RalA and RalB are
small GTPases that support malignant development and progression in experimental models of bladder, prostate, and squamous
cancer. However, demonstration of their clinical relevance in human
tumors remains lacking. Here, we developed tools to evaluate
Ral protein expression, activation, and transcriptional output and evaluated their association with clinicopathologic parameters in common human
tumor types. To evaluate the relevance of Ral activation and transcriptional output, we correlated RalA and RalB activation with the mutational status of key human
bladder cancer genes. We also identified and evaluated a transcriptional signature of genes that correlates with depletion of RalA and RalB in vivo. The Ral transcriptional signature score, but not
protein expression as evaluated by immunohistochemistry, predicted disease stage, progression to muscle invasion, and survival in human
bladder cancers and metastatic and stem cell phenotypes in
bladder cancer models. In
prostate cancer, the Ral transcriptional signature score was associated with seminal vesicle invasion,
androgen-independent progression, and reduced survival. In
squamous cell carcinoma, this score was decreased in
cancer tissues compared with normal mucosa, validating the experimental findings that Ral acts as a
tumor suppressor in this
tumor type. Together, our findings show the clinical relevance of Ral in human
cancer and provide a rationale for the development of Ral-directed
therapies.