RESEARCH ARTICLE Co-regulation and function of FOXM1/ RHNO1 bidirectional genes in cancer Carter J Barger1, Linda Chee1, Mustafa Albahrani1, Catalina Munoz-Trujillo1, Lidia Boghean1, Connor Branick1, Kunle Odunsi2, Ronny Drapkin3, Lee Zou4, Adam R Karpf1* 1Eppley Institute for Cancer Research and Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, United States; 2Departments of Gynecologic Oncology, Immunology, and Center for Immunotherapy, Roswell Park Comprehensive Cancer Center, Buffalo, United States; 3Penn Ovarian Cancer Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, United States; 4Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, United States Abstract The FOXM1 transcription factor is an oncoprotein and a top biomarker of poor prognosis in human cancer. Overexpression and activation of FOXM1 is frequent in high-grade serous carcinoma (HGSC), the most common and lethal form of human ovarian cancer, and is linked to copy number gains at chromosome 12p13.33. We show that FOXM1 is co-amplified and co- expressed with RHNO1, a gene involved in the ATR-Chk1 signaling pathway that functions in the DNA replication stress response. We demonstrate that FOXM1 and RHNO1 are head-to-head (i.e., bidirectional) genes (BDG) regulated by a bidirectional promoter (BDP) (named F/R-BDP). FOXM1 and RHNO1 each promote oncogenic phenotypes in HGSC cells, including clonogenic growth, DNA homologous recombination repair, and poly-ADP ribosylase inhibitor resistance. FOXM1 and RHNO1 are one of the first examples of oncogenic BDG, and therapeutic targeting of FOXM1/ RHNO1 BDG is a potential therapeutic approach for ovarian and other cancers. *For correspondence:
[email protected] Introduction Competing interests: The The forkhead/winged helix domain transcription factor FOXM1 promotes cancer by transactivating authors declare that no genes with oncogenic potential (Halasi and Gartel, 2013a; Kalathil et al., 2020).