Non-small cell lung cancer (NSCLC) remains one of the leading causes of cancer-related mortality, partly because it is often diagnosed at advanced stages and frequently develops resistance to platinum-based chemotherapy. We previously showed that MAFG becomes derepressed following miR-7 hypermethylation, promoting platinum resistance in NSCLC and ovarian cancer cell lines. Although MAFG is a well-established regulator of oxidative stress, recent evidence in melanoma and colorectal cancer suggests an additional role as a regulator of methylator phenotypes. However, how MAFG reshapes the lung cancer epigenome remains unknown. Here, we investigated the contribution of MAFG to DNA methylation remodeling by combining CRISPR/Cas9-mediated MAFG deletion with CpG-Methyl-Array profiling, followed by expression (qPCR) and methylation (qMSP) validation in tumor cell lines. Our translational approach integrated aptahistochemistry using MAFG-specific aptamers in 127 NSCLC patients, methylation analysis in 35 fresh-frozen tumors and 40 FFPE samples, and interrogation of TCGA methylation datasets. MAFG loss reduced promoter methylation of LIF and MAFG itself. Importantly, these effects were subtype-specific, with MAFG expression and methylation displaying distinct transcriptional programs in LUAD versus LUSC, and prognostic associations restricted to KRAS-mutated adenocarcinomas. In TCGA cohorts, lower MAFG methylation and higher MAFG protein levels were both associated with worse prognosis. In summary, our findings identify MAFG as a regulator of DNA methylation in NSCLC and support the use of MAFG DNA methylation, or protein levels as clinically relevant prognostic biomarkers, particularly in lung adenocarcinoma.
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