Prostate cancer is the second most common cancer in men, for which there are no reliable biomarkers or targeted therapies. Here we demonstrate that elevated levels of Δ133TP53β isoform characterize prostate cancers with immune cell infiltration, particularly T cells and CD163+ macrophages. These cancers are associated with shorter progression-free survival, Gleason scores ≥ 7, and an immunosuppressive environment defined by a higher proportion of PD-1, PD-L1 and colony-stimulating factor 1 receptor (CSF1R) positive cells. Consistent with this, RNA-seq of tumours showed enrichment for pathways associated with immune signalling and cell migration. We further show a role for hypoxia and wild-type p53 in upregulating Δ133TP53 levels. Finally, AUC analysis showed that Δ133TP53β expression level alone predicted aggressive disease with 88% accuracy. Our data identify Δ133TP53β as a highly accurate prognostic factor for aggressive prostate cancer.

The p53 protein is a pivotal tumor suppressor that is frequently mutated in many human cancers, although precisely how p53 prevents tumors is still unclear. To add to its complexity, several isoforms of human p53 have now been reported. The ⌬133p53 isoform is generated from an alternative transcription initiation site in intron 4 of the p53 gene (Tp53) and lacks the N-terminus. Elevated levels of ⌬133p53 have been observed in a variety of tumors. To explore the functions of ⌬133p53, we created a mouse expressing an N-terminal deletion mutant of p53 (⌬122p53) that corresponds to ⌬133p53. ⌬122p53 mice show decreased survival and a different and more aggressive tumor spectrum compared with p53 null mice, implying that ⌬122p53 is a dominant oncogene. Consistent with this, ⌬122p53 also confers a marked proliferative advantage on cells and reduced apoptosis. In addition to tumor development, ⌬122p53 mice show a profound proinflammatory phenotype having increased serum concentrations of interleukin-6 and other proinflammatory cytokines and lymphocyte aggregates in the lung and liver as well as other pathologies. Based on these observations, we propose that human ⌬133p53 also functions to promote cell proliferation and inflammation, one or both of which contribute to tumor development. (Blood. 2011;117(19): 5166-5177) Introduction p53 is most important for preventing cancers. We know this because mice deleted for the p53 gene (Trp53) are highly tumor prone 1 ; in humans, Li-Fraumeni syndrome, characterized by multiple tumor phenotypes, is the result of germline inherited mutations in the p53 gene (Tp53) 2 ; and most common human cancers contain mutations in Tp53 (www.p53.iarc.fr), generally rendering the protein functionally impaired. Ten isoforms of human p53 have been reported that are generated by the use of alternative translation initiation sites, splicing, or alternative promoters. [3][4][5][6][7][8][9] Two p53 isoforms (⌬40p53 and ⌬133p53) lack the N-terminus of p53, whereas 4 others (⌬40p53␤, ⌬40p53␥, ⌬133p53␤, and ⌬133p53␥) also lack part of the C-terminus beyond codon 331. In addition, 3 more isoforms have recently been described (⌬160p53, ⌬160p53␤, ⌬160p53␥) that use an alternative start codon at position 161 in the transcript for the ⌬133p53 isoform family. 8 The isoforms are generally expressed in a variable and to some extent tissue specific manner, although the ⌬133p53 isoform appears to be ubiquitous. 5 Aberrant expression of the ⌬133p53 isoforms occurs in a variety of tumors, including breast, 5 head and neck, 10 acute myeloid leukemia, 11 melanoma, 12 colon cancer, 13 and ovarian cancer, 14 suggesting that ⌬133p53 contributes to tumor formation. In zebrafish, the homolog of ⌬133p53 (⌬113p53) attenuates p53-dependent apoptosis by activating the homolog (bcl2l) of the antiapoptotic protein Bcl-xl, 15 and knockdown of ⌬113p53 using silencing RNA induced p53-dependent apoptosis. In another study, overexpression of ⌬133p53 extended the life span of normal human fibroblasts by inhibiting replicative senescen...

∆122p53 mice (a model of ∆133p53 isoform) are tumour-prone, have extensive inflammation and elevated serum IL-6. To investigate the role of IL-6 we crossed ∆122p53 mice with IL-6 null mice. Here we show that loss of IL-6 reduced JAK-STAT signalling, tumour incidence and metastasis. We also show that ∆122p53 activates RhoA-ROCK signalling leading to tumour cell invasion, which is IL-6-dependent and can be reduced by inhibition of JAK-STAT and RhoA-ROCK pathways. Similarly, we show that Δ133p53 activates these pathways, resulting in invasive and migratory phenotypes in colorectal cancer cells. Gene expression analysis of colorectal tumours showed enrichment of GPCR signalling associated with ∆133TP53 mRNA. Patients with elevated ∆133TP53 mRNA levels had a shorter disease-free survival. Our results suggest that ∆133p53 promotes tumour invasion by activation of the JAK-STAT and RhoA-ROCK pathways, and that patients whose tumours have high ∆133TP53 may benefit from therapies targeting these pathways.

The prognosis for people with the high-grade brain tumor glioblastoma is very poor, due largely to low cell death in response to genotoxic therapy. The transcription factor BCL6, a protein that normally suppresses the DNA damage response during immune cell maturation, and a known driver of B-cell lymphoma, was shown to mediate the survival of glioblastoma cells. Expression was observed in glioblastoma tumor specimens and cell lines. When BCL6 expression or activity was reduced in these lines, increased apoptosis and a profound loss of proliferation was observed, consistent with gene expression signatures suggestive of anti-apoptotic and pro-survival signaling role for BCL6 in glioblastoma. Further, treatment with the standard therapies for glioblastoma-ionizing radiation and temozolomide-both induced BCL6 expression in vitro, and an in vivo orthotopic animal model of glioblastoma. Importantly, inhibition of BCL6 in combination with genotoxic therapies enhanced the therapeutic effect. Together these data demonstrate that BCL6 is an active transcription factor in glioblastoma, that it drives survival of cells, and that it increased with DNA damage, which increased the survival rate of therapy-treated cells. This makes BCL6 an excellent therapeutic target in glioblastoma-by increasing sensitivity to standard DNA damaging therapy, BCL6 inhibitors have real potential to improve the outcome for people with this disease.