Bromodomain and extraterminal domain (BET) family
proteins such as BRD4 are epigenetic readers that control expression of a number of oncogenic
proteins. Targeting this family of
proteins has recently emerged as a promising anticancer approach. BET inhibitors (BETi), either alone or in combination with other
anticancer agents, have exhibited efficacy in a variety of
tumors. However, the molecular mechanisms underlying differential response to BETi are not well understood. In this study, we report that
death receptor 5 (DR5), a key component of the extrinsic apoptotic pathway, is markedly induced in response to BRD4 depletion and BETi treatment in
colorectal cancer cells. Induction of DR5, following BET inhibition, was mediated by endoplasmic reticulum stress and CHOP-dependent transcriptional activation. Enhanced DR5 induction was necessary for the chemosensitization and apoptotic effects of BETi and was responsible for increased BETi sensitivity in
colorectal cancer cells containing a mutation in speckle-type POZ
protein (SPOP), a subunit of BRD4
E3 ubiquitin ligase. In a
colorectal cancer xenograft model, BETi combined with
chemotherapy suppressed the
tumor growth in a DR5-dependent manner and potently inhibited patient-derived xenograft
tumor growth with enhanced DR5 induction and apoptosis. These findings suggest that BETi alone or in combination with
chemotherapy is effective against
colorectal cancer due to enhanced DR5 induction and apoptosis. DR5 induction may also serve as a useful marker for designing personalized treatment and improved
colorectal cancer combination
therapies.Significance: These findings reveal how BET inhibition sensitizes
chemotherapy and kills a subset of
colon cancer cells with specific genetic alterations and may provide a new molecular marker for improving
colon cancer therapies.