DNAJB1-PRKACA fusion in fibrolamellar liver cancer (Homo sapiens)

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"Fibrolamellar carcinoma (FLC) is a liver cancer of adolescents and young adults characterized by fusions of the genes encoding the protein kinase A catalytic subunit, PRKACA, and heat shock protein, DNAJB1. The chimeric DNAJB1-PRKACA protein has increased kinase activity and is essential for FLC xenograft growth.... a core function of DNAJB1-PRKACA is the phosphorylation and inactivation of salt-inducible kinases (SIKs). This leads to deregulation of the CRTC2 transcriptional coactivator and p300 acetyltransferase, resulting in transcriptional reprogramming and increased global histone acetylation, driving malignant growth. Our studies establish a central oncogenic mechanism of DNAJB1-PRKACA and suggest the potential of targeting CRTC2/p300 in FLC. Notably, these findings link this rare cancer’s signature fusion oncoprotein to more common cancer gene alterations involving STK11 and GNAS, which also function via SIK suppression." Diagram inspired by figure 1H in Gritti, Wan et al. (2025), https://pmc.ncbi.nlm.nih.gov/articles/PMC11803398.