IL-23 secreted by myeloid cells drives castration-resistant prostate cancer

Nature. 2018 Jul;559(7714):363-369. doi: 10.1038/s41586-018-0266-0. Epub 2018 Jun 27.

Abstract

Patients with prostate cancer frequently show resistance to androgen-deprivation therapy, a condition known as castration-resistant prostate cancer (CRPC). Acquiring a better understanding of the mechanisms that control the development of CRPC remains an unmet clinical need. The well-established dependency of cancer cells on the tumour microenvironment indicates that the microenvironment might control the emergence of CRPC. Here we identify IL-23 produced by myeloid-derived suppressor cells (MDSCs) as a driver of CRPC in mice and patients with CRPC. Mechanistically, IL-23 secreted by MDSCs can activate the androgen receptor pathway in prostate tumour cells, promoting cell survival and proliferation in androgen-deprived conditions. Intra-tumour MDSC infiltration and IL-23 concentration are increased in blood and tumour samples from patients with CRPC. Antibody-mediated inactivation of IL-23 restored sensitivity to androgen-deprivation therapy in mice. Taken together, these results reveal that MDSCs promote CRPC by acting in a non-cell autonomous manner. Treatments that block IL-23 can oppose MDSC-mediated resistance to castration in prostate cancer and synergize with standard therapies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Androgen Receptor Antagonists / pharmacology
  • Androgen Receptor Antagonists / therapeutic use
  • Androgens / deficiency
  • Animals
  • Benzamides
  • Cell Proliferation
  • Cell Survival
  • Humans
  • Interleukin-23 / antagonists & inhibitors*
  • Interleukin-23 / blood
  • Interleukin-23 / immunology
  • Interleukin-23 / metabolism*
  • Male
  • Mice
  • Myeloid-Derived Suppressor Cells / cytology
  • Myeloid-Derived Suppressor Cells / immunology
  • Myeloid-Derived Suppressor Cells / metabolism*
  • Nitriles
  • Nuclear Receptor Subfamily 1, Group F, Member 3 / metabolism
  • Phenylthiohydantoin / analogs & derivatives
  • Phenylthiohydantoin / pharmacology
  • Phenylthiohydantoin / therapeutic use
  • Prostatic Neoplasms, Castration-Resistant / blood
  • Prostatic Neoplasms, Castration-Resistant / metabolism
  • Prostatic Neoplasms, Castration-Resistant / pathology*
  • Prostatic Neoplasms, Castration-Resistant / therapy*
  • Receptors, Androgen / metabolism
  • Receptors, Interleukin / metabolism
  • Signal Transduction

Substances

  • Androgen Receptor Antagonists
  • Androgens
  • Benzamides
  • Interleukin-23
  • Nitriles
  • Nuclear Receptor Subfamily 1, Group F, Member 3
  • Receptors, Androgen
  • Receptors, Interleukin
  • Phenylthiohydantoin
  • enzalutamide