Reciprocal epigenetic Sox2 regulation by SMAD1-SMAD3 is critical for anoikis resistance and metastasis in cancer

Growth factors in the tumor environment are key regulators of cell survival and anoikis resistance during metastasis. Here we reveal significant dichotomy between TGF-β superfamily growth factors BMP and TGF-β/activin and their downstream SMAD effectors in regulation of anchorage-independent tumor cell survival in ovarian cancer. Gene expression profiling uncovered the transcription factor Sox2 as a key signaling node regulated in an opposing manner by anoikis-promoting BMP2 4 and 9 and anoikis-suppressing TGF-β and activin A. Mechanistically, repression of Sox2 by BMPs is mediated by type I receptors ALK2 and ALK3 induced SMAD1 activation, leading to SMAD1-dependent histone H3K27me3 recruitment and DNA methylation at SOX2s promoter. Conversely, TGF-β and activin A promote Sox2 expression directly by ALK5-mediated SMAD3 activation and histone H3K4me3 recruitment. Increased Sox2 expression promotes anoikis resistance, while decreasing Sox2 levels conversely reduces anoikis resistance and activates cell death pathways. Additionally, administrating BMP9 as a strategy to reduce Sox2 robustly inhibits intraperitoneal tumor burden and increases survival in multiple ovarian cancer xenograft models. Importantly, BMP-driven SMAD1 signaling can override the effects of TGF-β and activin on Sox2 regulation, which has potential clinical significance as we find high TGF-β levels in patient ascites. Our findings highlight the contrasting regulation of anoikis by distinct SMAD signaling pathways that are dependent on a novel dichotomous regulation of Sox2 and implicate the use of a subset of BMPs as a therapeutic strategy in cancer ### Competing Interest Statement The authors have declared no competing interest.