“In this study, through both computational and molecular characterization of PC cell lines, we determined that CREB5 is associated with basal PC and drives SCL traits.”
Androgen receptor (AR) signaling has long been the central driver of prostate cancer progression and the primary target of therapies for advanced disease. Yet, a significant subset of tumors either fail to respond or develop resistance, often by switching to AR-independent programs that resemble basal or stem cell-like states. Understanding what drives these aggressive, therapy-resistant phenotypes is a critical challenge in oncology.
A research paper, titled “CREB5 regulates stem cell-like transcriptional programs to enhance tumor progression in prostate cancer” was published in Volume 17 of Oncotarget by a multi-institutional team of researchers, identifies a key molecular regulator of this process and reveals how it promotes tumor progression.
The work was led by first author Allison Makovec from the Department of Medicine and the Masonic Cancer Center at the University of Minnesota – Twin Cities, and University of Kansas Medical Center, along with corresponding authors Emmanuel S. Antonarakis and Justin Hwang (both from the Department of Medicine and the Masonic Cancer Center at the University of Minnesota – Twin Cities). The team’s investigation demonstrates that the transcription factor CREB5 drives basal and stem cell-like transcriptional programs, interacts with AP-1 proteins, and enhances tumor-forming capacity in prostate cancer cells.
The Discovery: CREB5 Links to Basal and Stem Cell-Like Programs
The researchers began by analyzing transcriptomic data from 493 primary prostate tumors (TCGA) and 208 castration-resistant prostate cancers (CRPC) from the SU2C dataset. They ranked approximately 20,000 genes based on their correlation with gene signatures defining luminal, basal, club, and hillock epithelial cell identities.
CREB5 ranked among the top genes associated with basal, club, and hillock identities but was among the lowest associated with luminal identity—the opposite pattern of AR itself. In both primary and CRPC samples, CREB5 expression was inversely correlated with AR activity and positively correlated with KLF5, a transcription factor previously linked to AR-independent resistance.
Further analysis revealed that CREB5-high tumors had significantly lower expression of AR, FOLH1 (PSMA), KLK2, and KLK3 (PSA) compared to CREB5-low tumors. Interestingly, AR-V7—a constitutively active AR splice variant that drives therapy resistance—was also decreased in CREB5-high tumors, suggesting that CREB5 operates through AR-independent pathways rather than AR splice variants.
Molecular Associations: CREB5 and the AP-1 Network
To understand how CREB5 drives these transcriptional programs, the team used the Algorithm for Linking Activity Networks (ALAN), which compares gene behavior across all potential interactions. CREB5 showed highly concordant behavior with the 25 transcription factors that define the stem cell-like (SCL) subtype of CRPC, as previously defined by Tang et al. Notably, CREB5 exhibited nearly identical behavior to FOSL1, a key AP-1 transcription factor implicated in stem cell features, therapy resistance, and metastasis in other cancers.
This relationship was remarkably strong. In CRPC samples, CREB5 and FOSL1 expression were significantly correlated (r = 0.47, p < 0.001), and ALAN analysis showed an R² of 0.980 between their gene behaviors across all genes in the dataset. Even in benign prostate tissue (GTEx), the alignment remained strong (R² = 0.707).
Functional validation confirmed the regulatory relationship. In LNCaP cells overexpressing CREB5, RNA-seq showed increased FOSL1 expression across multiple conditions—including androgen deprivation (CSS), enzalutamide treatment, and androgen stimulation (R1881). In CWR-R1 cells, CREB5 overexpression significantly increased FOSL1 expression by RT-qPCR (p = 0.014).
Mechanisms: CREB5 Interacts with AP-1 Proteins and Binds Their Regulatory Elements
To determine how CREB5 exerts its effects, the team examined protein-protein interactions using rapid immunoprecipitation and mass spectrometry of endogenous proteins (RIME) from prior work. Compared to controls, CREB5 interacted with several AP-1 factors, including JUN, JUNB, JUND, ATF2, and ATF7.
Motif enrichment analysis of CREB5 binding sites (from ChIP-sequencing) revealed significant enrichment of AP-1 binding motifs, including those for JUN, JUNB, and ATF2. In enzalutamide-treated cells, CREB5-bound sites remained enriched near ATF2 motifs, and CREB5 binding patterns were highly consistent at these sites.
ChIP-sequencing further showed that CREB5 bound to the transcriptional start sites of several AP-1 genes, including ATF3 and FOSL2, and to FOSL1 itself—particularly in enzalutamide-treated cells. Moreover, CREB5 bound to the transcriptional start and end sites of all 25 SCL genes defined by Tang et al., confirming its role as a broad regulator of stem cell-like transcriptional programs.
Phenotypic Consequences: CREB5 Drives Tumor-Forming Capacity
If CREB5 promotes stem cell-like traits, it should enhance the ability of cancer cells to form tumors. The team tested this using 3D tumorsphere assays in three cell lines: LNCaP (AR-positive, hormone-sensitive), CWR-R1 (CRPC-like), and CWR-R1 enzalutamide-resistant (enzR).
CREB5 overexpression significantly increased the number of tumorspheres in LNCaP cells compared to luciferase (LUC) controls (p < 0.01), indicating enhanced tumor-forming capacity from single cells. This effect was not observed in the more aggressive CWR-R1 or CWR-R1 enzR lines, suggesting that CREB5 has the greatest impact in hormone-sensitive cells, consistent with prior studies.
In vivo, LNCaP cells with CREB5 overexpression were implanted into castrated and non-castrated male mice. After 56 days, CREB5 overexpression significantly increased tumor volume in both castrated (p = 0.002) and non-castrated (p = 0.008) mice. Notably, there was no significant effect on tumor growth rate, supporting the hypothesis that CREB5 promotes tumor formation (stemness) rather than simply accelerating proliferation.
Clinical Implications and Future Directions
These findings have several important implications. First, they identify CREB5 as a central regulator of lineage plasticity in prostate cancer—the ability of tumor cells to switch from an AR-driven luminal identity to an AR-independent basal or stem cell-like state. This plasticity is a major mechanism of resistance to AR-targeted therapies.
Second, the inverse relationship between CREB5 and AR activity was detectable even in primary, treatment-naïve tumors. This suggests that high CREB5 expression may serve as a future biomarker for identifying patients at risk of developing resistance or progressing to metastatic disease, even before therapy begins.
Third, the interaction between CREB5 and AP-1 transcription factors—particularly FOSL1—points to potential therapeutic strategies. AP-1 factors are known regulators of cancer cell plasticity across multiple malignancies, and there are now anti-cancer therapies targeting AP-1 factors. Whether such agents can perturb CREB5’s tumor-promoting activity remains an open question.
The authors acknowledge that the mechanistic relationship between CREB5 and KLF5—another SCL-associated transcription factor—remains unclear, as no direct biochemical interaction was detected. Future studies will need to explore whether these factors operate in parallel pathways or through indirect mechanisms.
Future Perspectives and Conclusion
This study does not claim to have fully mapped the regulatory network of CREB5 in prostate cancer. Rather, it establishes CREB5 as a key driver of basal and stem cell-like transcriptional programs and provides a mechanistic link to AP-1 transcription factors.
The perspective that emerges is one where lineage plasticity in prostate cancer is not a random event but is driven by specific transcriptional regulators like CREB5. By integrating computational modeling, molecular biology, and functional studies, the team demonstrates that CREB5 enhances tumor-forming capacity through interactions with AP-1 factors and regulation of SCL genes.
Continued research will be needed to determine whether targeting CREB5 or its interaction with AP-1 complexes can mitigate deadly stem cell-like phenotypes in prostate cancer and potentially in other malignancies where CREB5 has been implicated—including breast, colorectal, ovarian, and brain cancers. As the authors note, “increased CREB5 may lead to specific mechanisms of therapy response, and future therapeutic strategies may consider antagonizing CREB5 interactions with AP-1 complexes.”
Click here to read the full research paper published in Oncotarget.
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