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Cancer Letters

Elsevier BV

Preprints posted in the last 7 days, ranked by how well they match Cancer Letters's content profile, based on 35 papers previously published here. The average preprint has a 0.04% match score for this journal, so anything above that is already an above-average fit.

1
Small-RNA Profiling Links 5'-tRNA Halves to Post-therapeutic Disease Persistence and Poor Patient Survival in Glioblastoma

Anam, M.; Schanel, T. L.; Dunlap, S.; Mohamed, M.; Ahn, E.-Y. E.; Willey, C. D.; Su, Z.

2026-07-15 cancer biology 10.64898/2026.07.14.738483 medRxiv
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Glioblastoma (GBM) is a highly lethal brain cancer with limited therapeutic durability, where the majority of patients develop recurrent or persistent disease after standard chemoradiotherapy. Meanwhile, tRNA-derived fragments (tRFs) have become increasingly relevant to cancer biology; however, their clinical relevance in GBM remains undefined. Here, we report that a specific family of tRFs, 5-tRNA halves (tiR5s) dominates the small RNA landscape of GBM patient tumors and associates with worse overall survival, post-therapeutic disease persistence, and pro-invasive proteogenomic pathways across two independent GBM patient cohorts. This association between elevated tiR5 levels and therapeutic resistance re-emerges in radiation-resistant GBM xenograft models. Our findings reveal that tiR5s are an underappreciated molecular feature of highly aggressive GBM tumors, supporting further investigation into their biological roles and prognostic utility in GBM. HighlightsO_LItiR5s are the predominant tRF family in primary GBM patient tumors C_LIO_LIElevated tiR5 expression distinguishes primary GBM tumors that develop persistent disease after first-line therapy C_LIO_LIRadiation-resistant GBM PDX models show elevated tiR5 expression C_LIO_LIElevated tiR5 expression associates with poor overall patient survival and pro-invasive molecular programs in GBM patient tumors C_LI Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=200 SRC="FIGDIR/small/738483v1_ufig1.gif" ALT="Figure 1"> View larger version (54K): org.highwire.dtl.DTLVardef@184ddc1org.highwire.dtl.DTLVardef@1faadc2org.highwire.dtl.DTLVardef@a5ae02org.highwire.dtl.DTLVardef@1431506_HPS_FORMAT_FIGEXP M_FIG C_FIG

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Nuclear translocation of phosphorylated YB-1 via small extracellular vesicles contributes to the malignant phenotype of triple negative breast cancer

Santos, M.; Kim, Y.; Feng, Z.; Biebighauser, T.; Lorico, A.; Sossey-Alaoui, K.

2026-07-15 cancer biology 10.64898/2026.07.14.738446 medRxiv
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Despite continuous progress in diagnosis and therapy, breast carcinoma (BC) remains a major health problem. Triple-negative (Estrogen Receptor-/Progesterone Receptor-/HER2-) breast cancer (TNBC) is the most aggressive subtype due to its high metastatic potential and resistance to chemotherapy. The Y-box binding protein 1 (YB-1) transcription factor, a protein present in both cytoplasm and nucleus, is a driver of TNBC malignancy as it stimulates its cancer stem cell phenotype and disrupts cell cycle progression. Here, we hypothesized that YB-1-containing sEVs deliver YB-1 to the nuclear compartment of recipient cancer cells and play a major role in the activation of the metastatic process. We found a selective enrichment of YB-1 in sEVs from MDA and 4T1 cells, with [~]65% and 50% of all sEVs positive for YB-1 by d-STORM. Administration of sEVs from wild-type MDA and 4T1 to their YB-1 knockout counterparts resulted in nuclear translocation of sEV-associated YB-1 and increased tumorsphere formation. Pharmacological blockade of the nuclear transport machinery based on the inhibition of the formation of the "VOR" complex (VAP-A-ORP3-Rab7) by PRR851 impaired both nuclear translocation and the YB-1-induced increase in tumorsphere formation. YB-1 phosphorylation at S102 was required for nuclear localization. In fact, loss of YB-1 phosphorylation inhibited tumorsphere growth and stemness of cancer cells and YB-1-positive sEVs restored the oncogenic behavior of cancer cells expressing phospho-mutant YB-1. Moreover, PRR851 inhibited the nuclear translocation of the phosphorylated form of YB-1 and the oncogenic behavior of the TNBC cells. These data support the conclusion that the nuclear translocation of sEV-associated phosphorylated YB-1 is an important factor in the malignant behavior of TNBC and a potential therapeutic target.

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Real-world systemic therapy utilization and survival in synchronous metastatic solid cancer: a comprehensive nationwide analysis

Slotman, E.; van Disseldorp, L. M.; de Jong, G.; Fransen, H. P.; Reyners, A. K. L.; Tol, J.; Jager, A.; Westgeest, H. M.; Sonke, G. S.; van Laarhoven, H. W. M.; van Zuylen, L.; van den Heuvel, M. M.; Koopman, M.; Smit, E.; Raijmakers, N. J. H.; Siesling, S.

2026-07-21 oncology 10.64898/2026.07.20.26358468 medRxiv
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Introduction: This study aimed to provide population level survival trends during the era in which new systemic therapies transformed treatment guidelines for metastatic cancer, as well as insights on the real world use of these treatments and associated survival. Methods: Adults diagnosed with synchronous metastatic solid cancer in 2008 until 2022 (22 cancer types) were identified from the Netherlands Cancer Registry. Median overall survival (OS) was assessed by five year diagnostic period. For 2018 until 2022, systemic therapy use in any treatment line was analyzed and survival percentiles within treatment and cancer types were estimated with Kaplan Meier survival analyses. Results: Median OS in the overall cohort (n=280,419 patients) improved from 6 to 8 months between the period 2008 until 2012 and 2018 until 2022. Among patients diagnosed in 2018 until 2022, 15% received immunotherapy, 15% targeted therapy, 29% chemotherapy and/or traditional hormone therapy only, and 39% no systemic therapy. In some cancer types, a relatively large proportion of treated patients had longterm survival (e.g., immunotherapy in melanoma: p50 = 67 months). Other cancer types had a smaller subset of treated patients (p10 and p25) with substantially better outcomes than the median (e.g., targeted therapy in NSCLC: p50 = 22 months, p10 = 96 months). Conclusion: Population level survival for patients with synchronous metastatic solid cancer has modestly improved over time. The marked survival heterogeneity within cancer and treatment types highlights both the potential and uncertainty associated with (novel) treatments. Improved prediction of treatment effects and clear communication regarding survival expectation remain critical. Presenting multiple survival scenarios over median survival alone can support decision making.

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Epithelial Stem Cell Fate Determines Chemoradiotherapy Response in Rectal Cancer

Li, N.; Ishaqwala, F.; Wright, T. A.; Wilkinson, A.; Vlckova, P.; Trevers, K.; O'Sullivan, R.; Crampsie, S.; Basiarz, E.; Vanderkamp, S.; McCulloch, A. K.; Dobric, A.; Krishnaswamy, S.; Vanhaesebroeck, B.; Glasgow Serial Sampling Consortium, ; Roxburgh, C. S. D.; Hawkins, M.; Tape, C. J.

2026-07-15 cancer biology 10.64898/2026.07.15.736775 medRxiv
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Rectal cancers are often treated with neoadjuvant chemoradiotherapy (CRT), yet 85% of patients do not achieve a pathological complete response. To identify the molecular determinants of CRT response, we profiled the single-cell signalling, DNA-damage, cell-cycle, apoptotic, and cell-fate responses of 2,769 patient-derived organoid cultures treated with CRT, cancer-associated fibroblasts (CAFs), and signal-rewiring agents. We find that CRT response is determined by stem cell-fate. CRT triggers comparable DNA-damage in isogenic proliferative (proCSC) and revival (revCSC) colonic stem cells, but proCSC retain damage and die whereas revCSC resolve damage and persist. Both CRT and CAFs drive proCSC to a common treatment-resistant revCSC fate and high revCSC predicts worse survival in patients. Pharmacologically constraining stem-cell plasticity increases CRT sensitivity, and Spatial Perturbation of ARrayed Tumour Assembloids (SPARTA) confirms YAP/TEAD inhibition improves chemotherapy responses in human stromal-tumour models. These results suggest that cancer cell-fate, not genotoxic damage itself, ultimately governs response to standard-of-care chemoradiotherapy. HIGHLIGHTSO_LIRectal cancer stem cell-fate determines chemoradiotherapy-induced apoptosis C_LIO_LIproCSCs retain DNA-damage and die, whereas revCSCs repair damage and persist C_LIO_LICAFs and chemoradiotherapy converge on a common chemo-radioresistant revCSC state C_LIO_LISPARTA reveals TEAD inhibition blocks DNA-repair persisters in stromal assembloids C_LI

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Comprehensive molecular characterization of cutaneous squamous cell carcinoma reveals determinants of metastatic progression

Rentroia-Pacheco, B.; Sharma, H.; Pozza, L.; Traets, J. J. H.; Tandukar, B.; Steijlen, O. F. M.; Ruiter, R.; Cruz-Pacheco, N.; Huigh, D.; Van Hoeck, A.; Chen, Y.-T.; Infante, B.; Baskurt, D.; Arunachalam, V.; Eggermont, C. J.; Bas-Cristobal Menendez, A.; Nijsten, T.; van de Werken, H. J. G.; Mooyaart, A. L.; Bellomo, D.; Wakkee, M.; Shain, A. H.; Hollestein, L. M.

2026-07-20 oncology 10.64898/2026.07.17.26358051 medRxiv
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Cutaneous squamous cell carcinoma (cSCC) is the second most common form of cancer worldwide. While most cSCCs are not life-threatening, 2-5% of patients develop metastases. To better understand what causes some cSCCs to progress to metastatic disease, we assembled a nationwide cohort of 19,120 patients with clinico-pathologically annotated tumors linked to metastatic outcome. RNA-sequencing was performed on 378 tumors, and whole-exome sequencing on 147, with balanced numbers of tumors that progressed to metastatic disease (cases) and did not (controls). UV radiation was the dominant mutational signature with additional contributions from aging, APOBEC activity, and, in immunosuppressed patients, azathioprine exposure. We identified 38 genes under selection across a core set of signaling pathways. Gene expression clusters were primarily associated with the differentiation state of tumor cells and secondarily with the composition of the tumor microenvironment. Several mutational and transcriptional programs were associated with metastasis, including a dedifferentiated gene expression signature, activating mutations in the RAS signaling pathway, loss-of-function alterations in the SWI/SNF chromatin remodeling complex, and specific arm-level copy number alterations. A 23-gene expression signature was built to predict metastasis from primary cSCC tissue. The signature was validated in two independent cohorts (N=102 and 52), where it predicted metastasis independently of staging systems. Together, these findings provide the most detailed molecular portrait of cSCC to date and establish an assay for risk stratification suitable for clinical implementation.

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WNT11 suppresses tumor initiation and invasion by inactivating RAC1

Karthikeyan, S.; Casey, P.; Wang, M.

2026-07-15 cancer biology 10.64898/2026.07.13.738348 medRxiv
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WNT11, a non-canonical WNT ligand, plays well-defined roles in development and tissue architecture; however, its function in cancer remains ambiguous. Here, we characterize WNT11 as a context-dependent suppressor of cancer stemness, invasion, and in vivo tumor formation in human epithelial cancer models. We show that WNT11 upregulation reduces the expression of stemness-promoting genes, suppresses epithelial-to-mesenchymal transition, and inhibits sphere formation and tumor growth. Conversely, downregulation of WNT11 enhances these aggressive malignant properties of cancer cells. Mechanistically, we found that the ability of WNT11 to inhibit RAC1 GTPase activation is essential for its regulation of invasion and self-renewal. In cells unresponsive to WNT11, the connectivity between WNT11 and RAC1 activity is disengaged. Direct manipulation of RAC1 activity in these cells recapitulates the phenotype and molecular signature of WNT11-responsive cells, establishing RAC1 as a critical effector of WNT11-mediated tumor suppression. Taken together, these findings identify the cellular context in which WNT11 suppresses RAC1 activation as a key determinant of its anti-tumor effects and provide a mechanistic framework for understanding the diverse, and sometimes opposing, roles of WNT11 reported in cancer.

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Integrated molecular and functional profiling identifies E0771 as a basal-like triple-negative breast cancer model

Baxter, D.; Elvira-Lopez, J.; Isern, M. d. M.; Huaca, J. V.; Blasco, M. T.; Gomis, R.; Canovas, B.; Nebreda, A. R.

2026-07-15 cancer biology 10.64898/2026.07.14.738420 medRxiv
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Breast cancer is a heterogeneous disease whose clinical management relies heavily on accurate molecular subtyping. The murine E0771 mammary carcinoma cell line is widely used in preclinical studies, yet its molecular identity remains controversial, with reports variably classifying it as luminal B or triple-negative. In this study, we performed an integrated molecular and functional characterization of two independently sourced E0771 cell line stocks to resolve this discrepancy. Both stocks were genetically authenticated and exhibited concordant phenotypes. Immunohistochemical and molecular analyses demonstrated absence of oestrogen and progesterone receptors, classifying E0771 as triple-negative. Functionally, E0771 cells showed no transcriptional response to oestrogen and displayed resistance to endocrine therapy both in vitro and in vivo. Collectively, our results establish E0771 as an oestrogen-independent, basal-like triple-negative breast cancer model, supporting its appropriate use in studies of hormone-resistant breast cancer biology.

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FLT3-ITD signals for CEBPA and p53 proteolysis by the ubiquitin-proteosome pathway

Gu, X.; Biswas, S.; Zahran, Z. A.; Bae, S.; Balusu, R.; Jha, B. K.; Maciejewski, J. P.; Saunthararajah, Y.

2026-07-15 cancer biology 10.64898/2026.07.14.738455 medRxiv
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Internal-tandem-duplication of the receptor tyrosine kinase FLT3 (FLT3-ITD) generates ligand-independent signaling and is highly recurrent in acute myeloid leukemias (AMLs). One way signaling pathways can quickly influence cell fates is by phosphorylating key fate-determining proteins to trigger their proteolysis. We investigated the master transcription factor (MTF) driver of granulo-monocytic lineage-fates, CEBPA, for regulation by this mechanism because we found high CEBPA mRNA but little CEBPA protein in FLT3-ITD versus FLT3-wildtype AML cells, and inhibiting FLT3-ITD signaling with tyrosine kinase inhibitors (TKI) rapidly rescued CEBPA protein. Mass spectrometry analyses of CEBPA and its interactome demonstrated prominent interactions with major ubiquitin-proteosome pathway (UPP) components UHRF1 and USP7. TKI treatments decreased CEBPA and USP7 phosphorylations at serine 21 and serine 18 respectively alongside shifts in CEBPA interactions from degradative ubiquitin-ligase UHRF1 toward protective deubiquitinase USP7. The rescued CEBPA activated granulocytic-differentiation. Supporting that the serine-phosphorylations were phospho-degrons, UPP-inhibitors (bortezomib, MG132) increased phosphorylated and total CEBPA and USP7. The MTF regulator of apoptosis p53 is a known USP7 client, therefore, we also evaluated p53 status: TKIs and UPP-inhibitors stabilized USP7 and p53, triggering apoptosis in addition to granulocytic-differentiation specifically in FLT3-ITD but not FLT3-wildtype AML cells. UPP-inhibitors produced these consequences in TKI-resistant FLT3-ITD AML cells also. These data predicted genetic loss-of-function to CEBPA or TP53 is redundant in the FLT3-ITD context, borne out by mutual exclusivity of the mutations in clinical series. In summary, FLT3-ITD signals for CEBPA and p53 proteolysis to block lineage-maturation and apoptosis, positioning UPP-inhibitors as therapeutic candidates acting downstream of TKIs. KEY POINTSO_LIThe oncoprotein kinase FLT3-ITD signals for CEBPA and p53 proteolysis and hence suppresses lineage-differentiation and apoptosis C_LIO_LIProteosome-inhibitors are candidate remedies to restore CEBPA and p53, acting downstream of presently used FLT3-ITD kinase inhibitors C_LI GRAPHICAL ABSTRACT O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=171 SRC="FIGDIR/small/738455v1_ufig1.gif" ALT="Figure 1"> View larger version (56K): org.highwire.dtl.DTLVardef@6ae211org.highwire.dtl.DTLVardef@12003bforg.highwire.dtl.DTLVardef@d62eb9org.highwire.dtl.DTLVardef@1958693_HPS_FORMAT_FIGEXP M_FIG C_FIG

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Mechanism of response to FHD-286 and decitabine combination in patients with advanced myeloid malignancies

Collins, M. P.; Lahr, D. L.; Topal, S.; Khalil, A.; Hickman, D.; Spidale, N.; Pandit, N.; Reilly, S.; Lyons, K.; Horrigan, K.; Zhao, T.; Batonga, J.; Bosinger, M.; D'Aco, K.; Ball, B.; Kishtagari, A.; DiNardo, C. D.; Stein, E. M.; Quintas-Cardama, A.; Smolen, G. A.

2026-07-20 oncology 10.64898/2026.07.17.26358055 medRxiv
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Impaired cellular differentiation is a defining characteristic of myeloid malignancies and remains a major therapeutic challenge. The BRG1/Brahma-associated factor (BAF) chromatin remodeling complex, through the ATPases SMARCA4 and SMARCA2, maintains the stemness of leukemic blasts and thus represents a promising target for novel differentiation-based therapies. In a phase 1 study in advanced myeloid malignancies, the first-in-class dual SMARCA4/2 inhibitor FHD-286 combined with decitabine (DAC) was tolerated and produced an objective response rate of 12.8% (6/47) compared with no responses with FHD-286 monotherapy. To understand the basis of this activity, we integrated high-dimensional flow cytometry and single-cell genomic analyses of longitudinal bone marrow samples from responders and nonresponders. While FHD-286 monotherapy was predominantly associated with myeloid differentiation, responders to FHD-286+DAC combination therapy exhibited a range of myeloid and erythroid differentiation trajectories. FHD-286 potentiated the transcriptional impact of DAC, driving tumor clones to fully differentiate out of the immunophenotypically and transcriptionally defined blast compartment. Responders had a baseline transcriptional profile similar to that of CEBPA-mutant acute myeloid leukemia and showed further downregulation of CEBPA upon treatment. These findings reinforce tumor cell differentiation as a mechanism of response to pharmacologic SMARCA4/2 inhibition and support further evaluation of FHD-286+DAC in molecularly defined patient subsets.

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Mapping Topic Change in Influential Hepatocellular Carcinoma Research: A Two-Cohort Bibliometric Analysis

Su, Z.; Li, T.

2026-07-16 oncology 10.64898/2026.07.07.26357427 medRxiv
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The therapeutic landscape for hepatocellular carcinoma (HCC) is evolving rapidly, necessitating scalable approaches to synthesize the expanding scientific literature. We characterized thematic shifts in HCC treatment and prognosis research by conducting a retrospective bibliometric analysis of influential publications from 2023 and 2024. Using the OpenAlex database, we identified the 50 most highly cited papers from each year based on eighteen-month post-publication citation counts. Large language models were deployed to extract, normalize, and classify concepts from unstructured text into canonical topics and parent themes, enabling quantitative year-over-year frequency comparisons. Analysis of these 100 papers revealed a distinct maturation in research focus. Although broad categories like general immunotherapy remained prevalent, their relative frequency declined in favor of specific dual immune checkpoint regimens, notably CTLA-4 inhibition and the durvalumab plus tremelimumab combination. Concurrently, parent themes related to radiomics, imaging, and health systems exhibited significant growth in the 2024 cohort. These findings demonstrate a thematic transition in high-impact HCC research from foundational immuno-oncology toward optimized combination therapies and precision diagnostics. Furthermore, this study highlights the utility of artificial intelligence-driven bibliometrics for objectively tracking dynamic conceptual shifts in oncology. A web interface for exploring the data is available at https://pri.pepkio.com/.

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Tumor-Colonizing Microbiota Distinguish Early- and Late-Onset Colorectal Cancer in a Hispanic/Latino Patient Cohort

Manjarrez, S.; Diaz, F. C.; Carranza, F. G.; Waldrup, B.; Ninova, M.; Velazquez-Villarreal, E.

2026-07-21 oncology 10.64898/2026.07.19.26358429 medRxiv
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Background: Early-onset colorectal cancer (EOCRC) is increasing globally, particularly among Hispanic/Latino (H/L) populations, yet the contribution of tumor-colonizing microbiota to age-associated colorectal cancer (CRC) biology remains poorly understood. Most microbiome studies have focused on fecal communities or non-Hispanic populations, leaving the intratumoral microbial landscape of H/L patients largely unexplored. Methods: We performed an exploratory characterization of tumor-colonizing microbiota using whole-exome sequencing (WES) data from four primary colorectal tumors obtained from H/L patients treated at City of Hope, including two EOCRC (<50 years) and two late-onset colorectal cancer (LOCRC; [&ge;]50 years) cases. Following removal of host-derived sequences, microbial taxonomic profiling was conducted at the family, genus, and species levels, and microbial metabolic pathways were inferred. Clinical and pathological data were integrated to evaluate age-associated differences in microbial composition and predicted function. Results: Family-, genus-, and species-level analyses consistently demonstrated greater microbial diversity in LOCRC than EOCRC. LOCRC contained more than twice the number of unique bacterial families, nearly three times as many unique genera, and more than twice as many unique bacterial species. A conserved core microbiota, including Fusobacteriaceae, Prevotellaceae, Fusobacterium, and Prevotella, was identified across both age groups, whereas LOCRC was enriched in CRC-associated taxa including Fusobacterium nucleatum, Bacteroides fragilis, Parvimonas micra, Porphyromonas asaccharolytica, and Dialister pneumosintes. Species-level analyses revealed only a single shared bacterial species between EOCRC and LOCRC, indicating progressive microbial divergence with increasing taxonomic resolution. In contrast, functional profiling identified 11 predicted microbial metabolic pathways, of which nine were shared between age groups, two were unique to EOCRC, and none were exclusive to LOCRC. Core metabolic pathways involved in energy metabolism, amino acid biosynthesis, phospholipid metabolism, and central carbon metabolism exhibited comparable abundance across both groups, demonstrating substantial functional conservation despite pronounced taxonomic differences. Conclusions: Tumor-colonizing microbiota differ markedly between EOCRC and LOCRC in H/L patients, with late-onset tumors exhibiting substantially greater microbial richness and taxonomic complexity. Despite these compositional differences, microbial metabolic functions remain largely conserved, supporting the concept of functional redundancy within the colorectal tumor microenvironment (TME). Although exploratory, this proof-of-concept study provides one of the first characterizations of intratumoral microbiota in H/L EOCRC and establishes a foundation for larger multi-omics investigations aimed at identifying microbiome-based biomarkers and therapeutic targets for precision oncology.

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Gut microbiome derived folate metabolite suppresses colorectal cancer progression

Danner, R.; Cho, J.; Detwiler, Z.; Williams, J.; Han, J. A.; Yang, C.; Diebold, X.; Maeder, K.; Van Vraken, J. G.; Walker, A. S.; Lesser, C.; Chaudhari, S. N.

2026-07-15 cancer biology 10.64898/2026.07.14.738490 medRxiv
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The gut microbiota influences colorectal cancer (CRC) progression, primarily through the secretion of small molecule metabolites. While numerous microbial products are known to drive CRC, endogenous protective mechanisms remain largely uncharacterized. Utilizing a folate metabolomics platform, we demonstrate that the healthy gut microbiota produces folinic acid (FA), a known chemotherapeutic adjuvant also known as leucovorin. This microbially derived folinic acid is progressively depleted in mouse models of colitis-associated CRC and in human clinical metagenomic cohorts with advancing disease severity. Mechanistically, folinic acid acts as a signaling molecule that directly binds and inhibits the intracellular protease calpain-2. This interaction stabilizes epithelial E-cadherin protein expression and suppresses CRC epithelial-to-mesenchymal transition driving metastasis. Genetically manipulating gut microbial production of FA is sufficient to modulate CRC in vivo, even in the presence of chronic inflammation. This study reframes folinic acid from a chemotherapeutic enhancer to an endogenous microbial metabolite that actively suppresses CRC progression.

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An IL-34-IGF-1 inflammatory axis fuels KRAS-mutant lung cancer progression

Zak, J.; Chen, H.; Wang, E.; Ozark, P.; Mognol, G.; PARK, M. D.-Y.; Fournier, N.; Chaudary, P.; Hu, J.; Shepard, R.; Ghebremedin, A.; Paradise, M.; Rivera, J.; Harris, W. J.; Xu, Z.; Ramadan, A.; Lim, B.; Colonna, M.; Merad, M.; De Palma, M.; Onaitis, M.; Varner, J. A.

2026-07-15 cancer biology 10.64898/2026.07.14.738492 medRxiv
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Macrophages are innate immune cells of embryonic or adult origin with tissue specific roles in homeostasis, disease surveillance, and wound repair that can be co-opted to promote tumor growth and spread1-11. An understanding of the specific roles of macrophage subsets in lung tumor initiation and progression could promote new therapeutic approaches for this deadly disease. Here, we show that KRASG12D mutations in lung epithelium drive proliferation of resident, embryonically-derived alveolar macrophages, which then promote tumor cell proliferation and protection from ferroptosis, leading to tumor progression. Using genetically engineered mouse models of mutant KRASG12D non-small cell lung cancer12,13, we found that alveolar macrophages accumulate by proliferation in response to tumor cell-secreted IL-34, recapitulating events observed in late embryonic lung development. Tumor alveolar macrophages in turn drive IGF-1-dependent tumor cell proliferation. Neutralization or deletion of IL-34 suppresses IGF-1 expression, reduces macrophage and tumor cell proliferation and inhibits tumor progression. High IL34 and IGF1 correlate with poor survival in KRASG12D/V lung adenocarcinomas and in other solid tumors, indicating that bi-directional proliferative signaling between resident macrophages and tumor cells can drive human lung tumor progression. These studies identify resident macrophage-tumor cell interactions as key interception points for lung cancer therapy.

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Screen-Detected and Diagnostic Breast Cancers Show Distinct Treatment Pathways and Quality Indicator Performance

Bielcikova, Z.; Tichopad, A.; Rybar, M.; Petrakova, K.; Rozanek, M.; Mothejlova, K.; Dusek, L.; Donin, G.

2026-07-16 oncology 10.64898/2026.07.13.26357901 medRxiv
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Population-based mammography screening improves breast cancer outcomes, but its impact on real-world treatment pathways and quality indicators (QIs) remains incompletely described. We conducted a retrospective nationwide cohort study using linked data from the Czech National Cancer Registry and the National Registry of Reimbursed Health Services. Women aged [&ge;]18 years with a first breast cancer diagnosis between 2017 and 2024 were classified as screen-detected (SCR) or diagnostically-detected (DIG) according to the imaging modality preceding histological verification. Outcomes included stage distribution, untreated cases, first-line treatment, main treatment modality, time to treatment, multidisciplinary team discussion (MDT), centralization to Comprehensive Cancer Centres (COCs), and survival patterns. The verified cohort included 47,648 women: 26,817 SCR cases (56.3 %) and 20,831 DIG cases (43.7 %). In this nationwide analysis, SCR breast cancer was associated with earlier stage at diagnosis and better survival patterns, but also with longer time to treatment and longer time to MDT discussion than DIG-detected disease. Although treatment rates were high and centralization improved over time, substantial regional variation persisted in care pathways, MDT use, and access to COCs. These findings support continued strengthening of screening participation, monitoring of care intervals, and quality assurance of MDT reporting and regional oncology care delivery.

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Immune organization defines adaptive immune competence and clinical outcome in breast cancer

Sanfeliu, E.; Segui, E.; Martinez-Romero, A.; Albarran-Fernandez, V.; Pascual, T.; Marin, M.; Martinez-Saez, O.; Gomez-Bravo, R.; Garcia-Fructuoso, I.; Rodriguez-Hernandez, A.; Walbaum, B.; Galvan, P.; Angelats, L.; Rubio-Perez, C.; Saura, C.; Oliveira, M.; Ciruelos, E.; Manso, L.; Pernas, S.; Vidal, M.; Waks, A. G.; Tolaney, S. M.; Pare, L.; Parker, J. S.; Villagrasa, P.; Ferrero-Cafiero, J. M.; Perou, C. M.; Campo, E.; Tabernero, J.; Braso-Maristany, F.; Prat, A.

2026-07-20 oncology 10.64898/2026.07.17.26358324 medRxiv
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Tumor-infiltrating lymphocytes (TILs) are widely used to assess antitumor immunity in breast cancer but may not reflect the functional competence of adaptive immune responses. We show that immune organization, reflected by tertiary lymphoid structures (TLS) and coordinated humoral and cellular immune programs, represents a distinct dimension of tumor immunity beyond lymphocyte abundance. By integrating histologic, transcriptomic, spatial, and immune receptor profiling analyses across multiple breast cancer cohorts, we show that immune organization is associated with greater immune repertoire diversity, evidence of therapy-induced clonal selection, and improved clinical outcomes, independent of immune infiltration. Transcriptomic measures of immune organization retained independent prognostic value across external cohorts, whereas measures of immune infiltration did not. Furthermore, treatment-induced increases in immune organization, but not immune infiltration, were associated with therapeutic response. These findings identify immune organization as a dynamic and clinically measurable state of adaptive antitumor immunity with implications for prognosis, treatment monitoring, and therapeutic development in breast cancer.

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Homeostatic control of stem cell activity during intestinal regeneration.

Yang, S.; Zhou, J.; Luo, C.; Peng, G.; Zheng, K.; Han, K.

2026-07-15 cell biology 10.64898/2026.07.15.738595 medRxiv
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Stem cells proliferate rapidly to maintain fast tissue turnover during regeneration. However, the feedback mechanisms in stem cells that prevent hyperproliferation remain unclear, and their dysregulation can lead to organ failure and cancer. Here, we identified nuclear factor-Y (NF-Y) as the transcriptional repressors to maintain the stem cell quiescence during intestinal homeostasis. We found that NF-Y negatively regulates intestinal stem cell (ISC) proliferation through preferentially occupying the promoters of EGFR signaling pathway components Egfr/Mkp3/Raf/Ras/pointed, via the action of histone acetyltransferase Nejire (Nej)/p300 dependent transcription regulation. While the loss of NF-Y enhances ISC proliferation, cell death and sensitivity to stress and tumor induced mortality. Moreover, NF-Y acts together with Nej to restrict Egfr expression and suppress ISC hyperproliferation. Together, these results demonstrate NF-Y acts with Nej serve as a key negative feedback module to orchestrate transcription initiation and termination of growth signaling in the control of stem cell activity in homeostatic and disease conditions.

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Construction of a risk prediction model for postoperative bleeding in patients with thyroid cancer based on clinical data

zhang, y.; chen, w.; li, x.; shen, w.

2026-07-18 oncology 10.64898/2026.07.16.26358297 medRxiv
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Objective To develop and validate a risk model for predicting postoperative bleeding in patients with thyroid cancer. Methods A total of 2800 consecutive patients diagnosed with thyroid cancer in the Department of Thyroid and Breast Surgery of the Affiliated Hospital of Xuzhou Medical University between January 2020 and December 2023 were retrospectively analyzed. Patients were categorized into two groups based on postoperative bleeding occurrence: bleeding and non-bleeding groups. Univariate and multivariate logistic regression analyses were utilized to screen independent risk factors. Meanwhile, risk prediction models were developed and nomogram . Subgroup analysis was performed to identify independent risk factors. The predictive effects of the models were assessed using the Hosmer-Lemeshow test and receiver operating characteristic (ROC) curves. Results Of the 2800 recruited patients, 50 had postoperative bleeding, with an incidence rate of 1.7%. Multivariate logistic regression analysis showed that age, hypertension, total thyroidectomy, tumor size [&ge;]4 cm, and operation time [&ge;]90 min were the risk factors for postoperative bleeding in thyroid cancer patients (P<0.05). A risk prediction model was established based on the above factors, and the area under the ROC curve was 0.881, with a sensitivity of 94.0%, a specificity of 67.3%, and an accuracy of 74.0%. Decision curve analysis revealed that the model had good predictive ability. Conclusions The constructed risk prediction model has good predictive power and can provide a reference for healthcare professionals to predict the risk of bleeding in patients after thyroid cancer surgery.

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Integrated Plasma and Urinary Cell-free DNA Profiling Enables Noninvasive Molecular Detection from Ta to T4 Bladder Cancer

Riediger, A. L.; Schindler, I.; Heller, M.; Huber, J.; Sueltmann, H.; Goertz, M.

2026-07-15 oncology 10.64898/2026.07.13.26357430 medRxiv
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Background and Objective: Due to the heterogeneity of bladder cancer, minimally invasive molecular profiling may improve tumor characterization at the time of diagnosis. We evaluated whether integrated genomic and fragmentomic profiling of plasma and urinary circulating tumor DNA (ctDNA) detects BC-derived signals for diagnosis and disease stratification across all tumor stages. Methods: In this real-world cohort, 202 plasma and urine samples were obtained from 33 patients with non-muscle-invasive BC (NMIBC), mostly Ta tumors, and 15 patients with muscle-invasive BC (MIBC), as well as from 58 cancer-free controls. Low-coverage whole-genome sequencing was performed to assess ctDNA fragmentation, chromosomal instability and copy number variations. Matched tumor tissue was analyzed to evaluate concordance between liquid biopsy and tissue-derived molecular alterations. Key Findings and Limitations: Complementary genomic and fragmentomic profiling of cfDNA achieved detection rates of 75.8% in NMIBC patients and 91.7% in MIBC patients with paired plasma and urine. Distinct differences were observed between MIBC, NMIBC and cancer-free controls, consistent with increasing ctDNA signals during disease progression. Tumor tissue analysis confirmed BC-associated molecular alterations. Limitations include the single-center design and limited sample size. Conclusions and Clinical Implications: Multimodal profiling of plasma and urinary cfDNA enabled the detection of tumor-derived molecular signals for all bladder cancer stages, including early-stage disease. By integrating genomic and fragmentomic features, this minimally invasive approach provides molecular tumor characterization at the time of diagnosis and may support future risk-adapted diagnostic, therapeutic and surveillance strategies.

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Loss of either RASSF1A alone or in combination with Caveolin-1 inhibition is associated with different premalignant histopathological alterations in the mammary glands of transgenic mice

Cotarelo, C. L.; Weber, H. T.; Rosswag, S.; Wagner, T.; Schaefer, I.; Sleeman, J. P.; Thaler, S.

2026-07-15 cancer biology 10.64898/2026.07.14.738049 medRxiv
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Analyses of human breast carcinomas (BCs) and premalignant breast lesions show that the loss of RASSF1A is an early event in the development of ER+ BCs, which correlates linearly with malignant progression. This observation suggests that RASSF1A inhibition is important for the development and progression of ER+ BCs. In addition to RASSF1A, concurrent caveolin-1 (Cav-1) inhibition may further promote ER+ breast carcinogenesis. In the present study, transgenic Rassf1a-/- and Cav-1(-/-) single as well as Rassf1a-/-, Cav-1(-/-) double knockout mice were used to investigate the impact of single or combined Rassf1a and Cav-1 inactivation on BC initiation. Loss of either one or both proteins led to different, pre-malignant histopathological alterations within the mammary glands of the mice, but not to fully developed BC, confirming that Rassf1a and Cav-1 are both important for maintaining the integrity of mammary gland epithelial structure, but suggesting that further intracellular changes or extracellular factors are required for the development of luminal BC when both genes are lost.

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Recent COVID-19 Vaccination Before Glioblastoma Surgery Is Associated With Longer Survival

Uppalapati, S. C.; Butler, D. W.; Bouobda, G.; Liptrap, E. J.; Schmalz, P. G.; Holland, M. T.; Riley, K.; Filippova, N.; Nabors, L. B.; Markert, J. M.

2026-07-16 oncology 10.64898/2026.07.14.26358106 medRxiv
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Background: Glioblastoma remains resistant to most immune-based therapies. Surgery may create a perioperative window in which systemic immune activation and tumor antigen release intersect. We evaluated whether COVID-19 vaccination shortly before first glioblastoma surgery was associated with survival. Methods: We performed a retrospective single-center cohort study of adults with newly diagnosed glioblastoma undergoing initial biopsy or resection from 2021 to 2025. The primary exposure was documented COVID-19 vaccination within 100 days before first tumor surgery. Overall survival was analyzed from surgery using Kaplan-Meier and Cox models, with 1:1 propensity matching and sensitivity analyses addressing treatment completion, calendar time, surgical selection, steroid exposure, immune-cell variables, COVID severity, and negative-control vaccination. Results: The cohort included 187 patients: 64 perioperatively vaccinated and 123 non-perioperative comparators. Among vaccinated patients, 59/64 (92.2%) received mRNA vaccines; median vaccination-to-surgery interval was 81 days (IQR 71-90). Median overall survival was 743 days in vaccinated patients versus 318 days in comparators (unmatched HR 0.48, 95% CI 0.30-0.76; p=0.002). After 1:1 matching, median survival was 743 versus 349 days (HR 0.52, 95% CI 0.34-0.80). Sensitivity analyses accounting for adjuvant therapy, surgery year, extent of resection, steroid exposure, immune-cell measures, and COVID hospitalization were directionally consistent. Influenza vaccination was not associated with survival. Conclusions: COVID-19 vaccination within 100 days before first glioblastoma surgery was associated with longer overall survival. These findings identify perioperative vaccination timing as a potentially relevant and modifiable variable in glioblastoma outcomes.