In lung and prostate adenocarcinomas, neuroendocrine (NE) transformation to an aggressive derivative resembling small cell lung cancer (SCLC) is associated with poor prognosis. We previously described dependency of SCLC on the nuclear transporter exportin 1. Here, we explored the role of exportin 1 in NE transformation. We observed up-regulated exportin 1 in lung and prostate pretransformation adenocarcinomas. Exportin 1 was up-regulated after genetic inactivation of TP53 and RB1 in lung and prostate adenocarcinoma cell lines, accompanied by increased sensitivity to the exportin 1 inhibitor selinexor in vitro. Exportin 1 inhibition prevented NE transformation in different TP53/RB1-inactivated prostate adenocarcinoma xenograft models that acquire NE features upon treatment with the aromatase inhibitor enzalutamide and extended response to the EGFR inhibitor osimertinib in a lung cancer transformation patient-derived xenograft (PDX) model exhibiting combined adenocarcinoma/SCLC histology. Ectopic SOX2 expression restored the enzalutamide-promoted NE phenotype on adenocarcinoma-to-NE transformation xenograft models despite selinexor treatment. Selinexor sensitized NE-transformed lung and prostate small cell carcinoma PDXs to standard cytotoxics. Together, these data nominate exportin 1 inhibition as a potential therapeutic target to constrain lineage plasticity and prevent or treat NE transformation in lung and prostate adenocarcinoma.
Science translational medicine. 2023 Aug 02 [Epub]
Alvaro Quintanal-Villalonga, Vidushi Durani, Amin Sabet, Esther Redin, Kenta Kawasaki, Moniquetta Shafer, Wouter R Karthaus, Samir Zaidi, Yingqian A Zhan, Parvathy Manoj, Harsha Sridhar, Nisargbhai S Shah, Andrew Chow, Umesh K Bhanot, Irina Linkov, Marina Asher, Helena A Yu, Juan Qiu, Elisa de Stanchina, Radhika A Patel, Colm Morrissey, Michael C Haffner, Richard P Koche, Charles L Sawyers, Charles M Rudin
Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA., Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA., Center for Epigenetics Research, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA., Precision Pathology Center, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA., Antitumor Assessment Core, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA., Divisions of Human Biology and Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA 19024, USA., Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98195, USA.