Abstract 3081: KDM1A/LSD1 inhibition enhances estrogen receptor beta mediated tumor suppression in ovarian cancer

Abstract Introduction: Ovarian cancer (OCa) is the deadliest of all gynecologic cancers. Recent studies suggest that OCa cells express estrogen receptor beta (ERb), which functions as a tumor suppressor. However, ERb expression decreases during tumor progression and under the selection pressure of chemotherapy; this decrease occurs via epigenetic mechanisms and is inversely correlated with OCa progression. Lysine-specific histone demethylase 1A (KDM1A/LSD1), an epigenetic modifier, is highly overexpressed in OCa. However, it is not known if KDM1A regulates ERb expression and its corresponding tumor suppressor functions. In this study, we explored the hypotheses that KDM1A inhibits ERb expression and function and that ERb-mediated tumor suppression in OCa is enhanced by KDM1A inhibition. Methods: Transduction of KDM1A-specific shRNA or gRNA was used to generate KDM1A knockdown (KD) or knockout (KO) cells, respectively. Cell viability, survival, apoptosis, and invasion assays were used to determine the impact of KDM1A knockdown or inhibitor therapy on ERb agonist response in established and patient-derived OCa cells. Mechanistic studies were conducted using RNA-seq, discovery proteomics, chromatin immunoprecipitation (ChIP), co-immunoprecipitation (co-IP), proximity ligation, ERE-Luc reporter, RT-qPCR, and western blot analysis. The efficacy of the combination of KDM1A inhibitor and ERb agonist therapy was investigated using patient-derived explant (PDeX) models. In vivo efficacy of KDM1A inhibitor and ERb agonist was determined using orthotopic OCa and patient-derived xenograft (PDX) murine models. Results: Analysis of TCGA datasets revealed a negative correlation between ERb and KDM1A expression in OCa patients. ChIP experiments showed that KDM1A is enriched at the ERb 0N promoter and that KDM1A KD, KO, or inhibition specifically upregulates the expression of ERb isoform 1. Co-IP and proximity ligation assays demonstrated that KDM1A interacts with ERb. Combining the ERb agonist LY500307 with KDM1A inhibitor NCD38 decreased the cell viability, survival, and invasion of both established and patient-derived primary OCa cells while increasing apoptosis. KDM1A KD- or inhibition potentiated the efficacy of ERb agonist in inducing ERb target gene expression via altered histone methylation marks. RNA-seq and proteomic analysis demonstrated that KDM1A KO and ERb agonist treatment increased the expression of apoptotic genes and downregulated cell cycle, EMT, and DNA repair genes. Importantly, combination therapy significantly reduced OCa cell proliferation in PDeX models and reduced in vivo tumor growth in orthotopic and PDX models. Conclusions: Our findings demonstrate that KDM1A inhibition enhances ERb expression and tumor suppressive functions, suggesting that combination therapy of a KDM1A inhibitor and ERb agonist may be a promising therapeutic option for treating OCa. Citation Format: Prabhakar P. Venkata, Sridharan Jayamohan, Yi He, Salvador Alejo, Jessica D. Johnson, Uday P. Pratap, Suryavathi Viswanadhapalli, Susan Weintraub, Rajeshwar R. Tekmal, Ratna K. Vadlamudi, Edward Kost, Gangadhara R. Sareddy. KDM1A/LSD1 inhibition enhances estrogen receptor beta mediated tumor suppression in ovarian cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3081.