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Current prostate cancer (PCa) management calls for identifying novel and more effective therapeutic approaches. Self-renewing prostate tumor-initiating cells (TICs) hold intrinsic therapy-resistance and account for tumor relapse and progression. BMI-1 (Bcell- specific MMLV insertion site-1) regulates stem cell self-renewal, thus, impairing BMI-1 function for TICs-tailored therapies appears to be a promising approach. During the first year of this award and in collaboration with the initiating and other partnering PIs, we developed a time-of-adherence assay to identify CD49bhiCD29hiCD44hi cells as TICs. This year, we identified the first known translational inhibitors of BMI-1; C-209 that target prostate TICs. Employment of this specific BMI-1 inhibitor on patient-derived cells significantly decreased spheroid formation in vitro and prevented tumor initiation in vivo in mice (Bertino Lab), thereby diminishing the frequency of TICs. Furthermore, C-209 induced prostate cancer cell senescence, and G1 cell cycle arrest. BMI-1 inhibition, while displaying antitumor activity in mouse xenografts did not exert toxic effects on normal tissues. BMI-1 targeted therapy when combined with taxotere resulted in further antitumor activities. These data offer a paradigm for targeting TICs for a more effective PCa treatment. Therefore, we have accomplished our second year s goal to demonstrate the beneficial effects of targeting prostate TICs in vivo in mice in this synergistic award between three laboratories (Sabaawy, Bertino, and Kim) to develop a therapeutic strategy for BMI-1 inhibitors in prostate cancer.