Abstract
Therapy resistance to second-generation androgen receptor (AR) antagonists, such as enzalutamide, is common in patients with advanced prostate cancer (PCa). To understand the metabolic alterations involved in enzalutamide resistance, we performed metabolomic, transcriptomic, and cistromic analyses of enzalutamide-sensitive and -resistant PCa cells, xenografts, patient-derived organoids, patient-derived explants, and tumors. We noted dramatically higher basal and inducible levels of reactive oxygen species (ROS) in enzalutamide-resistant PCa and castration-resistant PCa (CRPC), in comparison to enzalutamide-sensitive PCa cells or primary therapy-naive tumors respectively. Unbiased metabolomic evaluation identified that glutamine metabolism was consistently upregulated in enzalutamide-resistant PCa cells and CRPC tumors. Stable isotope tracing studies suggest that this enhanced glutamine metabolism drives an antioxidant program that allows these cells to tolerate higher basal levels of ROS. Inhibition of glutamine metabolism with either a small-molecule glutaminase inhibitor or genetic knockout of glutaminase enhanced ROS levels, and blocked the growth of enzalutamide-resistant PCa. The critical role of compensatory antioxidant pathways in maintaining enzalutamide-resistant PCa cells was validated by targeting another antioxidant program driver, ferredoxin 1. Taken together, our data identify a metabolic need to maintain antioxidant programs and a potentially targetable metabolic vulnerability in enzalutamide-resistant PCa.
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All data generated or analyzed during this study are included in this published article and corresponding supplementary information files. Any additional datasets generated during and/or analyzed during this study are available from the corresponding author upon reasonable request.
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Acknowledgements
We would like to thank Lauren Zacharias, Hieu Vieu, Duyen Do, Jessica Sudderth, and the Children’s Research Institute Metabolomic core for their assistance with metabolic assays and analysis, as well as the Children’s Research Institute Flow Cytometry core and UTSW Live Cell Imaging core for providing training and equipment for microscopy and flow cytometry experiments. We also thank the Simmon’s Cancer Center’s Tissue Management Shared Resource, which provided the patient tissue reported in this publication with support from National Cancer Institute of the NIH award no. P30CA142543. Additionally, we would like to thank Jer-Tsong (JT) Hsieh, Donald Vander Griend, and Amina Zoubeidi for providing cell lines for this study. Additional thanks goes to Tracy Rosales for providing helpful information and advice on experiments involving glutaminase and glutamine metabolism. Some figures were created using biorender.com.
Funding
The National Cancer Institute at the National Institutes of Health Grant 1F31CA243276-01A1 and the Cancer Prevention and Research Institute of Texas Grant RP160157 (EBB). The National Cancer Institute at the National Institutes of Health Grant T32CA124334 (KP). Simmons Cancer Center at UT Southwestern for the Prostate Cancer Program, the Mimi and John Cole Prostate Cancer Fund, the Prostate Cancer Foundation, the Jasper L. and Jack Denton Wilson Foundation, and the Department of Defense Grants W81XWH-17-1-0674, W81XWH-19-1-0363, and W81XWH-21-1-0687 (GVR). RSM acknowledges funding support from National Cancer Institute (NCI)/NIH grant (R01CA245294), Cancer Prevention and Research Institute of Texas (CPRIT) Individual Investigator Research Award (RP190454), and US Department of Defense Breakthrough Award (W81XWH-21-1-0114).
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Experiments were conceptualized, performed, and analyzed by EBB. EBB also responsible for methodology, funding acquisition, and writing the original and editing further manuscript drafts. Funding was acquired, experiments performed, and editing manuscript drafts by KP. Experiments performed and manuscript drafts edited by AN and LB. Formal analysis performed and manuscript drafts edited by YG, DB, and WY. Manuscript drafts edited by AP and SC. Experiments performed and manuscript drafts edited by CG. Methodology, supervision, and manuscript drafts edited by RJD. Supervision and manuscript drafts edited by RSM and JSdB. Funding acquisition, methodology, supervision, and manuscript drafts edited by GVR.
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GVR serves or has served in an advisory role to Bayer, Johnson and Johnson, Myovant, EtiraRx, Amgen, Pfizer and Astellas. He has or has had grant support from Bayer, EtiraRx and Johnson and Johnson. RJD is a founder and advisor for Atavistik Bioscience, and a scientific advisor for Agios Pharmaceuticals, Nirology Therapeutics, Droia Ventures, and Vida Ventures. JSdB has served on advisory boards and received fees from Amgen, Astra Zeneca, Astellas, Bayer, Bioxcel Therapeutics, Boehringer Ingelheim, Cellcentric, Daiichi, Eisai, Genentech/Roche, Genmab, GSK, Harpoon, ImCheck Therapeutics, Janssen, Merck Serono, Merck Sharp & Dohme, Menarini/Silicon Biosystems, Orion, Pfizer, Qiagen, Sanofi Aventis, Sierra Oncology, Taiho, Terumo, and Vertex Pharmaceuticals; is an employee of the Institute of Cancer Research (ICR), which have received funding or other support for his research work from AZ, Astellas, Bayer, Cellcentric, Daiichi, Genentech, Genmab, GSK, Janssen, Merck Serono, MSD, Menarini/Silicon Biosystems, Orion, Sanofi Aventis, Sierra Oncology, Taiho, Pfizer, and Vertex, and which has a commercial interest in abiraterone, PARP inhibition in DNA repair defective cancers, and PI3K/AKT pathway inhibitors (no personal income); was named as an inventor, with no financial interest for patent 8 822 438, submitted by Janssen that covers the use of abiraterone acetate with corticosteroids; has been the CI/PI of many industry-sponsored clinical trials; and is a National Institute for Health Research (NIHR) Senior Investigator. AN, LB, DB, WY, AP, SC, and JSdB are employees of the Institute of Cancer Research (ICR), which has commercial interest in abiraterone. No other authors have any potential conflicts of interest to disclose.
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Blatt, E.B., Parra, K., Neeb, A. et al. Critical role of antioxidant programs in enzalutamide-resistant prostate cancer. Oncogene 42, 2347–2359 (2023). https://doi.org/10.1038/s41388-023-02756-w
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DOI: https://doi.org/10.1038/s41388-023-02756-w
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