Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in childhood. Despite rigorous clinical trials the survival for children with high-risk RMS has not changed for three decades. The children that do survive often suffer from life-long disfigurements as a result of the aggressive treatment. RMS is subdivided into two major classes, fusion-positive (FP-RMS) and fusion-negative (FN-RMS), based on the presence or absence of the PAX3-FOXO1 or PAX7-FOXO1 gene fusions. RMS resembles developing skeletal muscle and has been speculated to originate from genetically compromised skeletal muscle progenitors. Despite the expression of skeletal muscle master regulator proteins MYOD1 and MYOGENIN, RMS tumors and cells fail to terminally differentiate, suggesting that RMS is an arrested state of muscle development. The molecular underpinnings of the differentiation arrest in RMS and therapeutics to drive differentiation are unknown. The long-term goal is to elucidate the mechanisms that determine the basis for developmental arrest in RMS and design novel, directed drug therapies for RMS. A study recently identified PTEN promoter hypermethylation with decrease PTEN expression in over 90% of FN-RMS tumors. In a RMS genetically engineered mouse model (GEMM), PTEN loss decreased tumor latency, increased tumor penetrance, and much less differentiated tumors more closely resembling the embryonal RMS in children. PTEN loss did not increase mTOR signaling but was localized in the nucleus and increased PAX7 expression and ectopic DBX1 expression. DBX1 is a neuronal specific transcriptional repressor that is ectopically expressed across both human FN-RMS and FP-RMS. Forced DBX1 expression blocks myogenic differentiation in cultured myoblasts. The central hypothesis is that the PTEN-PAX7- DBX1 axis provides a key node in the developmental arrest in RMS and that DBX1 functions as a transcriptional repressor blocking differentiation in RMS. The objective of this proposal is to leverage our robust RMS mouse models coupled with in vitro assays to define the role of PTEN and DBX1 in RMS. To accomplish this objective, we propose the following Specific Aims: 1) Define the role of PTEN loss in RMS. 2) Determine the mechanism of DBX1 regulation in RMS. 3) Identify role of DBX1 in blocking myogenic differentiation in RMS. The proposed studies leverage a simple, rapid RMS GEMM to dissect genes that contribute to RMS biology in vivo and provide insight into the mechanism maintaining an arrested state of differentiation in RMS. We will use gain- and loss- of-function approaches both in vivo and in vitro to dissect the roles of AKT1, mTORC1, PAX7 and DBX1 in modulation of the PTEN loss phenotype. Differentiation therapy of embryonal tumors has proven an efficacious venue for therapy with 13-cis-retinoic acid for neuroblastoma and all-trans-retinoic acid for acute promyelocytic leukemia. Molecular and developmental dissection of RMS will reveal new vulnerabilities to develop new therapeutics to drive terminal differentiation of RMS. These studies will have broad impact as DBX1 is highly expressed in pediatric brain tumors and PTEN perturbations are involved in many cancers.
The long-term goal of my laboratory is to elucidate the mechanisms that determine the developmental arrest in rhabdomyosarcoma (RMS) and leverage these findings to develop novel, directed therapies. The objective of this proposal is to leverage our robust genetically engineered RMS mouse models coupled with in vitro assays to define the role of PTEN, PAX7 and DBX1 in RMS. This work will also contribute to other cancers given DBX1 overexpression is found in many brain cancers and PTEN deletions and mutations are found in a significant portion of the cancers.
