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Publication : The neuroendocrine transition in prostate cancer is dynamic and dependent on ASCL1.

First Author  Romero R Year  2024
Journal  Nat Cancer Volume  5
Issue  11 Pages  1641-1659
PubMed ID  39394434 Mgi Jnum  J:360745
Mgi Id  MGI:7785153 Doi  10.1038/s43018-024-00838-6
Citation  Romero R, et al. (2024) The neuroendocrine transition in prostate cancer is dynamic and dependent on ASCL1. Nat Cancer 5(11):1641-1659
abstractText  Lineage plasticity is a hallmark of cancer progression that impacts therapy outcomes, yet the mechanisms mediating this process remain unclear. Here, we introduce a versatile in vivo platform to interrogate neuroendocrine lineage transformation throughout prostate cancer progression. Transplanted mouse prostate organoids with human-relevant driver mutations (Rb1(-/-); Trp53(-/-); cMyc(+) or Pten(-/-); Trp53(-/-); cMyc(+)) develop adenocarcinomas, but only those with Rb1 deletion advance to aggressive, ASCL1(+) neuroendocrine prostate cancer (NEPC) resistant to androgen receptor signaling inhibitors. Notably, this transition requires an in vivo microenvironment not replicated by conventional organoid culture. Using multiplexed immunofluorescence and spatial transcriptomics, we reveal that ASCL1(+) cells arise from KRT8(+) luminal cells, progressing into transcriptionally heterogeneous ASCL1(+);KRT8(-) NEPC. Ascl1 loss in established NEPC causes transient regression followed by recurrence, but its deletion before transplantation abrogates lineage plasticity, resulting in castration-sensitive adenocarcinomas. This dynamic model highlights the importance of therapy timing and offers a platform to identify additional lineage plasticity drivers.
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