JAK/STAT PATHWAY COOPERATES WITH CIC FUSIONS TO DRIVE CIC-REARRANGED SARCOMAS

CIC-rearranged sarcoma is a rare disease driven by a specific fusion protein involving the CIC gene. Native CIC protein is a transcriptional repressor of the (RTK)/Ras/ERK signaling pathway, which is one of the most tumorigenic pathways in cancer. The most common rearrangement is with the double homeobox 4 (DUX4) transcription factor (CIC-DUX4), and others, such as CIC-NUTM1 fusions, have been identified in a subset of pediatric primitive neuroectodermal tumors. However, the molecular mechanisms by which CIC fusions induce tumorigenesis remains unknown. Hypothesis: Our preliminary data shows that CIC- DUX4/NUTM1 fusions activate JAK (cytokine receptors) and its downstream effector STAT1/3(transcription factors). We hypothesize that the JAK/STAT1/3 signal transduction pathway cooperates with CIC-fusions to induce the expression of oncogenic transcription factors ETV1/4/5 and drive these sarcomas. METHODS AND RESULTS: JAK1 is a potential target for CIC-fusions- We show high levels of JAK1/STAT1/3 activation in CIC-fusion patient-derived sarcoma cell lines (NCC-SCC-89/C) as compared to other sarcoma cell lines without the fusion. JAK1 inhibition using Solicitinub and Ruxolitinib reduced phosphorylation of STAT1/3 as well as protein and mRNA expression of transcriptional oncogenic factors ETV1/4/5 and cell proliferation. JAK1/STAT1/3 inhibition in patient-derived CIC-DUX4 xenograft models- To evaluate the pre-clinical effect of targeting the JAK1/STAT1/3 pathway, the CIC-DUX4 cell line was grafted into NSG mice. Ruxolitinib treatment significantly reduced tumor volume, STAT1 activation, and oncogenic transcriptional factors ETV1/4/5. CONCLUSION: We show that the JAK1/STAT1/3 pathway plays a critical role in cooperating with CIC-fusions to drive CIC-rearranged sarcomas providing insight into potential therapeutic avenues for these aggressive tumors.