The ecotropic virus integration site 1(Evi1) transcription factor, encoded in the MECOM complex locus, is implicated in several cancers, including ovarian cancer(OC). High-grade serous OC(HG-SOC) represents its most common and aggressive form. The pathobiological and clinical roles of MECOM and its products in HG-SOC are poorly understood.
Here, across all HG-SOC stages and grades, our meta-analysis demonstrated MECOM amplification in about 80% and EVI1 overexpression in 100% HG-SOC samples, relative to normal controls. We observed that Evi1 directly promotes double-strand DNA breaks repair via binding to DNA recombination/repair protein complexes, including a novel Rad50 isoform.
To elucidate the molecular basis and clinical significance of these findings, we studied genome-wide genome-wide Evi1-DNA binding, DNA copy number alterations, gene expression and proteome-scale Evi1 interactions, combining cell line and clinical meta-data and network/pathway analyses. Our experiments revealed major, previously unknown Evi1-binding DNA motifs specifying expression of 309 target genes, whose protein products were classified into eight functional and prognosis-significant modules implicated in embryogenesis, EMT, RNA metabolism, cancer cell survival, retinoic acid, anti-viral and therapeutic responses. The Evi1 pathway modules can collectively stratify the HG-SOC patients into four high-confidence post-surgery survival subgroups(P
Starting from early stages of HG-SOC, MECOM/Evi1 amplifies genomic instability and activates the Evi1 pathway that promotes most cancer hallmarks. Thus, MECOM/Evi1 and the Evi1 pathway provide mechanistic means for HG-SOC re-classification, introduces high-confidence early diagnostic and prognostic biomarkers and perspective therapeutic targets.