Transcriptional profiling clarifies a program of enzalutamide extreme non-response in lethal prostate cancer

Abstract The androgen receptor inhibitor enzalutamide is one of the principal treatments for metastatic prostate cancer. Most patients respond. However, a subset is primary refractory. Seeking to understand enzalutamide extreme non-response (ENR), we analyzed RNA-sequencing in biopsies from men trea...

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Main Authors: Anbarasu Kumaraswamy, Ya-Mei Hu, Joel A. Yates, Chao Zhang, Eva Rodansky, Dhruv Khokhani, Diana Flores, Zhi Duan, Yi Zhang, Shaadi Tabatabaei, Rachel Slottke, Shangyuan Ye, Primo Lara, Adam Foye, Charles J. Ryan, David A. Quigley, Jiaoti Huang, Rahul Aggarwal, Robert E. Reiter, Max S. Wicha, Tomasz M. Beer, Matthew Rettig, Martin Gleave, Christopher P. Evans, Owen N. Witte, Joshua M. Stuart, George V. Thomas, Felix Y. Feng, Eric J. Small, Zheng Xia, Joshi J. Alumkal
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:npj Precision Oncology
Online Access:https://doi.org/10.1038/s41698-025-01002-8
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author Anbarasu Kumaraswamy
Ya-Mei Hu
Joel A. Yates
Chao Zhang
Eva Rodansky
Dhruv Khokhani
Diana Flores
Zhi Duan
Yi Zhang
Shaadi Tabatabaei
Rachel Slottke
Shangyuan Ye
Primo Lara
Adam Foye
Charles J. Ryan
David A. Quigley
Jiaoti Huang
Rahul Aggarwal
Robert E. Reiter
Max S. Wicha
Tomasz M. Beer
Matthew Rettig
Martin Gleave
Christopher P. Evans
Owen N. Witte
Joshua M. Stuart
George V. Thomas
Felix Y. Feng
Eric J. Small
Zheng Xia
Joshi J. Alumkal
author_facet Anbarasu Kumaraswamy
Ya-Mei Hu
Joel A. Yates
Chao Zhang
Eva Rodansky
Dhruv Khokhani
Diana Flores
Zhi Duan
Yi Zhang
Shaadi Tabatabaei
Rachel Slottke
Shangyuan Ye
Primo Lara
Adam Foye
Charles J. Ryan
David A. Quigley
Jiaoti Huang
Rahul Aggarwal
Robert E. Reiter
Max S. Wicha
Tomasz M. Beer
Matthew Rettig
Martin Gleave
Christopher P. Evans
Owen N. Witte
Joshua M. Stuart
George V. Thomas
Felix Y. Feng
Eric J. Small
Zheng Xia
Joshi J. Alumkal
author_sort Anbarasu Kumaraswamy
collection DOAJ
description Abstract The androgen receptor inhibitor enzalutamide is one of the principal treatments for metastatic prostate cancer. Most patients respond. However, a subset is primary refractory. Seeking to understand enzalutamide extreme non-response (ENR), we analyzed RNA-sequencing in biopsies from men treated prospectively on an enzalutamide clinical trial. We focused on those with ENR (progression within 3 months) vs. long-term response (progression after 24 months). We identified an ENR program linked to proliferation, epithelial-to-mesenchymal transition, and stemness. High expression of this program in additional datasets was independently linked to poor tumor control with AR targeting but favorable tumor control with docetaxel, another standard treatment. CDK2 was implicated in the ENR program. CDK2 suppression reduced the ENR program and viability of ENR program-high prostate cancer models. The ENR gene program is predictive of non-response to AR targeting. Patients whose tumors harbor this program may be good candidates for docetaxel or CDK2 inhibitor clinical trials.
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publishDate 2025-07-01
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spelling doaj-art-66f0fca4fdc6485bbbe5b8213fcf4ffd2025-08-20T03:04:18ZengNature Portfolionpj Precision Oncology2397-768X2025-07-019111310.1038/s41698-025-01002-8Transcriptional profiling clarifies a program of enzalutamide extreme non-response in lethal prostate cancerAnbarasu Kumaraswamy0Ya-Mei Hu1Joel A. Yates2Chao Zhang3Eva Rodansky4Dhruv Khokhani5Diana Flores6Zhi Duan7Yi Zhang8Shaadi Tabatabaei9Rachel Slottke10Shangyuan Ye11Primo Lara12Adam Foye13Charles J. Ryan14David A. Quigley15Jiaoti Huang16Rahul Aggarwal17Robert E. Reiter18Max S. Wicha19Tomasz M. Beer20Matthew Rettig21Martin Gleave22Christopher P. Evans23Owen N. Witte24Joshua M. Stuart25George V. Thomas26Felix Y. Feng27Eric J. Small28Zheng Xia29Joshi J. Alumkal30Department of Internal Medicine, University of MichiganDepartment of Biomedical Engineering, Oregon Health & Science UniversityDepartment of Internal Medicine, University of MichiganDepartment of Internal Medicine, University of MichiganDepartment of Internal Medicine, University of MichiganDepartment of Internal Medicine, University of MichiganDepartment of Internal Medicine, University of MichiganDepartment of Internal Medicine, University of MichiganDepartment of Biomedical Engineering, Oregon Health & Science UniversityKnight Cancer Institute, Oregon Health & Science UniversityKnight Cancer Institute, Oregon Health & Science UniversityBiostatistics Shared Resource, Knight Cancer Institute, Oregon Health & Science UniversityUniversity of California DavisHelen Diller Family Comprehensive Cancer Center, University of California San FranciscoMasonic Cancer Center, University of MinnesotaHelen Diller Family Comprehensive Cancer Center, University of California San FranciscoDuke UniversityHelen Diller Family Comprehensive Cancer Center, University of California San FranciscoDepartments of Medicine and Urology, University of California Los AngelesDepartment of Internal Medicine, University of MichiganKnight Cancer Institute, Oregon Health & Science UniversityDepartments of Medicine and Urology, University of California Los AngelesDepartment of Urological Sciences, University of British ColumbiaUniversity of California DavisDepartment of Microbiology, Immunology, and Molecular Genetics at the David Geffen School of Medicine, University of California Los AngelesGenomics Institute and Department of Biomolecular Engineering, University of California Santa CruzKnight Cancer Institute, Oregon Health & Science UniversityHelen Diller Family Comprehensive Cancer Center, University of California San FranciscoHelen Diller Family Comprehensive Cancer Center, University of California San FranciscoDepartment of Biomedical Engineering, Oregon Health & Science UniversityDepartment of Internal Medicine, University of MichiganAbstract The androgen receptor inhibitor enzalutamide is one of the principal treatments for metastatic prostate cancer. Most patients respond. However, a subset is primary refractory. Seeking to understand enzalutamide extreme non-response (ENR), we analyzed RNA-sequencing in biopsies from men treated prospectively on an enzalutamide clinical trial. We focused on those with ENR (progression within 3 months) vs. long-term response (progression after 24 months). We identified an ENR program linked to proliferation, epithelial-to-mesenchymal transition, and stemness. High expression of this program in additional datasets was independently linked to poor tumor control with AR targeting but favorable tumor control with docetaxel, another standard treatment. CDK2 was implicated in the ENR program. CDK2 suppression reduced the ENR program and viability of ENR program-high prostate cancer models. The ENR gene program is predictive of non-response to AR targeting. Patients whose tumors harbor this program may be good candidates for docetaxel or CDK2 inhibitor clinical trials.https://doi.org/10.1038/s41698-025-01002-8
spellingShingle Anbarasu Kumaraswamy
Ya-Mei Hu
Joel A. Yates
Chao Zhang
Eva Rodansky
Dhruv Khokhani
Diana Flores
Zhi Duan
Yi Zhang
Shaadi Tabatabaei
Rachel Slottke
Shangyuan Ye
Primo Lara
Adam Foye
Charles J. Ryan
David A. Quigley
Jiaoti Huang
Rahul Aggarwal
Robert E. Reiter
Max S. Wicha
Tomasz M. Beer
Matthew Rettig
Martin Gleave
Christopher P. Evans
Owen N. Witte
Joshua M. Stuart
George V. Thomas
Felix Y. Feng
Eric J. Small
Zheng Xia
Joshi J. Alumkal
Transcriptional profiling clarifies a program of enzalutamide extreme non-response in lethal prostate cancer
npj Precision Oncology
title Transcriptional profiling clarifies a program of enzalutamide extreme non-response in lethal prostate cancer
title_full Transcriptional profiling clarifies a program of enzalutamide extreme non-response in lethal prostate cancer
title_fullStr Transcriptional profiling clarifies a program of enzalutamide extreme non-response in lethal prostate cancer
title_full_unstemmed Transcriptional profiling clarifies a program of enzalutamide extreme non-response in lethal prostate cancer
title_short Transcriptional profiling clarifies a program of enzalutamide extreme non-response in lethal prostate cancer
title_sort transcriptional profiling clarifies a program of enzalutamide extreme non response in lethal prostate cancer
url https://doi.org/10.1038/s41698-025-01002-8
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