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He MX, Cuoco MS, Crowdis J, Bosma-Moody A, Zhang Z, Bi K, Kanodia A, Su MJ, Ku SY, Garcia MM, Sweet AR, Rodman C, DelloStritto L, Silver R, Steinharter J, Shah P, Izar B, Walk NC, Burke KP, Bakouny Z, Tewari AK, Liu D, Camp SY, Vokes NI, Salari K, Park J, Vigneau S, Fong L, Russo JW, Yuan X, Balk SP, Beltran H, Rozenblatt-Rosen O, Regev A, Rotem A, Taplin ME, Van Allen EM. Transcriptional mediators of treatment resistance in lethal prostate cancer. Nat Med 2021; 27:426-433. [PMID: 33664492 PMCID: PMC7960507 DOI: 10.1038/s41591-021-01244-6] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 01/13/2021] [Indexed: 02/07/2023]
Abstract
Metastatic castration-resistant prostate cancer is typically lethal, exhibiting intrinsic or acquired resistance to second-generation androgen-targeting therapies and minimal response to immune checkpoint inhibitors1. Cellular programs driving resistance in both cancer and immune cells remain poorly understood. We present single-cell transcriptomes from 14 patients with advanced prostate cancer, spanning all common metastatic sites. Irrespective of treatment exposure, adenocarcinoma cells pervasively coexpressed multiple androgen receptor isoforms, including truncated isoforms hypothesized to mediate resistance to androgen-targeting therapies2,3. Resistance to enzalutamide was associated with cancer cell-intrinsic epithelial-mesenchymal transition and transforming growth factor-β signaling. Small cell carcinoma cells exhibited divergent expression programs driven by transcriptional regulators promoting lineage plasticity and HOXB5, HOXB6 and NR1D2 (refs. 4-6). Additionally, a subset of patients had high expression of dysfunction markers on cytotoxic CD8+ T cells undergoing clonal expansion following enzalutamide treatment. Collectively, the transcriptional characterization of cancer and immune cells from human metastatic castration-resistant prostate cancer provides a basis for the development of therapeutic approaches complementing androgen signaling inhibition.
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Affiliation(s)
- Meng Xiao He
- Harvard Graduate Program in Biophysics, Boston, MA USA ,grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.66859.34Broad Institute of Harvard and MIT, Cambridge, MA USA
| | - Michael S. Cuoco
- grid.66859.34Broad Institute of Harvard and MIT, Cambridge, MA USA
| | - Jett Crowdis
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.66859.34Broad Institute of Harvard and MIT, Cambridge, MA USA
| | - Alice Bosma-Moody
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.66859.34Broad Institute of Harvard and MIT, Cambridge, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
| | - Zhenwei Zhang
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.416999.a0000 0004 0591 6261Present Address: Department of Pathology, University of Massachusetts Memorial Medical Center, Worcester, MA USA
| | - Kevin Bi
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.66859.34Broad Institute of Harvard and MIT, Cambridge, MA USA
| | - Abhay Kanodia
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
| | - Mei-Ju Su
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
| | - Sheng-Yu Ku
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
| | - Maria Mica Garcia
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
| | - Amalia R. Sweet
- grid.239395.70000 0000 9011 8547Department of Medicine, Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, Boston, MA USA
| | | | - Laura DelloStritto
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.65499.370000 0001 2106 9910Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, MA USA
| | - Rebecca Silver
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
| | - John Steinharter
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
| | - Parin Shah
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
| | - Benjamin Izar
- Columbia Center for Translational Immunology, New York, NY USA ,grid.239585.00000 0001 2285 2675Department of Medicine, Division of Hematology/Oncology, Columbia University Medical Center, New York, NY USA
| | - Nathan C. Walk
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
| | - Kelly P. Burke
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.38142.3c000000041936754XDepartment of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA USA ,grid.62560.370000 0004 0378 8294Evergrande Center for Immunologic Diseases, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA USA
| | - Ziad Bakouny
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
| | - Alok K. Tewari
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
| | - David Liu
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.66859.34Broad Institute of Harvard and MIT, Cambridge, MA USA
| | - Sabrina Y. Camp
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.66859.34Broad Institute of Harvard and MIT, Cambridge, MA USA
| | - Natalie I. Vokes
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.66859.34Broad Institute of Harvard and MIT, Cambridge, MA USA ,grid.240145.60000 0001 2291 4776Present Address: Department of Thoracic/Head and Neck Oncology, MD Anderson Cancer Center, Houston, TX USA ,grid.240145.60000 0001 2291 4776Present Address: Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX USA
| | - Keyan Salari
- grid.66859.34Broad Institute of Harvard and MIT, Cambridge, MA USA ,grid.32224.350000 0004 0386 9924Department of Urology, Massachusetts General Hospital, Boston, MA USA
| | - Jihye Park
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.66859.34Broad Institute of Harvard and MIT, Cambridge, MA USA
| | - Sébastien Vigneau
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.66859.34Broad Institute of Harvard and MIT, Cambridge, MA USA ,grid.65499.370000 0001 2106 9910Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, MA USA
| | - Lawrence Fong
- grid.266102.10000 0001 2297 6811Division of Hematology and Oncology, University of California, San Francisco, San Francisco, CA USA
| | - Joshua W. Russo
- grid.239395.70000 0000 9011 8547Department of Medicine, Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, Boston, MA USA
| | - Xin Yuan
- grid.239395.70000 0000 9011 8547Department of Medicine, Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, Boston, MA USA
| | - Steven P. Balk
- grid.239395.70000 0000 9011 8547Department of Medicine, Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, Boston, MA USA
| | - Himisha Beltran
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
| | | | - Aviv Regev
- grid.66859.34Broad Institute of Harvard and MIT, Cambridge, MA USA ,grid.116068.80000 0001 2341 2786Department of Biology, Howard Hughes Medical Institute and Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA USA ,grid.418158.10000 0004 0534 4718Present Address: Genentech, South San Francisco, CA USA
| | - Asaf Rotem
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.66859.34Broad Institute of Harvard and MIT, Cambridge, MA USA ,grid.65499.370000 0001 2106 9910Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, MA USA ,grid.418152.bPresent Address: AstraZeneca, Waltham, MA USA
| | - Mary-Ellen Taplin
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
| | - Eliezer M. Van Allen
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.66859.34Broad Institute of Harvard and MIT, Cambridge, MA USA ,grid.65499.370000 0001 2106 9910Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, MA USA
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