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Abstract Metastatic breast cancer remains a major cause of cancer-related deaths in women, and there are few effective therapies against this advanced disease. Brain metastases, found in 15~35% of patients with breast cancer, are often incurable. Accumulating evidence suggests that key steps of tumor progression and metastasis are controlled by reversible epigenetic mechanisms. To systematically identify the druggable epigenetic regulators essential for breast cancer brain metastasis, we conducted an in vivo shRNA screen and identified multiple epigenetic regulators, including RNA acetyltransferase NAT10 as drivers of breast cancer brain metastasis. Knockdown of NAT10 significantly restrains breast cancer cell proliferation and migration in vitro and brain metastases in vivo. NAT10 promotes breast cancer cell growth through its RNA helicase activity but not its acetyltransferase activity. Integrative analyses of transcriptomics, proteomics, and NAT10 eCLIP-Seq data identify NAT10 downstream targets critical for breast cancer progression and metastasis. Thus, these results reveal novel therapeutic strategies to treat metastatic breast cancer. Citation Format: Jocelyn Chen, Wesley Cai, Peng Xu, Don Nguyen, Qin Yan. Genetic screen identifies epigenetic drivers of breast cancer brain metastasis abstract. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-06-12.
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