Activation of TWIST1 by COL11A1 promotes chemoresistance and inhibits apoptosis in ovarian cancer cells by modulating NF‐κB‐mediated IKKβ expression

We have shown that collagen type XI alpha 1 (COL11A1) promotes ovarian cancer progression and is associated with chemoresistance to cisplatin and paclitaxel in ovarian cancer cells. Here, we demonstrate how COL11A1 regulates twist family basic helix‐loop‐helix transcription factor 1‐related protein 1 (TWIST1) to induce chemoresistance and inhibit apoptosis in ovarian cancer cells. Small interfering RNA‐mediated reduction in COL11A1 protein levels increased the chemosensitivity to cisplatin and paclitaxel via downregulated TWIST1 expression. TWIST1 messenger RNA levels positively associated with COL11A1 messenger RNA expression levels in ovarian tumors. High TWIST1 expression levels were significantly associated with a progression‐free interval of ≤ 6 months (p = 0.001) and death (p = 0.040). In addition, patients with high TWIST1 mRNA levels had significantly shorter 5‐year overall‐survival (p = 0.004) and progression‐free survival (p = 0.009) rates, compared to patients with low TWIST1 levels. Increased TWIST1 expression caused by COL11A1‐induced transcription of the inhibitor of nuclear factor kappa B kinase subunit beta (IKKβ) gene occurred via increased SP1 phosphorylation and binding to the IKKβ promoter. COL11A1‐mediated nuclear factor‐kappa B activation, via transcriptional activation of IKKβ, promoted TWIST1, Mcl‐1, and GAS6 expression, which were associated with chemoresistance and anti‐apoptosis in ovarian cancer cells. We suggest that IKKβ and TWIST1 can potentially be targeted in patients with COL11A1‐positive ovarian cancer. What's new? COL11A1 and TWIST1 were previously found to be among the most differentially upregulated genes in chemoresistant ovarian tumors. Here, the authors examined the role of COL11A1‐dependent TWIST1 expression in chemoresistance and clinical outcome of epithelial ovarian carcinoma (EOC). TWIST1 upregulation caused by COL11A1‐induced IKKβ transcription occurred via increased SP1 binding to the IKKβ promoter. COL11A1‐mediated NF‐κB activation, via IKKβ transcriptional activation, promoted TWIST1 and Mcl‐1 or GAS6 expression, which were associated with chemoresistance and apoptosis inhibition. EOC patients with TWIST1 overexpression had higher chemotherapy resistance and shorter survival, highlighting TWIST1 as an important chemoresistance and poor prognosis marker in EOC.