Abstract Rb1 loss is a hallmark of lethal castration-resistant prostate cancer (CRPC), yet its role in shaping metastatic dissemination patterns remains poorly understood. Using our EvoCaP somatically engineered mouse model (SEMM), we generated Pten/Trp53/Rb1-deficient (2PR) mice and compared them to Pten/Trp53-deficient (2P) controls. Loss of Rb1 dramatically increased metastatic burden, particularly to visceral organs, and promoted neuroendocrine (NE) differentiation. Lineage tracing revealed that 2PR tumors establish metastatic hub organs that seed cascade dissemination to multiple secondary sites. Histologically, 2PR tumors displayed distinct NE and mesenchymal-like (ML) compartments, with NE regions showing elevated β-catenin and EZH2 expression, markers of aggressive castration-resistant prostate cancers including: CRPC-WNT (Wnt signaling driven) and CRPC-NE (EZH2-high) subtypes. Organoids derived from 2PR tumors confirmed these transcriptional changes and showed enhanced sensitivity to EZH2 and WNT inhibitors. These findings reveal how Rb1 loss drives lineage plasticity and metastatic evolution in prostate cancer, identifying therapeutic vulnerabilities in this lethal disease subtype. Citation Format: Dawid G. Nowak, Ryan N. Serio, Lise M. Brault, Domenic V. Gargiulo, Rebecca Hassett, Ryan J. Chaffee, Stephen J. Staklinski, Billy Lu, Adam C. Siepel. Rb1 loss defines distinct migration histories in metastatic prostate cancer subtypes abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 3537.
Nowak et al. (2026) studied this question.