24Dean.Tang@Roswellpark.org.
26The authors declare no potential conflicts of interest. 27 28 29 30 2 ABSTRACT (150 words) 35 36 Dysregulation of mRNA alternative splicing (AS) has been implicated in development and progression 37 of hematological malignancies. Here we describe the first comprehensive AS landscape in the 38 spectrum of human prostate cancer (PCa) development, progression and therapy resistance. We find 39 that the severity of splicing dysregulation correlates with disease progression and establish intron 40 retention (IR) as a hallmark of PCa stemness and aggressiveness. Systematic interrogation of 274 41 splicing-regulatory genes (SRGs) uncovers prevalent SRG mutations associated with, mainly, copy 42 number variations leading to mis-expression of ~68% of SRGs during PCa evolution. Consequently, 43 we identify many SRGs as prognostic markers associated with splicing disruption and patient 44 outcome. Interestingly, androgen receptor (AR) controls a splicing program distinct from its 45 transcriptional regulation. The spliceosome modulator, E7107, reverses cancer aggressiveness and 46 abolishes the growth of castration-resistant PCa (CRPC) models. Altogether, we establish aberrant 47 AS landscape caused by dysregulated SRGs as a novel therapeutic vulnerability for CRPC. 48 49 50 Statement of significance (49 words)
51We present the first comprehensive AS landscape during PCa evolution and link genomic and 52 transcriptional alterations in SRGs to global splicing dysregulation. AR regulates splicing in pri-PCa 53 and CRPC distinct from its transcriptional regulation. Intron retention is a hallmark for and 54 spliceosome represents a therapeutic vulnerability in aggressive PCa. 55 56 57 58 59 Prostate cancer (PCa) still causes a significant mortality among men world-wide (1). The prostate is 60 an exocrine gland containing mainly androgen receptor negative (AR -) basal and AR + luminal 61 epithelial cells, together with rare neuroendocrine (NE) cells (2,3). PCa predominantly displays a 62 luminal phenotype and histologically presents as adenocarcinomas (Ad) largely devoid of basal cells 63 (4). Most primary PCa (pri-PCa) are diagnosed as low to intermediate grade (i.e., Gleason grade ≤7),
64relatively indolent, and treated by radical prostatectomy and/or radiation with a good prognosis.
65Locally advanced (Gleason grade 9/10) and metastatic PCa are generally treated with androgen 66 deprivation therapy (ADT) using LHRH agonists/antagonists, which block testicular androgen 67 synthesis. Tumors that have failed this first-line therapy are termed castration-resistant PCa (CRPC) 68 and further treated with anti-androgens such as enzalutamide (Enza) that interfere with the functions 69 of AR. Enza extends CRPC patients' lives by ~5 months but tumors inevitably become refractory to 70 Enza. While the majority of CRPC and Enza-resistant tumors histologically present as 71 adenocarcinoma (i.e., CRPC-Ad), a significant fraction (up to 25%) of them evolve to an aggressive,
72AR-indifferent disease with NE fea...