Characterization of prostate cancer adrenal metastases: dependence upon androgen receptor signaling and steroid hormones

Minas J. Sakellakis, Andrew W. Hahn, Sumankalai Ramachandran, Miao Zhang, Anh Hoang, Jian H. Song, Jingjing Liu, Feng Wang, Hirak S. Basu, Peter Sheperd, Xuemei Wang, Daniel E. Frigo, Sue Hwa Lin, Theocharis Panaretakis, Jianhua Zhang, Nora Navone, Patricia Troncoso, Christopher J. Logothetis, Mark A. Titus

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Prostate cancer (PCa) typically spreads to the bone, and this distribution is attributed to the central role of the microenvironment in progression. However, metastasis to the adrenal glands, while not as common, does occur. The biology that accounts for adrenal metastases may be attributed to the unique local steroid metabolome and co-clinical characterization may elucidate the role steroid biosynthesis plays in PCa progression. Methods: Three patients with metastatic PCa who had archived tumor tissue from an adrenalectomy were retrospectively identified, and one adrenal metastasis was developed into a xenograft (MDA-PCa-250). The adrenal metastases were characterized by performing somatic DNA whole exome sequencing (WES), RNA-Seq, immunohistochemistry (IHC), and steroid metabolite quantitation. The influence of steroid metabolites on adrenal metastasis cells and tumor growth was tested in vitro and in vivo. Results: Clinically, adrenalectomy was performed during castration-resistant oligometastatic disease, and two men experienced resensitization to leuprolide. Somatic DNA WES revealed heterogeneous alterations in tumor suppressor and DNA damage repair pathway genes. Adrenal metastases had active androgen receptor (AR) signaling by IHC, and RNA-Seq supported a potential role for adrenal androgen precursor metabolism in activating the AR. Steroid quantitation suggested the adrenal androgen precursors were converted into testosterone in these metastases, and stable isotope tracing of an organoid from MDA-PCa-250 confirmed the capability of adrenal metastases to biosynthesize testosterone from adrenal precursors. In vitro testing of a cell line derived from MDA-PCa-250 showed that testosterone and cortisol stimulated tumor cell growth. In vivo experiments demonstrated that MDA-PCa-250 grew in intact mice with circulating testosterone, but not in castrated mice. Conclusions: PCa adrenal metastases depend upon AR signaling driven by androgen precursors, androstenedione and dehydroepiandrosterone, available in the microenvironment, despite the presence of heterogeneous somatic DNA alterations. Moreover, MDA-PCa-250 provides a preclinical model that can recapitulate the unique androgen-dependence of adrenal metastases. Clinical trial registration: This study does not report the clinical results of a clinical trial, but it does use samples from a completed clinical trial that is registered with clinicaltrials.gov (NCT01254864).

Original languageEnglish (US)
Pages (from-to)751-758
Number of pages8
JournalProstate Cancer and Prostatic Diseases
Volume26
Issue number4
DOIs
StatePublished - Dec 2023

ASJC Scopus subject areas

  • Oncology
  • Urology
  • Cancer Research

MD Anderson CCSG core facilities

  • Research Animal Support Facility
  • Biostatistics Resource Group
  • Tissue Biospecimen and Pathology Resource
  • Advanced Technology Genomics Core

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