Summary: The X-linked DDX3X gene encodes an ATP-dependent DEAD-box RNA helicase frequently altered in various human cancers, including melanomas. Despite its important roles in translation and splicing, how DDX3X dysfunction specifically rewires gene expression in melanoma remains completely unknown. Here, we uncover a DDX3X-driven post-transcriptional program that dictates melanoma phenotype and poor disease prognosis. Through an unbiased analysis of translating ribosomes, we identified the microphthalmia-associated transcription factor, MITF, as a key DDX3X translational target that directs a proliferative-to-metastatic phenotypic switch in melanoma cells. Mechanistically, DDX3X controls MITF mRNA translation via an internal ribosome entry site (IRES) embedded within the 5′ UTR. Through this exquisite translation-based regulatory mechanism, DDX3X steers MITF protein levels dictating melanoma metastatic potential in vivo and response to targeted therapy. Together, these findings unravel a post-transcriptional layer of gene regulation that may provide a unique therapeutic vulnerability in aggressive male melanomas. : Here, Phung et al. show that the X-linked gene DDX3X encoding an RNA helicase is frequently mutated in male melanoma and directs a post-transcriptional program that impacts clinical outcome and therapy response. These findings provide insights into the underlying mechanisms driving metastatic potential and resistance of aggressive melanomas. Keywords: DDX3X, melanocyte, melanoma, MITF, IRES, translation control, migration, metastasis, therapy, resistance
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