Targeting PRMT5 to combat cancer drug resistance associated with neuroendocrine differentiation

Neuroendocrine Tumors (NETs) occur in multiple organs and share many similarities. Although NETs are
relatively rare compared to breast and lung cancers, the incidence of NETs is steadily increasing. Conventional
therapies are not effective in treating NETs, and the survival rates of patients with NETs remain low. Transdifferentiation
to NETs is suggested as a mechanism of cancer therapy resistance across all epithelial cancers,
therefore it is important to understand the initiation and progression of NETs. However, challenges in studying
NETs have limited progress in developing therapies. Merkel cell carcinoma (MCC) is a high-grade NET of the
skin that is more deadly than melanoma, with about 80% of cases caused by Merkel cell polyomavirus. This type
of NET with its viral oncogenic causal factors is thus a valuable model to investigate the biology of NETs. NETs
normally exhibit low mutation rates, and epigenetic modifications are hypothesized to be important drivers. In
this proposal, we will critically evaluate the role of Protein Arginine Methyltransferase 5 (PRMT5) in MCC as an
epigenetic regulator in MCC by investigating PRMT5-mediated arginine methylation that is associated with
neuroendocrine differentiation. We hypothesize that PRMT5-mediated histone methylation and downstream
targets affected by this methylation are required for the maintenance of NET state of MCC and can additionally
affect cancer drug resistance. This project will (1) determine effects of PRMT5 on the NET identity of MCC and
drug resistance, and (2) identify PRMT5 targets associated with the NET state of MCC. Inhibitors for PRMT5 are
currently in clinical trials for several types of cancer, and understanding the molecular mechanisms of PRMT5
as an epigenetic regulator in MCC will help evaluate the use of PRMT5 inhibitors as a potential therapeutic
intervention not only for MCC but also for the treatment of other NETs.