Castration-resistant prostate cancer can be treated with the anti-androgen enzalutamide, but responses and duration of response are variable. To identify genes that support enzalutamide resistance, we performed a short hairpin RNA (shRNA) screen in the bone-homing, castrationresistant prostate cancer cell line, C4-2B. We identified eleven genes (TFAP2C, CAD, SPDEF, EIF6, GABRG2, CDC37, PSMD12, COL5A2, AR, MAP3K11, and ACAT1), whose loss resulted in decreased cell survival in response to enzalutamide. To validate our screen, we performed transient knockdowns in C4-2B and 22Rv1 cells and evaluated cell survival in response to enzalutamide. Through these studies, we validated three genes (ACAT1, MAP3K11, and PSMD12) as supporters of enzalutamide resistance in vitro. Although ACAT1 expression is lower in metastatic castration-resistant prostate cancer samples versus primary prostate cancer samples, knockdown of ACAT1 was sufficient to reduce cell survival in C4-2B and 22Rv1 cells.MAP3K11 expression increases with Gleason grade, and the highest expression is observed in metastatic castration-resistant disease. Knockdown of MAP3K11 reduced cell survival and pharmacologic inhibition of MAP3K11 with CEP-1347 in combination with enzalutamide resulted in a dramatic increase in cell death. This was associated with decreased phosphorylation of AR-Serine650, which is required for maximal AR activation. Finally, while PSMD12 expression did not change during disease progression, knockdown of PSMD12 resulted in decreased AR and AR splice variant expression, likely contributing to the C4-2B and 22Rv1 decrease in cell survival.Our study has therefore identified at least three new supporters of enzalutamide resistance in castration-resistant prostate cancer cells in vitro.
IntroductionEarly stage prostate cancer is an androgen-dependent disease, and advanced prostate cancer is largely treated with androgen deprivation therapy, which targets androgen receptor (AR). Inevitably, tumors progress to castration-resistant prostate cancer. In castration-resistant prostate cancer, AR signaling continues through multiple mechanisms including AR full length (AR-FL) over-expression, increases in androgen production, and induction of constitutively active AR splice variants (AR-V) [1]. Currently, abiraterone acetate and enzalutamide are standard therapies in metastatic castration-resistant prostate cancer [2, 3]. Enzalutamide is well tolerated and effective, extending castration-resistant prostate cancer patient survival by 5 months versus placebo after chemotherapy[4] and delaying initiation of chemotherapy by 18 months versus placebo [5]. Nevertheless, tumors progress to enzalutamide-resistant castration-resistant prostate cancer. How these tumors progress to resistance is an area of active investigation, but both AR-dependent and AR-independent mechanisms have been proposed.The purpose of our studies was to identify genes that support resistance to enzalutamide and identify gene products (proteins) that once targeted could re-sensitize tum...