patient-derived xenograft models (PDX). In silico analyses revealed HDAC3 as a critical factor that can drive resistance to hormonal interventions, which we validated in vitro . Using cell lines and mCRPC PDX tumors in vitro , we identified drug-drug synergy between enzalutamide and the pan-HDAC inhibitor vorinostat, providing therapeutic proof-of-concept. These findings demonstrate rationale for new therapeutic strategies using a combination of AR and HDAC inhibitors to improve patient outcome in advanced stages of mCRPC.

Original languageEnglish
DOIs
Publication statusPublished - 24 Feb 2023
Externally publishedYes

Publication series

NamemedRxiv
PublisherCold Spring Harbor Laboratory Press

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