DNA demethylating agents suppress preclinical models of synovial sarcoma
Nobuhiko Hasegawa, … , Ana Banito, Kevin B. Jones
Nobuhiko Hasegawa, … , Ana Banito, Kevin B. Jones
Published April 29, 2025
Citation Information: J Clin Invest. 2025;135(13):e190855. https://doi.org/10.1172/JCI190855.
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Research Article Genetics Oncology

DNA demethylating agents suppress preclinical models of synovial sarcoma

Abstract

Synovial sarcoma is an aggressive soft-tissue cancer driven by the chimeric SS18::SSX fusion oncoprotein, which disrupts chromatin remodeling by combining two antagonistic transcriptional regulators. SS18 participates in BAF complexes that open chromatin, while the SSX genes are cancer-testis antigens that interface with chromatin decorated with monoubiquitinated histone H2A placed by polycomb repressive complex activity. Because KDM2B brings polycomb repressive complex to unmethylated CpG islands, it is plausible that methylation directly determines the distribution of SS18::SSX to target loci. Given that synovial sarcoma is also characterized by a peculiarly low DNA hypomethylation profile, we hypothesized that further disturbance of DNA methylation would have a negative impact on synovial sarcoma growth. DNMT1 disruption by CRISPR/Cas9 targeting or pharmacological inhibition with cytidine analogs 5-aza-2′-deoxycytidine (decitabine) and 5-azacytidine led to decreased genome-wide methylation, redistribution of SS18::SSX, and altered gene expression profiles, most prominently including upregulation of tumor suppressor genes, immune-related genes, and mesenchymal differentiation-related genes. These drugs suppressed growth of synovial sarcoma cell lines and drove cytoreduction in mouse genetic models. DNMT1 inhibitors, already approved for treating myelodysplastic syndromes, warrant further clinical investigation for synovial sarcoma as repurposed, targeted treatments exploiting a vulnerability in the intrinsic biology of this cancer.

Authors

Nobuhiko Hasegawa, Nezha S. Benabdallah, Kyllie Smith-Fry, Li Li, Sarah McCollum, Jinxiu Li, Caelen A. Jones, Lena Wagner, Vineet Dalal, Viola Golde, Anastasija Pejkovska, Lara Carroll, Malay Haldar, Seth M. Pollack, Scott W. Lowe, Torsten O. Nielsen, Ana Banito, Kevin B. Jones

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Figure 5

Decitabine and azacytidine treatments affect genetically induced synovial sarcomas in mice.

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Decitabine and azacytidine treatments affect genetically induced synovia...
(A) Diagram of a genetically induced mouse model and details of drug administration. (B) Tumor growth curves for each group. Normalized (fractional) tumor volumes are presented as mean ± SD. Two-tailed homoscedastic t test P values less than 0.05 are indicated with a single asterisk, those less than the Bonferroni-corrected P values are indicated with a double asterisk (red for 5-AZA compared with vehicle, purple for 5-AZA compared with decitabine; n = 8 for vehicle and decitabine treatments, and 10 for 5-AZA treatments). (C) Course of normalized mean tumor size from day 0 of treatment, administered for 14 days and then stopped. Two-tailed homoscedastic t test; P values less than 0.05 are indicated with a single asterisk, those less than the Bonferroni-corrected P value are indicated with a double asterisk (blue for decitabine compared with vehicle, red for 5-AZA compared with vehicle, purple for 5-AZA compared with decitabine; n = 9 for 5-AZA and decitabine treatment groups, and 5 for the vehicle control group).