Novel inhibition of AKR1C3 and androgen receptor axis by PTUPB synergizes enzalutamide treatment in advanced prostate cancer.

Castration-resistant prostate cancer (CRPC) is the main driving force of mortality in prostate cancer patients. Among the parameters contributing to the progression of CRPC and treatment failure, elevation of the steroidogenic enzyme AKR1C3 and androgen receptor variant 7 (AR-V7) are frequently reported. The AKR1C3/AR-V7 complex has been recognized as a major driver for drug resistance in advanced prostate cancer. Herein we report that the level of AKR1C3 is reciprocally regulated by the full-length androgen receptor (AR-FL) through binding to the distal enhancer region of the AKR1C3 gene. A novel function of PTUPB in AKR1C3 inhibition was discovered and PTUPB showed more effectiveness than indomethacin and celecoxib in suppressing AKR1C3 activity and CRPC cell growth. PTUPB synergizes with enzalutamide treatment in tumor suppression and gene signature regulation. Combination treatments with PTUPB and enzalutamide provide benefits by blocking AR/AR-V7 signaling, which inhibits the growth of castration relapsed VCaP xenograft tumors and patient-derived xenograft organoids. Targeting of the ARK1C3/AR/AR-V7 axis with PTUPB and enzalutamide may overcome drug resistance to AR signaling inhibitors in advanced prostate cancer.

Oncogene. 2023 Jan 03 [Epub ahead of print]

Joy C Yang, Pengfei Xu, Shu Ning, Logan J Wasielewski, Hans Adomat, Sung Hee Hwang, Christophe Morisseau, Martin Gleave, Eva Corey, Allen C Gao, Primo N Lara, Christopher P Evans, Bruce D Hammock, Chengfei Liu

Department of Urologic Surgery, University of California Davis, Davis, CA, USA., Vancouver Prostate Centre, Vancouver, BC, Canada., Department of Entomology and Nematology, University of California Davis, Davis, CA, USA., Department of Urology, University of Washington, Washington, WA, USA., UC Davis Comprehensive Cancer Center, University of California Davis, Davis, CA, USA., Department of Urologic Surgery, University of California Davis, Davis, CA, USA. .