Aberrant corticosteroid metabolism in tumor cells enables GR takeover in enzalutamide resistant prostate cancer

作者：Li Jianneng; Alyamani Mohammad; Zhang Ao; Chang Kai Hsiung; Berk Michael; Li Zhenfei; Zhu Ziqi; Petro Marianne; Magi Galluzzi Cristina; Taplin Mary Ellen; Garcia Jorge A; Courtney Kevin; Klein Eric A; Sharifi Nima^*

来源：eLife, 2017, 6: e20183.

DOI：10.7554/eLife.20183

Prostate cancer is driven by androgen stimulation of the androgen receptor (AR). The next-generation AR antagonist, enzalutamide, prolongs survival, but resistance and lethal disease eventually prevail. Emerging data suggest that the glucocorticoid receptor (GR) is upregulated in this context, stimulating expression of AR-target genes that permit continued growth despite AR blockade. However, countering this mechanism by administration of GR antagonists is problematic because GR is essential for life. We show that enzalutamide treatment in human models of prostate cancer and patient tissues is accompanied by a ubiquitin E3-ligase, AMFR, mediating loss of 11 beta-hydroxysteroid dehydrogenase-2 (11 beta-HSD2), which otherwise inactivates cortisol, sustaining tumor cortisol concentrations to stimulate GR and enzalutamide resistance. Remarkably, reinstatement of 11 beta-HSD2 expression, or AMFR loss, reverses enzalutamide resistance in mouse xenograft tumors. Together, these findings reveal a surprising metabolic mechanism of enzalutamide resistance that may be targeted with a strategy that circumvents a requirement for systemic GR ablation.

• 出版日期2017-2-13