1. Academic Validation
  2. NSD2 targeting reverses plasticity and drug resistance in prostate cancer

NSD2 targeting reverses plasticity and drug resistance in prostate cancer

  • Nature. 2026 Jan;649(8095):216-226. doi: 10.1038/s41586-025-09727-z.
Jia J Li # 1 2 3 4 5 Alessandro Vasciaveo # 2 5 6 7 8 Dimitris Karagiannis 3 5 Zhen Sun 9 Kristjan H Gretarsson 3 5 Xiao Chen 3 5 10 Ouathek Ouerfelli 11 Fabio Socciarelli 12 Ziv Frankenstein 5 13 Hanyang Dong 14 Min Zou 5 15 16 Wei Yuan 17 Guangli Yang 11 Gabriel M Aizenman 6 7 8 Tania Pannellini 12 18 Xinjing Xu 3 5 Himisha Beltran 19 Yu Chen 9 20 Kevin Gardner 5 13 Brian D Robinson 12 Johann de Bono 17 Or Gozani 14 Cory Abate-Shen 1 2 4 5 13 15 Mark A Rubin 21 Massimo Loda 12 22 Charles L Sawyers 9 23 Andrea Califano 1 2 5 24 25 26 Chao Lu 27 28 Michael M Shen 29 30 31 32 33
Affiliations

Affiliations

  • 1 Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
  • 2 Department of Systems Biology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
  • 3 Department of Genetics and Development, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
  • 4 Department of Urology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
  • 5 Herbert Irving Comprehensive Cancer Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
  • 6 Center for Data Science and Artificial Intelligence, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA.
  • 7 Center for Therapeutics Discovery, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA.
  • 8 Cancer Genome and Epigenetics Program, NCI-Designated Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA.
  • 9 Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • 10 Marine College, Shandong University, Weihai, China.
  • 11 Organic Synthesis Core Facility, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • 12 Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA.
  • 13 Department of Pathology and Cell Biology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
  • 14 Department of Biology, Stanford University, Stanford, CA, USA.
  • 15 Department of Molecular Pharmacology and Therapeutics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
  • 16 Arvinas, New Haven, CT, USA.
  • 17 Division of Clinical Studies, The Institute of Cancer Research, London, UK.
  • 18 Haematopathology Division, IEO European Institute of Oncology, Milan, Italy.
  • 19 Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
  • 20 Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • 21 Department of Biomedical Research, Bern Center for Precision Medicine, University of Bern, Bern, Switzerland.
  • 22 Nuffield Department of Surgical Sciences, Lincoln College, University of Oxford, Oxford, UK.
  • 23 Howard Hughes Medical Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • 24 Department of Biomedical Informatics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
  • 25 Department of Biochemistry and Molecular Biophysics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
  • 26 Chan Zuckerberg Biohub, New York, NY, USA.
  • 27 Department of Genetics and Development, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA. cl3684@cumc.columbia.edu.
  • 28 Herbert Irving Comprehensive Cancer Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA. cl3684@cumc.columbia.edu.
  • 29 Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA. mshen@columbia.edu.
  • 30 Department of Systems Biology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA. mshen@columbia.edu.
  • 31 Department of Genetics and Development, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA. mshen@columbia.edu.
  • 32 Department of Urology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA. mshen@columbia.edu.
  • 33 Herbert Irving Comprehensive Cancer Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA. mshen@columbia.edu.
  • # Contributed equally.
Abstract

Lineage plasticity is a Cancer hallmark that drives disease progression and treatment resistance1,2. Plasticity is often mediated by epigenetic mechanisms that may be reversible; however, there are few examples of such reversibility. In castration-resistant prostate Cancer (CRPC), plasticity mediates resistance to Androgen Receptor (AR) inhibitors and progression from adenocarcinoma to aggressive subtypes, including neuroendocrine prostate Cancer (CRPC-NE)3-5. Here we show that plasticity-associated treatment resistance in CRPC can be reversed through the inhibition of NSD2, a Histone Methyltransferase6. NSD2 upregulation in CRPC-NE correlates with poor survival outcomes, and NSD2-mediated H3K36 dimethylation regulates enhancers of genes associated with neuroendocrine differentiation. In prostate tumour organoids established from genetically engineered mice7 that recapitulate the transdifferentiation to neuroendocrine states, and in human CRPC-NE organoids, CRISPR-mediated targeting of NSD2 reverts CRPC-NE to adenocarcinoma phenotypes. Moreover, a canonical AR program is upregulated and responses to the AR inhibitor enzalutamide are restored. Pharmacological inhibition of NSD2 with a first-in-class small molecule reverses plasticity and synergizes with enzalutamide to suppress growth and promote cell death in human patient-derived organoids of multiple CRPC subtypes in culture and in xenografts. Co-targeting of NSD2 and AR may represent a new therapeutic strategy for lethal forms of CRPC that are currently recalcitrant to treatment.

Figures
Products