Small cell lung cancer (SCLC) causes over 200,000 patient deaths worldwide each year. A major factor contributing to the dismal outcome of SCLC, as in many solid tumors, is resistance to current therapies that have remained largely the same for the past 30 years. Cell-of-origin and molecular determinants of SCLC recurrence as well as progression are fascinating yet poorly understood subjects of immense clinical importance. Despite evidence of pre-malignant cells possessing the same tumor-initiating mutations and potential implications in tumor progression, characterization of these cells has been challenging due to lack of tractable model and informed ways of defining aberrant processes. Using genetically engineered mouse models of SCLC, we isolated pre-malignant cells with specific lineage-tracer and established lines of the cells that lack known oncogenic aberrations and do not undergo spontaneous transformation in culture and allograft model. Comparative molecular profiling of the pre-malignant cell and SCLC cell resulted in identification of `drivers' pathologically relevant to tumor progression as opposed to ones identified in conventional approaches comparing whole lung and tumor. The objectives of this proposal are to define molecular properties of preSC as well as its malignant progression using integrative gene expression analyses and functional genetics, and to assess preSC as therapeutic target. The hypothesis is that plasticity in cholesterol metabolism defines pre- malignant precursor cells of SCLC (preSC) during tumor progression. This hypothesis has been formulated based on our preliminary findings pointing to increased cholesterol metabolism during malignant progression and the reduced growth of oncogene-transformed cells in response to a drug with anti-cholesterol properties. We propose the following specific aims.
In Aim 1, we will determine roles of genes for cholesterol metabolism and its related signaling pathways, using virus-mediated gene expression approaches in vivo and in vitro.
In Aim 2, we will test whether changes in systemic level of cholesterol metabolism influences tumor progression by modulating body cholesterol level using high-cholesterol diet or drugs known to regulate cholesterol synthesis and transport.
In Aim 3, we will examine human lung tumors for deregulated cholesterol metabolism by analyzing proteins that play role in cholesterol intake and synthesis. To validate clinical significance of cholesterol metabolism in tumor progression, we aim to establish human pre-malignant cells and test effect of modulating cholesterol metabolism on oncogene-induced transformation of human pre-malignant cells. This proposal outlines a first step toward understanding detailed molecular mechanisms of key driver molecules during tumor progression, which will pave the way for even more exciting experiments aimed at developing novel strategies for prevention and treatment. Lastly, successful outcomes of this proposal could provide a paradigm of identifying key determinant of many cancers given that cell-of-origins and lineage markers for those caners will be known in the near future.

Public Health Relevance

Small cell lung cancer is the most aggressive form of lung cancers that affects both men and women and cause approximately 200,000 patient-deaths worldwide. We propose to discover key molecular determinants of the cancer progression and test functional significance of frequently mutated genes in human tumors. The outcome of the proposal will provide crucial information to be used to develop novel strategies to prevent and treat the lung cancer patients.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZCA1)
Program Officer
Spalholz, Barbara A
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Virginia
Schools of Medicine
United States
Zip Code
Jia, Deshui; Augert, Arnaud; Kim, Dong-Wook et al. (2018) Crebbp Loss Drives Small Cell Lung Cancer and Increases Sensitivity to HDAC Inhibition. Cancer Discov 8:1422-1437
Yang, Dian; Denny, Sarah K; Greenside, Peyton G et al. (2018) Intertumoral Heterogeneity in SCLC Is Influenced by the Cell Type of Origin. Cancer Discov 8:1316-1331
Kim, Dong-Wook; Kim, Keun-Cheol; Kim, Kee-Beom et al. (2018) Transcriptional deregulation underlying the pathogenesis of small cell lung cancer. Transl Lung Cancer Res 7:4-20
Kim, Dong-Wook; Wu, Nan; Kim, Young-Chul et al. (2016) Genetic requirement for Mycl and efficacy of RNA Pol I inhibition in mouse models of small cell lung cancer. Genes Dev 30:1289-99