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Targeted therapeutic strategies for prostate cancer treatment using novel lipid kinase inhibitors in combination with current drugs
Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Prostate cancer (PCa) is one of the most common cancer types and the fifth cancer-related cause of death among Western world men.  The sex steroid hormone, androgen and androgen receptor (AR) play important roles in PCa progression. Herewith, androgen deprivation therapy (ADT) is used as a regimen for PCa, but inevitably leads to development of castration-resistant PCa (CRPC) and distant metastasis. No effective treatment for metastatic PCa currently exists. Furthermore, it remains poorly understood whether and how the steroid hormone signaling in cooperation with multiple pathways that control proliferation, survival and invasion of cancer cells may contribute to metastatic dissemination and growth.

The aims of my PhD thesis focused on: (i) studying the clinical importance of estrogen- and androgen-related signaling pathways in promoting homing and metastatic growth of PCa cells in bone, (ii) gaining deeper understanding of the underlying mechanisms that facilitate PCa metastasis and treatment resistance, with focus on phosphatidylinositol-4-phosphate 5-kinase type-1 alpha (PIP5K1α), estrogen- and androgen receptor signaling, (iii) testing and characterizing the therapeutic potential of PIP5K1α inhibitor in combination with anti-estrogen or anti-androgen agents to improve treatment and overcome treatment resistance in CRPC.

In my thesis work we have shown that key biomarker genes exhibited unique expression profiles and signatures in PCa subtypes within large patient cohorts. Alterations in androgen- and estrogen-related biomarkers and PIP5K1α/Akt pathways were associated with poor patient outcome. We further discovered that CRPC cells and cancer stem-like cells utilized estrogen-associated factors including aromatase and estrogen receptor alpha (ERα), as well as cyclin A1, a key cell cycle regulator, to gain proliferative advantage, and to survive and metastasize to distant organs.

We found that the interaction between PIP5K1α and AR splice variant AR-V7 contributed to enzalutamide resistance. In series of in vivo treatment experiments using tumor xenograft mice, we demonstrated that ISA-2011B alone or in combination with enzalutamide had great therapeutic potential to suppress growth of tumors that had elevated levels of PI3K/Akt and AR-V7, and that were resistant to enzalutamide monotherapy.

We further showed that combination treatment using tamoxifen together with ISA-2011B selectively blocked elevated ERα/cyclin D1 and PIP5K1α/Akt, leading to tumor regression and had superior inhibitory effect over monotherapy in xenograft mice.

My studies therefore suggest that steroid hormone receptors, PIP5K1α signaling cascade and multiple cellular pathways cooperatively promote PCa progression. Taken together, the reported findings are the first to suggest a new therapeutic potential to inhibit or utilize the mechanisms related to ERα and PIP5K1α/Akt network, and provide a new therapeutic strategy to treat castration-resistant ER-positive subtype of tumors with metastatic potential.

Place, publisher, year, edition, pages
Umeå: Umeå University , 2020. , p. 70
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2084
Keywords [en]
Prostate cancer, bone metastasis, castration-resistant, treatment, precision therapy, PIP5K1A, steroid hormone receptors, cancer stem cells
National Category
Cancer and Oncology
Research subject
Oncology
Identifiers
URN: urn:nbn:se:umu:diva-169646ISBN: 978-91-7855-263-4 (print)ISBN: 978-91-7855-264-1 (electronic)OAI: oai:DiVA.org:umu-169646DiVA, id: diva2:1423294
Public defence
2020-05-08, Hörsal 933, Unod B9, NUS, Norrlands universitetssjukhus, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2020-04-17 Created: 2020-04-14 Last updated: 2024-07-02Bibliographically approved
List of papers
1. Targeted Inhibition of Estrogen Receptor Alpha Signaling and PIP5K1α/Akt Pathways in Castration-Resistant Prostate Cancer
Open this publication in new window or tab >>Targeted Inhibition of Estrogen Receptor Alpha Signaling and PIP5K1α/Akt Pathways in Castration-Resistant Prostate Cancer
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(English)Manuscript (preprint) (Other academic)
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-169645 (URN)
Available from: 2020-04-14 Created: 2020-04-14 Last updated: 2022-12-15
2. Cyclin A1 and P450 Aromatase Promote Metastatic Homing and Growth of Stem-like Prostate Cancer Cells in the Bone Marrow
Open this publication in new window or tab >>Cyclin A1 and P450 Aromatase Promote Metastatic Homing and Growth of Stem-like Prostate Cancer Cells in the Bone Marrow
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2016 (English)In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 76, no 8, p. 2453-2464Article in journal (Refereed) Published
Abstract [en]

Bone metastasis is a leading cause of morbidity and mortality in prostate cancer. While cancer stem-like cells have been implicated as a cell of origin for prostate cancer metastasis, the pathways that enable metastatic development at distal sites remain largely unknown. In this study, we illuminate pathways relevant to bone metastasis in this disease. We observed that cyclin A1 (CCNA1) protein expression was relatively higher in prostate cancer metastatic lesions in lymph node, lung, and bone/bone marrow. In both primary and metastatic tissues, cyclin A1 expression was also correlated with aromatase(CYP19A1), a key enzyme that directly regulates the local balance of androgens to estrogens. Cyclin A1 overexpression in the stem-like ALDHhigh subpopulation of PC3M cells, one model of prostate cancer, enabled bone marrow integration and metastatic growth. Further, cells obtained from bone marrow metastatic lesions displayed self-renewal capability in colony forming assays. In the bone marrow, cyclin A1 and aromatase enhanced local bonemarrow-releasing factors, including androgen receptor, estrogen and matrix metalloproteinase MMP9 and promoted the metastatic growth of prostate cancer cells. Moreover, ALDHhigh tumor cells expressing elevated levels of aromatase stimulated tumor/host estrogen production and acquired agrowth advantage in the presence of host bone marrow cells.Overall, these findings suggest that local production of steroids and MMPs in the bone marrow may provide a suitable microenvironment for ALDHhigh prostate cancer cells to establish metastatic growths, offering new approaches to therapeutically target bone metastases.

Place, publisher, year, edition, pages
American Association for Cancer Research (AACR), 2016
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-169641 (URN)10.1158/0008-5472.CAN-15-2340 (DOI)000374170700039 ()
Available from: 2020-04-14 Created: 2020-04-14 Last updated: 2022-12-15Bibliographically approved
3. Targeted suppression of AR-V7 using PIP5K1 alpha inhibitor overcomes enzalutamide resistance in prostate cancer cells
Open this publication in new window or tab >>Targeted suppression of AR-V7 using PIP5K1 alpha inhibitor overcomes enzalutamide resistance in prostate cancer cells
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2016 (English)In: Oncotarget, E-ISSN 1949-2553, Vol. 7, no 39, p. 63065-63081Article in journal (Refereed) Published
Abstract [en]

One mechanism of resistance of prostate cancer (PCa) to enzalutamide (MDV3100) treatment is the increased expression of AR variants lacking the ligand binding-domain, the best characterized of which is AR-V7. We have previously reported that Phosphatidylinositol-4-phosphate 5-kinase alpha (PIP5K alpha), is a lipid kinase that links to CDK1 and AR pathways. The discovery of PIP5K alpha inhibitor highlight the potential of PIP5K1 alpha as a drug target in PCa. In this study, we show that AR-V7 expression positively correlates with PIP5K1 alpha in tumor specimens from PCa patients. Overexpression of AR-V7 increases PIP5K1 alpha, promotes rapid growth of PCa in xenograft mice, whereas inhibition of PIP5K1 alpha by its inhibitor ISA-2011B suppresses the growth and invasiveness of xenograft tumors overexpressing AR-V7. PIP5K1 alpha is a key co-factor for both AR-V7 and AR, which are present as protein-protein complexes predominantly in the nucleus of PCa cells. In addition, PIP5K1 alpha and CDK1 influence AR-V7 expression also through AKT-associated mechanism dependent on PTEN-status. ISA-2011B disrupts protein stabilization of AR-V7 which is dependent on PIP5K1 alpha, leading to suppression of invasive growth of AR-V7-high tumors in xenograft mice. Our study suggests that combination of enzalutamide and PIP5K1 alpha may have a significant impact on refining therapeutic strategies to circumvent resistance to antiandrogen therapies.

Keywords
Prostate cancer metastasis, enzalutamide resistance, lipid kinase inhibitor, AR-V7, PIP5K1α
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-128475 (URN)10.18632/oncotarget.11757 (DOI)000387167800020 ()2-s2.0-84993967394 (Scopus ID)
Available from: 2016-12-15 Created: 2016-12-05 Last updated: 2024-01-17Bibliographically approved
4. The functional interlink between AR and MMP9/VEGF signaling axis is mediated through PIP5K1α/pAKT in prostate cancer
Open this publication in new window or tab >>The functional interlink between AR and MMP9/VEGF signaling axis is mediated through PIP5K1α/pAKT in prostate cancer
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2020 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 146, no 6, p. 1686-1699Article in journal (Refereed) Published
Abstract [en]

Currently, no effective targeted therapeutics exists for treatment of metastatic prostate cancer (PCa). Given that matrix metalloproteinases 9 (MMP9) and its associated vascular endothelial growth factor (VEGF) are critical for tumor vascularization and invasion under castration-resistant condition, it is therefore of great importance to define the functional association and interplay between androgen receptor (AR) and MMP9 and their associated key survival and invasion pathways in PCa cells. Here, we found that there was a significant correlation between MMP9 and AR protein expression in primary and metastatic PCa tissues, and a trend that high level of MMP9 expression was associated with poor prognosis. We demonstrated that constitutive activation of AR increased expression of MMP9 and VEGF/VEGF receptors. We further showed that AR exerts its effect on MMP9/VEGF signaling axis through PIP5K1α/AK. We showed that MMP9 physically interacted with PIP5K1α via formation of protein-protein complexes. Furthermore, elevated expression of MMP9 enhanced ability of AR to activate its target gene cyclin A1. The elevated sequential activation of AR/PIP5K1α/AKT/MMP9/VEG signaling axis contributed to increased invasiveness and growth of metastatic tumors. Conversely, treatment with PIP5K1α inhibitor significantly suppressed invasiveness of PCa cells expressing constitutively activated AR, this was coincident with its inhibitory effect of this inhibitor on AR/MMP9/VEGF pathways. Our results suggest that AR and MMP9-associated network proteins may be effectively targeted by blocking PIP5K1α/AKT pathways using PIP5K1α inhibitor in metastatic PCa.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
matrix metalloproteinases 9, AKT, androgen receptor, metastatic prostate cancer, targeted therapy
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-162846 (URN)10.1002/ijc.32607 (DOI)000481247000001 ()31381135 (PubMedID)2-s2.0-85071148602 (Scopus ID)
Funder
Swedish Childhood Cancer Foundation, TJ2015-0097Swedish Cancer Society, 170621The Kempe Foundations
Available from: 2019-09-11 Created: 2019-09-11 Last updated: 2022-12-15Bibliographically approved

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