Supplementary Table S1. List of PTPRK-RSPO3 gene fusions in TCGA's colon cancer cohort. Chr. # of Gene 2. Chr. # of Gene 1

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1 Supplementary Tale S1. List of PTPRK-RSPO3 gene fusions in TCGA's colon cancer cohort TCGA Case ID Gene-1 Gene-2 Chr. # of Gene 1 Chr. # of Gene 2 Genomic coordiante of Gene 1 at fusion junction Genomic coordinate of Gene 2 at fusion junction Numer of spanning reads found in RNAseq TCGA-AA-3842 PTPRK RSPO3 chr6 chr TCGA-AA-3664 PTPRK RSPO3 chr6 chr TCGA-AA-3518 PTPRK RSPO3 chr6 chr TCGA-A PTPRK RSPO3 chr6 chr

2 Wnt receptors Wnt responders Wnt modulators Wnt ligands Wnt signaling RSPO-LGR Suppplementary Tale S2. Expression profile of Wnt and RSPO signalings genes in three lung cancer cell lines. The data in log2(microarray signal) were downloaded from CCLE's gene expression dataase. Category Cell line A549 H46 H29 Category Cell line A549 H46 H29 PORCN RSPO Norrin RSPO WNT RSPO WNT RSPO WNT2B LGR WNT LGR WNT LGR WNT DVL WNT5A DVL WNT5B DVL WNT IQGAP WNT7A IQGAP WNT7B IQGAP WNT8A DKK WNT8B DKK WNT9A DKK WNT9B E-cadherin WNT1A RNF WNT1B ZNRF WNT SFRP WNT SFRP FZD SFRP FZD SFRP FZD AXIN FZD WIF FZD catenin FZD CD FZD FZD PTPRK FZD FZD LRP LRP ROR ROR Ryk

3 15 1 Gene Exp (log2[rsem]) 1 5 Gene Exp (log2[signal[) c LGR4 LGR5 LGR6 d LGR4 LGR5 LGR Gene Exp (log2[rsem]) 1 5 Gene Exp (log2[signal[) RSPO1 RSPO2 RSPO3 RSPO4 RSPO1 RSPO2 RSPO3 RSPO4 Supplementary Figure S1. RSPO3 and LGR4 were the predominant ligand receptor pair expressed in lung AD and lung cancer cell lines. (a ) Expression level and distriution of LGR4 6 in the 23 samples of TCGA s LUAD cohort (a) and CCLE s 186 lung cancer cell lines (). (c d) Expression level and distriution of RSPO1 4 in the same TCGA cohort (c) and CCLE lung cancer cell line collection (d).

4 15 Normal Tumor RSPO3 Exp (log2[signal]) 1 5 TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA TCGA Supplementary Figure S2. High expression of RSPO3 in selected tumors was due to upregulation of gene expression instead of repression. Log2[RSEM] values of RSPO3 from tumor and matched normal tissues in TCGA s 55 cases were plotted side y side for each tumor.

5 % Surviving RSPO3-high RSPO3-norm (Logrank test p =.7) N = 84 2 N = Months of Survival 1 % Surviving N = 5 N = RSPO3-norm RSPO3-high (Logrank test p =.59) Months of Survival Supplementary Figure S3. High expression of RSPO3 was associated with poor survival in two other lung cancer studies. Kaplan Meier survival plot of RSPO3 expression vs. overall survival in two lung cancer cohorts, GSE3141 (a) and GSE3121 (). RSPO3 high were defined as those samples at 2 SDs aove the population mean (Z = 2) for oth GSE3141 and GSE3121.

6 25 2 TCGA-AA-3664 RPKM TCGA-AA-3842 TCGA-AA-3518 TCGA-A Sample Numer Supplementary Figure S4. High levels of RSPO3 expression in colon cancers were all driven y recurrent fusions with PTPRK. The RNA seq data in RPKM (reads per kiloase per million reads) of RSPO3 from TCGA s 244 colorectal samples were sorted from low to high and plotted. Samples with PTPRK RSPO3 gene fusions were marked y arrows with case IDs.

7 RSPO3 Keap1 ABCC2 K Ras TP53 EGFR mrna Downregulation mrna Upregulation Mutation RSPO3 Keap1 ABCC2 AKR1C1 AKR1C2 -Expression high -Expression low Supplementary Figure S5. High expression of RSPO3 is strongly associated with Keap1 deficiency in oth primary lung AD tumors and lung cancer cell lines. (a) Parallel view of gene expression and mutation status of RSPO3 vs. Keap1, ABCC2 ( a target gene of the Keap1 NRF2 pathway), K Ras, TP53, and EGFR in the 23 samples of TCGA s LUAD cohort. The diagram was generated using the OncoPrint function of cbioportal. Down and up regulation are defined as those samples with log2[rsem] values at 1 SD elow or aove, respectively, the population mean. () A heat map of the expression profile of RSPO3, Keap1, ABCC2, AKR1C1, and AKR1C2 in CCLE s 186 lung cancer cell line set. Mutation status of Keap1 in CCLE cell lines is unknown and thus not included.

8 GFP PLVX GFP Keap1 GFP PLVX GFP Keap1 Keap1 Actin NRF2 Actin c anti Keap1 anti NRF GFP GFP-Keap1 % Control Exp AKR1C2 RSPO3 Supplementary Figure S6. Expression of GFP Keap1 in lung cancer cell line H1944 cells led to decreased levels of NRF2 and reduced expression of RSPO3 and AKR1C2. (a) WB results of H1944 cells expressing GFP control or Keap1 GFP proed with anti Keap1 antiody. () WB results of the same cells proed with anti NRF2 antiody. These experiments were repeated once with representative data shown. (c) RT qpcr analysis of AKR1C2 and RSPO3 in H1944 cells expressing GFP control or GFP Keap1. The data are normalized to 18S RNA and the values are the mean of three replicate experiments. Error ars are S.E.M.

9 Supplementary Figure S7. Nine putative NRF2 inding sites are located upstream of the promoter region of RSPO3. The sequences and positions of the 9 putative NRF inding sites located upstream of the transcription start site (TSS) of RSPO3 are listed. The profile of NRF2 inding sites determined from ChIP Seq (Malhotra et al., 21) is shown for comparison. ntgannnngcn is the consensus sequence of NRF inding sites.

10 15 15 RSPO3 Exp (log2[rsem]) 1 5 RSPO3 Exp (log2[rsem]) 1 5 c Log2[RSPO3 copy numer] d RSPO3-GISTIC 2 15 P =.65 (One way ANOVA) 1..8 P =.55 (One way ANOVA) # of Mutations 1 Fraction RSPO3-high, Keap1-def RSPO3-low, Keap1-def RSPO3-low, Keap1-norm. RSPO3-high, Keap1-def RSPO3-low, Keap1-def RSPO3-low, Keap1-norm Supplementary Figure S8. RSPO3 high and norm tumors were not significantly different in gene copy numer, mutation urden, and the fraction of copy numer altered genome in the 23 samples of TCGA s LUAD set. (a) RSPO3 Expression vs. RSPO3 gene copy numer as determined y Affymetrix SNP6. () RSPO3 expression vs. gene copy numer as determined y the GISTIC assay. (c) RSPO3 expression vs. mutation urden. (d) RSPO3 expression vs. fraction of copy numer altered genome.

11 c Methylaiton eta at Keap1-norm Keap1-def Methylaiton eta at Keap-norm Keap1-def Methylaiton eta at Keap1-norm Keap1-def RSPO3 Exp (log2[rsem]) RSPO3 Exp (log2[rsem]) RSPO3 Exp (log2[rsem]) Supplementary Figure S9. All RSPO3 high tumors had lost methylation in the three CpG sequences located downstream of the RSPO3 promoter region. (a c) Scatter plot of the methylation eta values at the three CpG sites, (a), (), and (c) vs. RSPO3 expression in relation to Keap1 status. Keap1 norm = no Keap1 mutation or down regulation. Keap1 def = Keap1 deficient.

12 P LGR4 p LRP6 tlrp6 Catenin Actin Expression of protein (%) LGR4 plrp6 LRP6 -Catenin Parent shlgr4-#39 shlgr4-#4 shlgr4-#43 c Cell Index Parental shlgr4-39 shlgr4-4 shlgr4-43 d Migration cell numer P <.5 (One way ANOVA) * * e Invasion cell numer P <.5 (One way ANOVA) * * Growth Time (Hour) Parental shlgr4-39 shlgr4-4 shlgr4-43 Parental shlgr4-39 shlgr4-4 shlgr4-43 Supplementary Figure S1 Confirmation of the effect of LGR4 KD y a second shrna (#43). (a) WB results of LGR4 expression and Wnt signaling in A549 parental cells (P) and those expressing control shrna (C), shlgr4 4 (4), or shlgr4 43 (43). () Quantification of the WB signals in (a). (c e) Growth (c), migration (d), and invasion (e) of A549 parental cells and those expressing control shrna, shlgr4 4, or shlgr4 43. The experiments were repeated twice and errors ars are S.E.M. *p <.5 vs. control shrna, Dunnett s multiple comparison test.

13 Parental shrna-cont shlgr4-4 O.D. (57 nm) Growth Time (day) O.D. (57 nm) Parental shrna-cont shrspo3-63 shrspo Growth Time (day) Supplementary Figure S11. MTT assay confirmed the negative effect of KD of LGR4 or RSPO3 on cell growth of A549 cells. (a) Growth curve of A549 cells with KD of LGR4 (shlgr4 4) vs. parental A549 cells and those expressing control shrna. () Growth curve of A549 cells with KD of RSPO3 (shrna 63, 67) vs. parental A549 cells and those expressing control shrna. The experiments were repeated once with representative data shown here.

14 Expression of LGR4 (%) Parental shrna-cont shlgr4-4 Expression of IQGAP1 (%) Parental shrna-cont shiqgap1 Supplementary Figure S12. Quantified results of the WB signals in Figure 3e. (a), Levels of LGR4 as normalized to actin. () Levels of IQGAP1 as normalized to actin.

15 Migration cell numer RSPO3 +RSPO3 Parental Vector LGR4-KD IQGAP1-KD Supplementary Figure S13. The actual numer of migrated cells of the experiment in Fig. 3f.

16 Parental shrna-cont LGR4-KD Supplementary Figure S14. KD of LGR4 in A549 cells led to change from a mesenchymal like morphology to an epithelial (cole stone) like morphology. Representative right field micrographs of parental A549 cells, cells expressing control shrna or LGR4 KD shrna (shlgr4 4).

17 15 Expression of protein (%) 1 5 A549-Parental A549-shLGR4-39 A549-shLGR4-4 H46-Parental H46-shLGR4-39 H46-shLGR4-4 LGR4 E-cadherin Fironectin N-cadherin Vimentin 3 Expression of protein (%) 2 1 Parental Vector-cont shrspo3-63 shrspo3-67 Ze1 E-cadherin Fironectin N-cadherin Vimentin Supplementary Figure S15. Quantified results of the WB signals in Figure 4 c. (a) results of the WB signals in Figure 4 as normalized to actin. () Results of the WB signals in Figure 4c as normalized to actin.

18 Parental shrna-control LGR4-KD Parental shrna-control LGR4-KD -LGR4 -Actin Supplementary Figure S16. KD of LGR4 in A549 cells led to reduced tumor growth. (a) Photographs of the sucutaneous tumors from parental A549 cells and those expressing control shrna or the LGR4 KD shrna (shlgr4 4). () WB analysis of LGR4 of the tumors from sucutaneous study using the LGR4 antiody 7E7. Actin was used as loading control.

19 #96 #93 #97 #94 #98 #95 #99 #97 Supplementary Figure S17. H &E staining of lung sections from the animals injected with A549 cell expressing control shrna (a) or LGR4 KD (shlgr 4) (). The numers denote the codes used for each animal. Representative micrographs of the remaining two animals are shown in Figure 6C.

20 % Surviving Axin2-norm Axin2-high (Z > +1) Axin2-low (Z < -1) (logrank test p =.16 N = 126 RSPO3 Exp (log2[rsem]) 2 1 N = 41 N = Months Survival 15 RSPO3 (R =.4, p =.5) AXIN2 Exp (log2[rsem]) Supplementary Figure S18. Expression level of Axin2 was not correlated with survival nor with that of RSPO3. (a) Kaplan Meier survival curves of patients with tumors of either high, low, or norm levels of expression of Axin2. High and low expressions are defined as 1 standard deviation aove (Z > +1) or elow (Z < 1) the population mean of log2[resm] of RNA seq data. The rest of the samples are define as norm. () Plot of the RNA seq data of Axin2 vs. RSPO3. Correlation efficiency (R) and p values are y Spearmen test (non parametric).

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