Abstract
Abstract Primary prostate cancer is characterized by its dependence on androgen receptor (AR) and often has hyperactive PI3K signaling, most frequently through loss of PTEN. PI3K/AKT pathway inhibitors are in late-stage clinical development in combination with anti-AR therapy. Androgen deprivation therapy is a cornerstone of treatment for advanced prostate cancer, but the development of castration-resistant prostate cancer (CRPC) eventually occurs. CRPC remains largely dependent on AR for growth with a subset of CRPC that lose AR dependence. There is an urgent need to study the molecular pathways leading to AR activation and the loss of AR reliance in order to identify therapeutic targets. KMT2D is a histone methyltransferase and an important regulator of gene expression. Here we found that KMT2D establishes the chromatin competence necessary for the recruitment of AR and FOXA1 transcription factors (TFs) to activate AR-dependent transcription in AR-high prostate models. In AR-low models such as the stem cell-like (SCL) subtype, KMT2D controls residual AR-FOXA1 gene expression programs and AP-1 TFs such as FOSL1, a driver of the SCL subtype. In SCL, single cell RNA-seq and single cell chromatin assays confirm a key role for KMT2D in the maintenance of a mixed lineage cell state through the regulation of AP-1 and FOXA1 TFs. Combined suppression of PI3K/AKT and KMT2D reduces cell proliferation in prostate cancer cells and patient derived organoids, providing a rationale for epigenetically informed combination therapies with PI3K/AKT inhibitors in PTEN-deficient prostate cancer. Together, these data establish KMT2D as a major mediator of subtype-specific chromatin accessibility and transcriptomic landscape in CRPC, required for prostate cancer growth and therapeutic response. Citation Format: Srushti Kittane, Erik Ladewig, Taibo Li, Jillian Love, Amaia Arruabarrena-Aristorena, Xinyu Guo, Mirna Sallaku, Liliana Garcia-Martinez, Ryan Blawski, Javier Carmona Sanz, Christopher Simpkins, Wanlu Chen, Bujamin Vokshi, Peihua Zhao, Nachiket Kelkar, Laura Baldino, Ingrid Kalemi, Pau Castel, Emiliano Cocco, Lluis Morey, Charles Sawyers, Hongkai Ji, Maurizio Scaltriti, Alexis Battle, Christina Leslie, Wouter Karthaus, Eneda Toska. The histone methyltransferase KMT2D mediates subtype-specific transcriptional regulation and therapeutic response in prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1245.