Inhibition of NF-kappa B signaling restores responsiveness of castrate resistant prostate cancer cells to anti-androgen treatment by decreasing androgen receptor variants expression

Androgen receptor splicing variants (ARVs) which lack the ligand-binding domain (LBD) are associated with the development of castration-resistant prostate cancer (CRPC), including resistance to the new generation of high affinity anti-androgens. However, the mechanism by which ARVs expression is regulated is not fully understood. In this study, we show that activation of classical NF-κB signaling increases the expression of ARVs in prostate cancer (PCa) cells and converts androgen sensitive PCa cells to become androgen insensitive; while, downregulation of NF-κB signaling inhibits ARVs expression and restores responsiveness of CRPC to anti-androgen therapy. In addition, we demonstrated that combination of anti-androgen with NF-κB targeted therapy inhibits efficiently tumor growth of human CRPC xenografts. These results indicate that induction ARVs by activated NF-κB signaling in PCa cells is a critical mechanism by which the PCa progresses to CRPC. This has important implications since it can prolong the survival of CRPC patients by restoring the tumors to once again respond to conventional androgen-deprivation therapy (ADT).