DNAJB1-PRKACA fusion drives fibrolamellar liver cancer through impaired SIK signaling and CRTC2/p300-mediated transcriptional reprogramming

Fibrolamellar carcinoma (FLC) is a liver cancer of adolescents and young adults defined by fusion of the DNAJB1 heat shock protein and protein kinase A (PKA) catalytic subunit (DNAJB1-PRKACA). The resulting chimeric protein has increased kinase activity and is essential for FLC xenograft growth. However, the critical oncogenic pathways controlled by DNAJB1-PRKACA have not been defined. Here, we explored this question by studying patient-derived FLC models and engineered systems and analyzing patient samples. We show that the core function of DNAJB1-PRKACA is the direct phosphorylation and inactivation of the Salt-inducible kinases. This leads to deregulation of the CRTC2 co-activator and p300 acetyltransferase, resulting in transcriptional reprogramming and global increases in histone acetylation necessary for malignant growth. Our studies establish a central oncogenic mechanism of DNAJB1-PRKACA and suggest opportunities for therapeutic targeting of CRTC2/p300 in FLC. Notably, these findings link this signature fusion oncoprotein of a rare cancer type to more common cancer gene alterations involving the STK11 tumor suppressor and GNAS oncogene, which also function via SIK suppression. To investigate the effects of PKA and SIK inhibitors on FLX1 cell lines, we treated these cells under four different conditions: DMSO (control), PKA inhibitor, SIK inhibitor, and a combination of both inhibitors. Subsequently, we harvested triplicate biological replicates for RNA-seq and analyzed the data.