Effective clinical management of prostate cancer (PCA) has been challenged by significant intratumoural heterogeneity on the genomic and pathological levels and limited understanding of the genetic elements governing disease progression1. Here, we exploited the experimental merits of the mouse to test the hypothesis that pathways constraining progression might be activated in indolent Pten-null mouse prostate tumours and that inactivation of such progression barriers in mice would engender a metastasis-prone condition. Comparative transcriptomic and canonical pathway analyses, followed by biochemical confirmation, of normal prostate epithelium versus poorly progressive Pten-null prostate cancers revealed robust activation of the TGFβ/BMP–SMAD4 signalling axis. The functional relevance of SMAD4 was further supported by emergence of invasive, metastatic and lethal prostate cancers with 100% penetrance upon genetic deletion of Smad4 in the Pten-null mouse prostate. Pathological and molecular analysis as well as transcriptomic knowledge-based pathway profiling of emerging tumours identified cell proliferation and invasion as two cardinal tumour biological features in the metastatic Smad4/Pten-null PCA model. Follow-on pathological and functional assessment confirmed cyclin D1 and SPP1 as key mediators of these biological processes, which together with PTEN and SMAD4, form a four-gene signature that is prognostic of prostate-specific antigen (PSA) biochemical recurrence and lethal metastasis in human PCA. This model-informed progression analysis, together with genetic, functional and translational studies, establishes SMAD4 as a key regulator of PCA progression in mice and humans.
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The authors are grateful to the late W. Gerald for providing the primary gene expression data and clinical outcome files13. We thank S. Zhou for excellent mouse husbandry and care, B. Xiong and G. Tonon for bioinformatic assistance, and S. Jia, J. M. Stommel, J. Paik, M. Kim and A. C. Kimmelman for helpful discussion. We thank M. Vidal, the Ellison Foundation and DFCI ISR for support of ORF cloning efforts, R. Maser for MSCV-puro-v5 gateway vector, W. Hahn for shRNA constructs. We thank the DF/HCC Specialized Histopathology Core and the DF/HCC Tissue Microarray and Imaging core for the TMA IHC staining; the DFCI/BWH Center for Molecular Oncologic Pathology (CMOP) for the quantification of the IHC. Z.D was supported by the Damon Runyon Cancer Research Foundation. D.H. was supported by a graduate fellowship from the National Science Foundation. H.Z. was supported by the Helen Hay Whitney Foundation. Y.A.W. was supported by the Multiple Myeloma Research Foundation. This work is supported by the Belfer Institute for Applied Cancer Science, NCI U01-CA84313 (L.C. and R.A.D.), DF/HCC SPORE in Prostate Cancer P50 CA090381-08 (Z.D.), the National Cancer Institute (M.L. RO1CA131945 and P50 CA90381, L.M. RO1 5R01CA136578, M.S. R01CA141298), and the Linda and Arthur Gelb Center for Translational Research (M.L.). R.A.D. was supported by an American Cancer Society Research Professorship and L.M. was supported by the Prostate Cancer Foundation.
The gene signature and technology developed in this paper have been licensed by Metamark GENETICS (http://www.metamarkgenetics.com/). L.C. and R.A.D. are the founders of Metamark GENETICS. Z.D., C.W. and M.L. are consultants for Metamark GENETICS.
The file contains Supplementary Figures 1-21 with legends and Supplementary Tables 1-8. (PDF 1558 kb)
This table shows a complete differentially expressed gene list was generated by a class comparison between WT (n=3) and Ptenpc-/- (n=5) anterior prostates at 15 weeks of age. (XLS 705 kb)
This table shows a complete differentially expressed gene list was generated by a class comparison between Ptenpc-/- (n=5) and Ptenpc-/-Smad4pc-/- (n=5) anterior prostate tumors at 15 weeks of age. (XLS 103 kb)
This table shows a complete differentially expressed gene list was generated by a class comparison between Ptenpc-/- and Ptenpc-/-p53pc-/- mouse anterior prostates at 15 weeks of age. (XLS 89 kb)
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