Abstract 238: Androgen insensitivity syndrome germline loss-of-function mutations in the androgen receptor that acquire somatic gain-of-function in prostate cancer

Genomic alterations in the androgen receptor (AR) commonly occur in patients with advanced prostate cancer resistant to androgen deprivation therapies. While still retaining androgen sensitivity, recurring AR mutations become drivers of antiandrogen resistance by causing alterations in the ligand binding pocket that enables one specific antiandrogen to bind that particular mutant receptor in an agonist conformation, thereby aberrantly activating AR transcriptional activity. We chronically treated antiandrogen-sensitive preclinical prostate cancer models (LNCaP-AR and CWR22Pc) with antiandrogens followed by high-throughput sequencing of the AR exons 2-8 to search for novel mutations that may be associated with antiandrogen resistance. The mutation A597T in the DNA binding domain was found in four LNCaP-AR xenograft tumors from mice receiving enzalutamide or ARN-509, while the ligand binding domain mutation P893S was uncovered in CWR22Pc cells treated in vitro with combined androgen depletion and bicalutamide. Recent whole exome sequencing studies of clinical prostate cancer identified single patients with each of these mutations at high allele frequencies and without concurrent AR amplification (www.cBioPortal.org). A597T occurred in a Gleason 6 primary tumor, whereas P893S was found in a patient with metastatic castration resistant prostate cancer who had received bicalutamide during the course of treatment. Remarkably, both A597T and P893S were earlier reported as germline loss-of-function mutations in patients with androgen insensitivity syndrome. Using an AR reporter assay in AR-null cells coupled with overexpression of these AR mutants, we confirmed that P893S is not activated by the androgen dihydrotestosterone (DHT), but nevertheless is potently stimulated by bicalutamide. In silico modeling showed that in contrast to the wild-type AR, cofactor-recruiting helix 12 of the ligand binding domain of P893S substantially drifted away from an agonist conformation when bound to DHT but was able to adopt the active conformation when simulated with bicalutamide. Importantly, overexpression of AR-P893S in CWR22Pc cells conferred bicalutamide resistance in vivo. These findings highlight an unexpected contextual element to the function of AR mutants, and suggest that rare or private AR mutations may nonetheless act as drivers of clinical progression.

Citation Format: Philip A. Watson, Minna D. Balbas, Zeda Zhang, Taslima F. Ishmael, Kayla E. Lawrence, John Wongvipat, Sophie D. Sawyers, Yi-Mi Wu, Dan Robinson, Yang Shen, Arul M. Chinnaiyan, Charles L. Sawyers. Androgen insensitivity syndrome germline loss-of-function mutations in the androgen receptor that acquire somatic gain-of-function in prostate cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 238.

Facilitating a culture of responsible and effective sharing of cancer genome data

Rapid and affordable tumor molecular profiling has led to an explosion of clinical and genomic data poised to enhance the diagnosis, prognostication and treatment of cancer. A critical point has now been reached at which the analysis and storage of annotated clinical and genomic information in unconnected silos will stall the advancement of precision cancer care. Information systems must be harmonized to overcome the multiple technical and logistical barriers to data sharing. Against this backdrop, the Global Alliance for Genomic Health (GA4GH) was established in 2013 to create a common framework that enables responsible, voluntary and secure sharing of clinical and genomic data. This Perspective from the GA4GH Clinical Working Group Cancer Task Team highlights the data-aggregation challenges faced by the field, suggests potential collaborative solutions and describes how GA4GH can catalyze a harmonized data-sharing culture.

Organoid culture systems for prostate epithelial and cancer tissue

This protocol describes a recently developed strategy to generate 3D prostate organoid cultures from healthy mouse and human prostate (either bulk or FAC-sorted single luminal and basal cells), metastatic prostate cancer lesions and circulating tumour cells. Organoids derived from healthy material contain the differentiated luminal and basal cell types, whereas organoids derived from prostate cancer tissue mimic the histology of the tumour. The stepwise establishment of these cultures and the fully defined serum-free conditioned medium that is required to sustain organoid growth are outlined. Organoids established using this protocol can be used to study many different aspects of prostate biology, including homeostasis, tumorigenesis and drug discovery.

Applying ⁸⁹Zr-Transferrin To Study the Pharmacology of Inhibitors to BET Bromodomain Containing Proteins

Chromatin modifying proteins are attractive drug targets in oncology, given the fundamental reliance of cancer on altered transcriptional activity. Multiple transcription factors can be impacted downstream of primary target inhibition, thus making it challenging to understand the driving mechanism of action of pharmacologic inhibition of chromatin modifying proteins. This in turn makes it difficult to identify biomarkers predictive of response and pharmacodynamic tools to optimize drug dosing. In this report, we show that ⁸⁹Zr-transferrin, an imaging tool we developed to measure MYC activity in cancer, can be used to identify cancer models that respond to broad spectrum inhibitors of transcription primarily due to MYC inhibition. As a proof of concept, we studied inhibitors of BET bromodomain containing proteins, as they can impart antitumor effects in a MYC dependent or independent fashion. In vitro, we show that transferrin receptor biology is inhibited in multiple MYC positive models of prostate cancer and double hit lymphoma when MYC biology is impacted. Moreover, we show that bromodomain inhibition in one lymphoma model results in transferrin receptor expression changes large enough to be quantified with ⁸⁹Zr-transferrin and positron emission tomography (PET) in vivo. Collectively, these data further underscore the diagnostic utility of the relationship between MYC and transferrin in oncology, and provide the rationale to incorporate transferrin-based PET into early clinical trials with bromodomain inhibitors for the treatment of solid tumors.

Investigation of a frequently mutated transcriptional repressor in prostate cancer, in particular its role in modulating androgen signaling and its effects on TMPRSS2-ERG dependent tumor maintenance

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Background: Recent genomic profiling of primary and metastatic prostate cancers revealed up to 27% of tumors contain putative loss-of-function point mutations or copy number deletions within the gene ERF, an ETS transcriptional repressor with a remarkably similar DNA-binding domain to the TMPRSS2-ERG gene product. Methods: Bioinformatic analysis of 450 patient tumors was obtained from the TCGA and SU2C datasets. Transcriptomic and cistromic analysis was achieved by RNA-seq and ChIP-seq on VCaP cells, as well as patient-derived organoid cultures of both normal and neoplastic prostates. Gene expression was inhibited by CRISPR or shRNA technology. Results: ERF copy number deletions are associated with Gleason 8+ primary disease (p = 0.0369), and ERF mRNA level inversely correlates with androgen-driven transcription (p < 0.0001) in the absence of androgen receptor amplification. Transient inhibition of ERG expression in TMPRSS2-ERG+ cancer models leads to a contraction of the androgen transcriptome. On the other hand, inhibition of ERF leads to an expansion of the androgen transcriptome, and moreover, supersedes the opposing effects of ERG. ERF and the TMPRSS2-ERG gene product have overlapping ETS cistromes that are associated with androgen-receptor binding sites; inhibition of one leads to occupancy at the vacated sites by the other. CRISPR-mediated inhibition of ERG in TMPRSS2-ERG+ models leads to a complete halt of growth, but concomitant loss of ERF partially restores cellular proliferation. Conclusions: ERF is a tumor suppressor with genomic loss-of-function mutations in up to 27% of prostate cancers, thereby expanding the concept of an ETS positive subtype. ERF occupies ETS sites of androgen-regulated genes and is an endogenous dampener of their transcription. Moreover, even in tumors lacking ERF mutations, upregulated ERG now occupies many of these same ETS sites, unmasking their transcriptional control by androgen. Thus, a key oncogenic activity of TMPRSS2-ERG is to antagonize endogenous ERF.

Abstract IA22: Reflections on precision medicine

The clinical success of molecularly targeted therapies such as imatinib for chronic myeloid leukemia sparked a revolution in cancer drug development as well as global efforts to define the landscape of genomic alterations across all cancers. Today we live in a world with a near complete understanding of all cancer gene mutations, giving us an unprecedented opportunity to leverage this knowledge to improve treatment outcomes, through precision medicine. Despite the many remarkable successes over the past 15 years, the goal of improved therapy for all cancers remains daunting due to the complexity of the genomic landscape and the challenges of overcoming drug resistance. With the rapid spread of next generation sequencing into the clinical arena at various cancer centers and health care institutions throughout the world, we have an opportunity to accelerate our understanding of treatment response and resistance through data sharing across these growing silos of genomic and clinical datasets. In this lecture I will illustrate the power of this approach through specific examples in prostate cancer and discuss interactional efforts to catalyzed data sharing through the Global Alliance for Genomics and Health (GA4GH).

Citation Format: Charles L. Sawyers. Reflections on precision medicine. [abstract]. In: Proceedings of the AACR Precision Medicine Series: Integrating Clinical Genomics and Cancer Therapy; Jun 13-16, 2015; Salt Lake City, UT. Philadelphia (PA): AACR; Clin Cancer Res 2016;22(1_Suppl):Abstract nr IA22.

Emerging mechanisms of resistance to androgen receptor inhibitors in prostate cancer

During the past 10 years, preclinical studies implicating sustained androgen receptor (AR) signalling as the primary driver of castration-resistant prostate cancer (CRPC) have led to the development of novel agents targeting the AR pathway that are now in widespread clinical use. These drugs prolong the survival of patients with late-stage prostate cancer but are not curative. In this Review, we highlight emerging mechanisms of acquired resistance to these contemporary therapies, which fall into the three broad categories of restored AR signalling, AR bypass signalling and complete AR independence. This diverse range of resistance mechanisms presents new challenges for long-term disease control, which may be addressable through early use of combination therapies guided by recent insights from genomic landscape studies of CRPC.

Abstract LB-A24: Molecular alteration of SMAD4 in hindgut-derived colorectal tumors identifies a distinct subset of patients and is associated with worse recurrence-free survival

This abstract has been withheld from publication due to its inclusion in the AACR-NCI-EORTC Molecular Targets Conference 2015 Official Press Program. It will be posted online at the time of its presentation in a press conference or in a session: 10:00 AM ET Friday, November 6.

Citation Format: Jesse Joshua Smith, Lik Hang Lee, Xi Chen, Chao Wu, Raphael Pelossof, Garrett M. Nash, Larissa R. Temple, Jose G. Guillem, Martin R. Weiser, Philip B. Paty, Jinru Shia, Julio Garcia-Aguilar, Charles L. Sawyers. Molecular alteration of SMAD4 in hindgut-derived colorectal tumors identifies a distinct subset of patients and is associated with worse recurrence-free survival. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2015 Nov 5-9; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2015;14(12 Suppl 2):Abstract nr LB-A24.

Identification of Different Classes of Luminal Progenitor Cells within Prostate Tumors

Primary prostate cancer almost always has a luminal phenotype. However, little is known about the stem/progenitor properties of transformed cells within tumors. Using the aggressive Pten/Tp53-null mouse model of prostate cancer, we show that two classes of luminal progenitors exist within a tumor. Not only did tumors contain previously described multipotent progenitors, but also a major population of committed luminal progenitors. Luminal cells, sorted directly from tumors or grown as organoids, initiated tumors of adenocarcinoma or multilineage histological phenotypes, which is consistent with luminal and multipotent differentiation potentials, respectively. Moreover, using organoids we show that the ability of luminal-committed progenitors to self-renew is a tumor-specific property, absent in benign luminal cells. Finally, a significant fraction of luminal progenitors survived in vivo castration. In all, these data reveal two luminal tumor populations with different stem/progenitor cell capacities, providing insight into prostate cancer cells that initiate tumors and can influence treatment response.

All the World's a Stage: Facilitating Discovery Science and Improved Cancer Care through the Global Alliance for Genomics and Health

The recent explosion of genetic and clinical data generated from tumor genome analysis presents an unparalleled opportunity to enhance our understanding of cancer, but this opportunity is compromised by the reluctance of many in the scientific community to share datasets and the lack of interoperability between different data platforms. The Global Alliance for Genomics and Health is addressing these barriers and challenges through a cooperative framework that encourages "team science" and responsible data sharing, complemented by the development of a series of application program interfaces that link different data platforms, thus breaking down traditional silos and liberating the data to enable new discoveries and ultimately benefit patients.

Identification of an oncogenic RAB protein

In a short hairpin RNA screen for genes that affect AKT phosphorylation, we identified the RAB35 small guanosine triphosphatase (GTPase)-a protein previously implicated in endomembrane trafficking-as a regulator of the phosphatidylinositol 3'-OH kinase (PI3K) pathway. Depletion of RAB35 suppresses AKT phosphorylation in response to growth factors, whereas expression of a dominant active GTPase-deficient mutant of RAB35 constitutively activates the PI3K/AKT pathway. RAB35 functions downstream of growth factor receptors and upstream of PDK1 and mTORC2 and copurifies with PI3K in immunoprecipitation assays. Two somatic RAB35 mutations found in human tumors generate alleles that constitutively activate PI3K/AKT signaling, suppress apoptosis, and transform cells in a PI3K-dependent manner. Furthermore, oncogenic RAB35 is sufficient to drive platelet-derived growth factor receptor α to LAMP2-positive endomembranes in the absence of ligand, suggesting that there may be latent oncogenic potential in dysregulated endomembrane trafficking.

Androgen Receptor Upregulation Mediates Radioresistance after Ionizing Radiation

Clinical trials have established the benefit of androgen deprivation therapy (ADT) combined with radiotherapy in prostate cancer. ADT sensitizes prostate cancer to radiotherapy-induced death at least in part through inhibition of DNA repair machinery, but for unknown reasons, adjuvant ADT provides further survival benefits. Here, we show that androgen receptor (AR) expression and activity are durably upregulated following radiotherapy in multiple human prostate cancer models in vitro and in vivo. Moreover, the degree of AR upregulation correlates with survival in vitro and time to tumor progression in animal models. We also provide evidence of AR pathway upregulation, measured by a rise in serum levels of AR-regulated hK2 protein, in nearly 20% of patients after radiotherapy. Furthermore, these men were three-fold more likely to experience subsequent biochemical failure. Collectively, these data demonstrate that radiotherapy can upregulate AR signaling after therapy to an extent that negatively affects disease progression and/or survival.

Integrative clinical genomics of advanced prostate cancer

Toward development of a precision medicine framework for metastatic, castration-resistant prostate cancer (mCRPC), we established a multi-institutional clinical sequencing infrastructure to conduct prospective whole-exome and transcriptome sequencing of bone or soft tissue tumor biopsies from a cohort of 150 mCRPC affected individuals. Aberrations of AR, ETS genes, TP53, and PTEN were frequent (40%-60% of cases), with TP53 and AR alterations enriched in mCRPC compared to primary prostate cancer. We identified new genomic alterations in PIK3CA/B, R-spondin, BRAF/RAF1, APC, β-catenin, and ZBTB16/PLZF. Moreover, aberrations of BRCA2, BRCA1, and ATM were observed at substantially higher frequencies (19.3% overall) compared to those in primary prostate cancers. 89% of affected individuals harbored a clinically actionable aberration, including 62.7% with aberrations in AR, 65% in other cancer-related genes, and 8% with actionable pathogenic germline alterations. This cohort study provides clinically actionable information that could impact treatment decisions for these affected individuals.

Cabozantinib resolves bone scans in tumor-naïve mice harboring skeletal injuries

The receptor tyrosine kinase inhibitor cabozantinib (XL184, BMS-907351 Cometriq) has displayed impressive clinical activity against several indications, culminating in its recent approval for medullary thyroid cancer. Among malignancies with tropism for the bone (prostate, breast), one striking feature of early clinical reports about this drug has been the rapid and complete resolution of bone scans, a phenomenon almost never observed even among therapies already shown to confer survival benefit. In castration-resistant prostate cancer, not all conventional response indicators change as dramatically posttreatment, raising the possibility that cabozantinib may impair the ability of bone-seeking radionuclides to integrate within the remodeling bone. To test this hypothesis, we surgically induced bone remodeling via physical insult in non-tumor-bearing mice and performed 18F-sodium fluoride (18F-NaF) positron emission tomographic (PET) and technetium 99m-methylene diphosphonate (99mTc-MDP) single-photon emission computed tomographic (SPECT) scans pre- and posttreatment with cabozantinib and related inhibitors. A consistent reduction in the accumulation of either radiotracer at the site of bone remodeling was observed in animals treated with cabozantinib. Given that cabozantinib is known to inhibit several receptor tyrosine kinases, we drugged animals with various permutations of more selective inhibitors to attempt to refine the molecular basis of bone scan resolution. Neither the vascular endothelial growth factor receptor (VEGFR) inhibitor axitinib, the MET inhibitor crizotinib, nor the combination was capable of inhibiting 18F-NaF accumulation at known bioactive doses. In summary, although the mechanism by which cabozantinib suppresses radionuclide incorporation into foci undergoing bone remodeling remains unknown, that this phenomenon occurs in tumor-naïve models indicates that caution should be exercised in interpreting the clinical significance of this event.

Feedback suppression of PI3Kα signaling in PTEN-mutated tumors is relieved by selective inhibition of PI3Kβ

In PTEN-mutated tumors, we show that PI3Kα activity is suppressed and PI3K signaling is driven by PI3Kβ. A selective inhibitor of PI3Kβ inhibits the Akt/mTOR pathway in these tumors but not in those driven by receptor tyrosine kinases. However, inhibition of PI3Kβ only transiently inhibits Akt/mTOR signaling because it relieves feedback inhibition of IGF1R and other receptors and thus causes activation of PI3Kα and a rebound in downstream signaling. This rebound is suppressed and tumor growth inhibition enhanced with combined inhibition of PI3Kα and PI3Kβ. In PTEN-deficient models of prostate cancer, this effective inhibition of PI3K causes marked activation of androgen receptor activity. Combined inhibition of both PI3K isoforms and androgen receptor results in major tumor regressions.

Identifying actionable targets through integrative analyses of GEM model and human prostate cancer genomic profiling

Copy-number alterations (CNA) are among the most common molecular events in human prostate cancer genomes and are associated with worse prognosis. Identification of the oncogenic drivers within these CNAs is challenging due to the broad nature of these genomic gains or losses which can include large numbers of genes within a given region. Here, we profiled the genomes of four genetically engineered mouse prostate cancer models that reflect oncogenic events common in human prostate tumors, with the goal of integrating these data with human prostate cancer datasets to identify shared molecular events. Met was amplified in 67% of prostate tumors from Pten p53 prostate conditional null mice and in approximately 30% of metastatic human prostate cancer specimens, often in association with loss of PTEN and TP53. In murine tumors with Met amplification, Met copy-number gain and expression was present in some cells but not others, revealing intratumoral heterogeneity. Forced MET overexpression in non-MET-amplified prostate tumor cells activated PI3K and MAPK signaling and promoted cell proliferation and tumor growth, whereas MET kinase inhibition selectively impaired the growth of tumors with Met amplification. However, the impact of MET inhibitor therapy was compromised by the persistent growth of non-Met-amplified cells within Met-amplified tumors. These findings establish the importance of MET in prostate cancer progression but reveal potential limitations in the clinical use of MET inhibitors in late-stage prostate cancer.

Abstract 2244: SPOP mutations in prostate cancer across demographically diverse patient cohorts

Background

Recurrent mutations in the Speckle-Type POZ Protein (SPOP) gene have been reported in up to 15% of prostate cancers. However, the frequency and features of cancers with these mutations across different populations is unclear. In addition, detection of point mutations in archival samples can be technically challenging, making mutational analysis of well annotated archival tissue difficult. We set out to investigate SPOP mutations across diverse cohorts, and validate a series of assays employing High Resolution Melting Analysis (HRM) and Sanger sequencing for mutational analysis of FFPE material.

Methods:

An assay employing HRM and Sanger sequencing was optimized to screen for somatic mutations in recurrently altered areas of the SPOP gene. 720 prostate cancer samples from six international cohorts spanning Caucasian, African American, and Asian patients, including both PSA-screened and unscreened populations, were screened for their SPOP mutation status. Status of SPOP was correlated to molecular features (ERG rearrangement, PTEN deletion, CHD1 deletion) as well as clinical and pathologic features.

Results:

The overall frequency of SPOP mutations was 8.1% in 720 patient's samples, ranging from 4.6% in the African American cohort to 14.4% in the WCMC cohort. There were no significant differences in frequency between ethnicities or cohorts (p=0.14). SPOP mutation was inversely associated with ERG rearrangement (p&lt;0.01), and SPOP mutant cancers had higher rates of CHD1 deletions (p&lt;0.01). There were no significant differences in rates or time to biochemical recurrence (BCR) in SPOP wild-type (wt) vs mutants (p=0.18, 0.30 respectively). The mutational assays showed excellent sensitivity and specificity in high quality samples. Limitations of this study include missing mutational data due to sample quality and lack of power to identify a difference in clinical outcomes.

Conclusions:

In this study we were able to show the high sensitivity of HRM followed by Sanger Sequencing to detect mutated SPOP in 720 cases consisting of fresh frozen as well as FFPE material. Using next generation sequencing did not rescue samples which were determined as “assay failure” by HRM and or Sanger Sequencing. SPOP is mutated in 4.6-14.4% of prostate cancer patients across different ethnic and demographic backgrounds. There was no significant association between SPOP mutations with ethnicity, clinical or pathologic parameters. Mutual exclusivity of SPOP mutation with ERG rearrangement as well as a high association with CHD1 deletion reinforces SPOP mutation as defining a distinct molecular subclass of prostate cancer.

Citation Format: Mirjam Blattner, Daniel Lee, Catherine O´Reilly, Kyung Park, Theresa Y. MacDonald, Francesca Khani, Kevin Turner, Peter J. Wild, Haley Hieronymus, Charles L. Sawyers, Ashutosh K. Tewari, Holger Moch, Ghil Suk Yoon, Ove Andrén, Katja Fall, Juan Miguel Mosquera, Brian D. Robinson, Andrea Sboner, Christopher E. Barbierie, Mark A. Rubin. SPOP mutations in prostate cancer across demographically diverse patient cohorts. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2244. doi:10.1158/1538-7445.AM2014-2244

CDK9-mediated transcription elongation is required for MYC addiction in hepatocellular carcinoma

One-year survival rates for newly diagnosed hepatocellular carcinoma (HCC) are <50%, and unresectable HCC carries a dismal prognosis owing to its aggressiveness and the undruggable nature of its main genetic drivers. By screening a custom library of shRNAs directed toward known drug targets in a genetically defined Myc-driven HCC model, we identified cyclin-dependent kinase 9 (Cdk9) as required for disease maintenance. Pharmacological or shRNA-mediated CDK9 inhibition led to robust anti-tumor effects that correlated with MYC expression levels and depended on the role that both CDK9 and MYC exert in transcription elongation. Our results establish CDK9 inhibition as a therapeutic strategy for MYC-overexpressing liver tumors and highlight the relevance of transcription elongation in the addiction of cancer cells to MYC.

Abstract 4774: The antitumor effects of PI3K beta inhibitors in PTEN negative prostate cancer are enhanced by inhibition of reactivated PI3K alpha signaling

The PI3K pathway is dysregulated in many cancers via selective activation of class 1 isoforms. In tumors with deficient PTEN function, signaling is driven by PI3K beta. We show here that a selective inhibitor of PI3K beta inhibits the AKT/mTOR pathway in tumors with defective PTEN function, but is ineffective in those where the pathway is driven by receptor tyrosine kinases. However, inhibition of PI3K signaling by PI3K beta inhibitors is limited by relief of AKT/mTOR dependent feedback and reactivation of IGF1R and other receptors. This results in activation of PI3K alpha and a rebound of PI3K-AKT signaling. This rebound is suppressed and tumor cell inhibition is enhanced with combined inhibition of PI3K alpha and beta. Combined administration of isoform selective PI3K inhibitors may more effectively inhibit the pathway than pan-PI3K inhibitors because of the greater selectivity and decreased off-target toxicity of the former.

In PTEN deficient models of prostate cancer, triple therapy with PI3K alpha and beta selective inhibitors combined with a potent androgen receptor inhibitor suppresses the reciprocal feedback activation of both pathways and results in marked (complete) eradication of tumors in vivo.

Citation Format: Sarit Schwartz, Brett S. Carver, John Wongvipat, Vanessa Rodrik-Outmezguine, Elisa De Stanchina, Cath Trigwell, Simon Barry, Jose Baselga, Sarat Chandarlapaty, Howard I. Scher, Charles L. Sawyers, Neal Rosen. The antitumor effects of PI3K beta inhibitors in PTEN negative prostate cancer are enhanced by inhibition of reactivated PI3K alpha signaling. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4774. doi:10.1158/1538-7445.AM2014-4774

Identification of multipotent luminal progenitor cells in human prostate organoid cultures

The prostate gland consists of basal and luminal cells arranged as pseudostratified epithelium. In tissue recombination models, only basal cells reconstitute a complete prostate gland, yet murine lineage-tracing experiments show that luminal cells generate basal cells. It has remained challenging to address the molecular details of these transitions and whether they apply to humans, due to the lack of culture conditions that recapitulate prostate gland architecture. Here, we describe a 3D culture system that supports long-term expansion of primary mouse and human prostate organoids, composed of fully differentiated CK5+ basal and CK8+ luminal cells. Organoids are genetically stable, reconstitute prostate glands in recombination assays, and can be experimentally manipulated. Single human luminal and basal cells give rise to organoids, yet luminal-cell-derived organoids more closely resemble prostate glands. These data support a luminal multilineage progenitor cell model for prostate tissue and establish a robust, scalable system for mechanistic studies.

Organoid cultures derived from patients with advanced prostate cancer

The lack of in vitro prostate cancer models that recapitulate the diversity of human prostate cancer has hampered progress in understanding disease pathogenesis and therapy response. Using a 3D organoid system, we report success in long-term culture of prostate cancer from biopsy specimens and circulating tumor cells. The first seven fully characterized organoid lines recapitulate the molecular diversity of prostate cancer subtypes, including TMPRSS2-ERG fusion, SPOP mutation, SPINK1 overexpression, and CHD1 loss. Whole-exome sequencing shows a low mutational burden, consistent with genomics studies, but with mutations in FOXA1 and PIK3R1, as well as in DNA repair and chromatin modifier pathways that have been reported in advanced disease. Loss of p53 and RB tumor suppressor pathway function are the most common feature shared across the organoid lines. The methodology described here should enable the generation of a large repertoire of patient-derived prostate cancer lines amenable to genetic and pharmacologic studies.