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Cancer Letters

○ Elsevier BV

Preprints posted in the last 90 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
Radiotherapy-induced vascular dysfunction alters neutrophil phenotype to promote tumor cell colonization of mammary adipose tissue

Martello, S. E.; Stevenson, B. H.; Korbey, H.; Corn, K. C.; Zhu, T.; Lin, E. J.; Paul, M.; Stubenrauch, K. E.; Wang, J.; Perez, A.; Rafat, M.

2026-10-06 cancer biology 10.64898/2026.10.03.756445 medRxiv
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Recurrence remains a significant clinical challenge for triple-negative breast cancer patients and radiotherapy (RT) is a key therapeutic tool that significantly reduces the risk of relapse. Despite this, patients with chronic lymphopenia and a high neutrophil:lymphocyte ratio (NLR) experience recurrence at significantly higher rates than those whose hematological biomarkers return to baseline post-RT, and there are currently no treatments to prevent this relapse. Here, we utilized in vivo mouse models of lymphocyte-deficiency to identify the mechanism behind systemic immune status and recurrence. Using a model of RT-induced circulating tumor cell (CTC) colonization, we found that neutrophils are sustained in the irradiated, lymphocyte-deficient mammary tissue up to 10 days post-RT. Persistent neutrophil accumulation was accompanied by excessive vascular remodeling and tumor cell colonization of the mammary tissue, both of which were abated upon systemic neutrophil depletion. Neutrophils in the colonization-permissive microenvironment exhibited a state of pathological activation consistent with a polymorphonuclear myeloid-derived suppressor cell (PMN-MDSC) phenotype that was not seen in systemic compartments, highlighting a microenvironment-induced phenotype shift. This phenotype was recapitulated in vitro when naive neutrophils were exposed to the secretome of RT-induced senescent endothelial cells (ECs). We found that these activated neutrophils then regulated the dysfunction of irradiated ECs in a canonical NF-kB-dependent manner, increasing their barrier permeability and activating downstream inflammatory signals. Our findings not only establish neutrophils as a critical component of tumor cell colonization in lymphocyte-deficient subjects but also uncover a positive feedback loop between neutrophils and irradiated vasculature that leads to aberrant tissue remodeling and ultimately tumor cell colonization. This work deepens our understanding of how systemic factors influence treatment-damaged microenvironments, which could ultimately lead to identification of molecular targets for prevention of RT failure.

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Mitochondrial rewiring supports survival of triple negative breast cancer cells after ionizing radiation

Wall, S. W.; Wang, K.; Greer, A.; Baek, M. L.; Lane, A.; Berner, M. J.; Lei, J. T.; Garces, A. A.; Khoury, S.; Caggiano, E.; Meyer, M. D.; Latka, S.; Villanueva, H.; Schueler, E.; Taniguchi, C. M.; Patel, R.; Echeverria, G. V.

2026-09-07 cancer biology 10.64898/2026.09.03.748963 medRxiv
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Triple negative breast cancer (TNBC) is an aggressive disease with limited therapeutic options. Conventional treatments include neoadjuvant chemo-immunotherapy followed by surgical resection and may include further adjuvant immunotherapy and/or radiotherapy of the tumor bed and lymph nodes. Nonetheless, TNBC patients with residual disease have rapid metastatic recurrence. While the roles of metabolic and mitochondrial adaptations in chemotherapeutic resistance have been the subject of many studies, their importance in the context of ionizing radiation (IR) therapy remains poorly understood. We established longitudinal in vitro models of post-IR human TNBC, characterized by cellular regression to a residual phenotypic state, then eventual cell repopulation. This was accompanied by plastic adoption of unique metabolic, proteomic, and morphologic features that largely reverted when cells regrew. Following IR, residual cells exhibited extensive mitochondrial rewiring, including elevated mitochondrial content, oxidative phosphorylation (oxphos) rates, cristae structures, and metabolite levels. Concomitantly, levels of the short protein isoform of the mitochondrial inner membrane protein optic atrophy 1 (OPA1) were significantly elevated in residual cells, and OPA1 knockout ablated mitochondrial adaptations induced by IR. OPA1 genetic or pharmacologic perturbations led to improved cellular responses to IR. Metabolomic and proteomic analyses of radio-residual cells uncovered a coordinated program of antioxidant and redox capacity elevation with mitochondrial metabolism, which was corroborated by analyses of external datasets. Together, these findings provide evidence that TNBC cells surviving radiotherapy adopt an OPA1-dependent program of mitochondrial reorganization that supports their survival and regrowth, thereby positioning OPA1 as a therapeutic dependency that could improve radiotherapy efficacy in TNBC.

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Hypoxia-conditioned HNSCC cell line secretomes drive phenotypic, functional, and transcriptional reprogramming of human neutrophils

Pereckova, J.; Zavadil Kokas, F.; Voznicova, S.; Kolarova, T.; Hrstka, R.; Vasicek, O.; Perecko, T.

2026-07-31 cancer biology 10.64898/2026.07.31.741959 medRxiv
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Neutrophils display marked functional plasticity in cancer; however, it remains poorly understood how soluble factors derived from hypoxic and irradiated head and neck squamous cell carcinoma (HNSCC) cells reprogram neutrophil phenotype and function. Here, we employed a well characterized and controlled in vitro model to examine how tumor-conditioned media (TCM) from HNSCC cell lines cultured under ambient (21% O2) or hypoxic (1% O2) conditions, with or without 6 Gy gamma irradiation, modulate human neutrophil phenotype, and functional and transcriptional responses. Initial analyses were performed using TCM from three different HNSCC cell lines, whereas subsequent mechanistic characterization focused on FaDu-derived TCM. We show that TCM prolongs neutrophil survival in a cell line-dependent manner. Among the tested cell lines, hypoxia-conditioned FaDu-derived TCM promoted immunomodulatory neutrophil state characterized by enhanced survival, selective priming of ROS production, and elevated TRAIL-R3/TRAIL-R2 ratio. Induction of classical activation markers (CD11b, CD62L) was not evident. Transcriptomic analysis revealed minimal effects of normoxic TCM. Hypoxia-conditioned TCM induced a pronounced transcriptional program enriched in hypoxia- and stress-associated pathways. In contrast, irradiation of tumor cells had a limited additional impact on neutrophil reprogramming. Together, these findings indicate hypoxia-conditioned tumor secretomes as important drivers of neutrophil functional adaptation in vitro, supporting a model in which soluble factors alone are sufficient to induce a persistent, immunomodulatory neutrophil phenotype. This work provides mechanistic insight into tumor-neutrophil crosstalk, highlighting hypoxia-driven signaling as a potential therapeutic target in radioresistant HNSCC and supporting a role for neutrophil reprogramming in this context.

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TFE3 fusions drive expression of CD44 and SPP1 in Translocation Renal Cell Carcinoma

Asrani, K.; Woo, J.; Vidotto, T.; Feng, K.; Lorenzetti, A.; Imada, E.; Li, H.; Singh, R.; Thotakura, A.; Ray, S.; Oliveira, L.; Amaral, A.; Palande, V.; Anchoori, R.; Mandal, J.; Elias, R.; Thoburn, C.; Rana, M. M.; Gangule, H. N.; Gao, A.; Phatak, P.; Donahue, J.; Ged, Y.; Singla, N.; Copland, J.; Schmidt, L.; Linehan, W. M.; Argani, P.; Lotan, T.

2026-09-22 cancer biology 10.64898/2026.09.18.752493 medRxiv
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Xp11.2 translocation RCC [Xp11.2 tRCC]) is an underdiagnosed and aggressive subtype of RCC with few specific or targeted therapies. The transmembrane glycoprotein CD44 is an emerging target in many advanced malignancies, and with its ligand OPN (SPP1), is a crucial driver of cancer progression, stemness, metastasis, and immune suppression. Here we show that common TFE3-fusions [ including SFPQ-TFE3, PRCC-TFE3, ASPSCR1-TFE3, and NONO-TFE3] are associated with upregulated expression of CD44 and SPP1, as observed in multiple human and murine bulk transcriptomic studies and a murine tRCC snRNA-Seq dataset. CD44 and/or SPP1 protein expression were also upregulated in murine models of transgenic tRCC kidneys and urine specimens, patient-derived cell lines and human tRCC cases, by immunoblotting and/or IHC. Transient deletion of CD44 was associated with profound and specific suppression of tRCC cell line growth, with decreased mTOR signaling. These data suggest that CD44 and/or SPP1 may potentially drive tumorigenesis in tRCC.

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Breast cancer ovarian metastases show increased activity of GPCR pathways

Oesterreich, S.; Savariau, L.; Qin, Y.; Shah, O.; Basudan, A. M.; Merkel, C.; Sisoudiya, S. D.; Sivakumar, S.; Sokol, E. S.; McGinn, O.; Li, Z.; Liu, T.; Tasdemir, N.; Tallapaneni, P.; Coffman, L.; Elishaev, E.; Atkinson, J. M.; Lucas, P. C.; Lee, A. V.

2026-07-31 cancer biology 10.64898/2026.07.30.741805 medRxiv
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Treatment resistance and metastases occur in 10-20% of patients with invasive lobular carcinoma (ILC), the most common special histological subtype of breast cancer. ILC metastasizes to the ovary more frequently than no special type (NST) tumors, also known as invasive ductal carcinoma (IDC). To characterize the genomic landscape of breast cancer ovarian metastases, we analyzed 15,613 local breast cancers, 22,010 non-ovarian metastases, and 246 ovarian metastases sequenced using FoundationOne(R)CDx or FoundationOne(R) assays. Ovarian metastases had enriched CDH1, PIK3CA, and TBX3 mutations and depleted TP53 and MYC alterations relative to local breast cancers, with additional depletion of ESR1 mutations compared to non-ovarian metastases. CDH1 mutations were less frequent in ovarian metastases (47%) than local ILC (81.3%), with reduced 16q loss (64% vs 84%), indicating that ovarian metastases also arise from non-ILC tumors. We extended these findings to a UPMC cohort of 27 ovarian metastases (13 ILC, 8 IDC, 6 mixed ductal-lobular carcinoma) with patient-matched primary tumors in most cases. In both cohorts, patients with ovarian metastases were significantly younger than those with other metastatic sites. In the UPMC cohort, the most frequent mutations were in PIK3CA, CDH1, KMT2C, FOXA1, and RUNX1. Transcriptomic analysis identified upregulated G protein-coupled receptor (GPCR) pathways, including metabotropic glutamate receptor signaling. Functional studies showed that calcium-sensing receptor (CaSR), a GPCR overexpressed in ovarian metastases, drives MEK/ERK-dependent migration and F-actin reorganization in ILC cell lines, enhanced by estrogen and blocked by calcilytic, MEK, or anti- estrogen treatment. Our findings inform future therapeutic targeting of ovarian metastasis.

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The KRAS G12C Inhibitor Divarasib Stabilizes RBM39 and Antagonizes Aryl-Sulfonamide Degraders

Chen, S.-Y.; Zou, Y.; Wu, J.; Nam, G.; Lee, H.; Chen, Y.; Federico, C.; Setayeshpour, Y.; Lin, C.-C.; Wu, S.-C.; Strickler, J. H.; Hong, J.; Fitzgerald, M. C.; Chi, J.-T. A.

2026-08-20 pharmacology and toxicology 10.64898/2026.08.16.745134 medRxiv
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KRAS G12C inhibitors have demonstrated meaningful clinical benefit in KRAS G12C-mutant non-small cell lung cancer (NSCLC), yet responses remain heterogeneous and treatment-associated toxicities persist for reasons that are incompletely understood. Cysteine profiling indicates that these covalent inhibitors are highly selective for mutant KRAS; however, such approaches cannot detect noncovalent engagement of additional non-RAS proteins. Here, we used a protein-folding stability profiling technique, stability of proteins from rates of oxidation (SPROX), to identify protein targets of the clinical KRAS G12C inhibitor, divarasib (GDC-6036), in KRAS-mutant NSCLC lysates. SPROX revealed a focused set of candidate interactors, including the essential splicing factor RBM39, which was reproducibly stabilized at both divarasib concentrations tested. We subsequently confirmed that divarasib directly and noncovalently binds to RBM39 protein. In NSCLC cells, divarasib increased RBM39 protein abundance and antagonized RBM39 degradation induced by the aryl-sulfonamide molecular glue indisulam through a post-transcriptional mechanism. Divarasib and RBM39 degraders reciprocally antagonized each other's cytotoxicity, and RBM39 knockdown modestly reduced divarasib-induced cell death. Mechanistically, divarasib-mediated RBM39 stabilization regulated both INSR expression and alternative splicing, altered downstream insulin receptor signaling, and contributed to divarasib-associated cytotoxicity. Consistent with these findings, RBM39 and INSR expression were positively correlated across multiple human cancer types. Collectively, these findings identify RBM39 as a previously unrecognized noncovalent target of divarasib and uncover an RBM39-INSR signaling axis that modulates cellular responses to both divarasib and RBM39 degraders.

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BCL11B targeting in tumor CD8+ T cells amplifies anti-tumor response by blocking exhaustion while promoting stemness and cytotoxicity

Silvane, L.; Zelenka, T.; Talada, D. P.; Cismasiu, V. B.; Islam, S.; Singh, R. P.; Ngove, Z.; Chakraborty, S.; Hall, M. S.; Blauvelt, J. L.; Eksioglu, E.; Manrique, S. Z.; Johnson, J. O.; Obermayer, A. N.; Alfaro, A.; Huang, W.; Sarnaik, A.; Tarhini, A. A.; Mullinax, J. E.; George, E.; Hwu, P.; Davila, E.; Conejo-Garcia, J. R.; Bryceson, Y. T.; Chen, D.-T.; Shaw, T. I.; Pilon-Thomas, S.; Avram, D.

2026-08-07 immunology 10.64898/2026.08.03.742578 medRxiv
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Tumor infiltrating CD8+ T cells (TILs) progress to a state of terminal exhaustion (Ttex) which have impaired functionality and are nonrenewable. However their precursors (Tpex) are renewable and can generate efficient effector cells. We started from the observation that melanoma patients undergoing therapy with checkpoint inhibitors show increased survival when their T cells have low BCL11B mRNA. In line with this, ablation of Bcl11b in CD8+ TILs conferred a superior anti-tumor response in murine melanoma and ovarian cancer models. Bcl11b KO TILs failed to progress to the Ttex state and retained elevated stemness. Bcl11b exerted its role by repressing expression of essential transcription factors (TF) controlling stemness, and conversely by promoting expression of exhaustion-associated TFs and inhibitory receptor genes, through complex epigenetic control. In addition, Bcl11b KO CD8+ T cells showed increased Ag-specific cytolytic activity and elevated Gzmb and Prf1 proteins, but no increase in their mRNAs, however presented higher expression of genes with role in translation. Furthermore, CRISPR-CAS9-mediated deletion of BCL11B in human TILs from a patient with poor response to adoptive cell therapy with autologous TILs, improved their cytolytic activity and promoted expression of the stemness-associated TF TCF1, underlying its potential therapeutic use. HIGHLIGHTS- Adoptive transfer of Bcl11b KO CD8+ TILs surpasses WT in tumor burden reduction - Bcl11b ablation reprograms TILs and impairs the progression to Ttex state - Bcl11b KO CD8+ T cells have elevated cytotoxicity and kill only Ag-MHCI targets - BCL11B deletion in nonresponder ACT-TIL improves cytolytic activity and elevates TCF1 GRAPHICAL ABSTRACT O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=64 SRC="FIGDIR/small/742578v1_ufig1.gif" ALT="Figure 1"> View larger version (33K): org.highwire.dtl.DTLVardef@10040d4org.highwire.dtl.DTLVardef@1a045caorg.highwire.dtl.DTLVardef@145f790org.highwire.dtl.DTLVardef@8012ab_HPS_FORMAT_FIGEXP M_FIG C_FIG

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ALDH1B1 promotes mitochondrial γ-butyrobetaine biosynthesisand fatty acid oxidation in colorectal cancer

Feng, Z.; Bearrood, T. E.; Campbell, S. L.; Kinsey, A. M.; Matulionis, N.; Chen, C.-H.; Seike, T.; Leak, L.; Tarhan, A. K.; Dixon, S. J.; Mochly-Rosen, D.; Christofk, H. R.; Chen, J. K.

2026-09-25 cancer biology 10.64898/2026.09.24.753323 medRxiv
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Metabolic reprogramming is a hallmark of cancer cells, and stem-like populations often upregulate aldehyde dehydrogenases (ALDHs). Functional studies have established essential roles for individual ALDH isoforms in tumor initiation, progression, and metastasis; however, the mechanisms by which these enzymes promote malignancy remain poorly understood. Here we show that aldehyde dehydrogenase 1B1 (ALDH1B1), a mitochondrial enzyme highly expressed in colorectal cancer (CRC) and pancreatic ductal adenocarcinoma (PDAC), generates {gamma}-butyrobetaine (GBB) and {gamma}-aminobutyric acid (GABA) in CRC cells. The biosynthesis of both aminocarboxylic acids has been attributed to the cytosolic enzyme ALDH9A1, and we demonstrate that mitochondrial GBB and GABA are functionally distinct from the cytosolic pools of these metabolites. We further demonstrate that mitochondrial GBB can function as an antiport substrate of carnitine-acylcarnitine translocase (CACT), the transporter that mediates fatty acid uptake into the mitochondrial inner matrix. This activity complements the role of cytosolic GBB as the biosynthetic precursor to carnitine. Accordingly, ALDH1B1 can markedly enhance mitochondrial fatty acid oxidation (FAO), a catabolic process that has been linked to CRC and PDAC stemness, progression, and metastasis. Our findings reveal an unexpected role for ALDH1B1 in carnitine metabolism, GABA biosynthesis, and FAO and illustrate how the compartmental reprogramming of metabolic pathways can promote tumor growth.

9
Circulating colorectal tumor cells remodel their surfaceome to increase their viability and metastatic potential in the bloodstream

Cabaud, O.; Aulas, A.; Lopresti, A. M.; Acquaviva, C.; Finetti, P.; Dessaux, C.; Ganier, L.; Da-Costa, Q.; Germier, C.; Mescam, L.; Elkaoutari, A.; Audebert, S.; Camoin, L.; de Rauglaudre, B.; Boudin, L.; Denicolai, E.; Lumet, G.; Cohendet, A.; Picard, M.; Birnbaum, D.; Gouarne, C.; Chanez, B.; De Chaisemartin, C.; Lelong, B.; Marchetto, S.; Goncalves, A.; Bertucci, F.; Borg, J.-P.; Mamessier, E.

2026-07-27 cancer biology 10.64898/2026.07.24.740526 medRxiv
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Circulating tumor cells (CTCs) are the potential seeds of distant metastases; however, little is known about how they survive in the bloodstream. Using a large cohort of colorectal cancer (CRC) patients, we found that the pseudokinase receptor PTK7 is highly expressed in primary tumors and metastatic lesions. Consistent with previous reports, high PTK7 expression is associated with reduced disease-free survival and increased metastatic dissemination. Surprisingly, PTK7 is absent from most CTCs and undergoes a cell-autonomous ONtumor/OFFCTC/ONmetastasis switch that can be recapitulated in a xenografted mouse model, in in vitro systems, and a fluidic platform. PTK7-negative cancer cells exhibit increased expression of YAP1-driven genes, senescence-like features, and enhanced resistance to hemodynamic stress following loss of cell-cell and cell-matrix adhesion. This adaptive phenotype depends on metalloproteases, notably ADAM17, whose cleavage activity remodels the CTCs surfaceome. Functionally, the PTK7 OFFCTC state confers enhanced metastatic potential in vivo, and can be pharmacologically suppressed using metalloprotease inhibitors. Collectively, our findings identify a reversible, cell-autonomous, protease-driven surfaceome remodeling program that enables metastatic adaptation during hematogenous dissemination. Highlights / statement of significanceBy investigating potential markers for circulating colorectal tumor cells with strong metastatic potential, we describe a reversible and cell-autonomous remodeling of the circulating tumor cell surfaceome in patients that confers resistance to anoikis and stress induced by entry into the bloodstream. One Sentence SummaryThe dynamic regulation of PTK7 serves as a surrogate marker for tumor cell plasticity, aggressiveness, survival in the bloodstream, and efficiency in forming metastases. Trial registrationCTC colon Cohort: registered on https://ClinicalTrials.gov identifier NCT03256084; date of registration 2017-07-17 B-Org cohort: registered on https://ClinicalTrials.gov NCT05384184; date of registration 2019-06-06 Ethics statement for animal experimentsStudies on animals were conducted in accordance with the current ethical standards of the European Community (Directive 2010/63/EU), the Ethics Committee for Animal Experimentation (CEEA#14) and the French Ministry of Higher Education and Research, which approved and authorized the entire procedure described in this paper (project number APAFIS #35294).

10
Immunizing small cell lung cancer mice with isoaspartylated Elavl4 after chemotherapy mimics improved survival of anti-ELAVL4 antibody-positive small cell lung cancer patients

Velarde, D. A.; Valdes, J. A.; Lee, H.; Yan, C.; Elmalh, S.; Moreno, A. D.; Mullen, D. J.; Gladstone, M. A.; Gulivani, S.; Nie, Q.; Li, M.; Kast, W. M.; Offringa, I. A.

2026-09-01 cancer biology 10.64898/2026.08.31.748151 medRxiv
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Introduction: Small cell lung cancer (SCLC) patients have an ~8% 5-year survival; new therapies are urgently needed. Approximately 15% of SCLC patients have naturally-occurring low-titer antibodies against neuronal ELAVL proteins, associated with improved response to therapy and significantly improved survival. We previously determined that the anti-ELAVL4 response is triggered by isoaspartylation in the unstructured ELAVL4 N-terminal region. Methods: We used a Tp53fl/fl;Rb1fl/fl inducible SCLC mouse model to test whether 1) immunization with isoaspartylated Elavl4 (isoAsp-Elavl4) prior to SCLC induction improves survival in the absence of any other treatment, and 2) immunization with isoAsp-Elavl4 following completion of 3 rounds of cisplatin+etoposide therapy improves survival. Immunizations contained incomplete Freund's adjuvant with either a recombinant N-terminal fragment of Elavl4 (amino acids 1-117), incubated under isoaspartyl-inducing conditions, or phosphate-buffered saline (used as the negative control, since Elavl4 spontaneously isoaspartylates). Mice were monitored by blinded assessors until euthanasia was indicated. Results: IsoAsp-Elavl4-immunized animals all became immune responsive, and spontaneous anti-isoAsp-Elavl4 antibodies were observed in 7% of the control animals. Kaplan-Meier analyses revealed that pre-SCLC immunization with isoAsp-ELAVL4 in the absence of other treatments did not affect survival. In contrast, immunization of SCLC mice following chemotherapy significantly improved survival. Conclusions: An anti-isoAsp-ELAVL4 response can be actively induced in mice and significantly increases SCLC survival when given following chemotherapy. This indicates that the anti-isoAsp-ELAVL4 immune response can be leveraged to develop new therapies for SCLC patients.

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T50 O-GlcNAc PKM2 promotes aerobic glycolysis and PDAC progression via ARNT-CDC27-AKT pathway

Yang, B.; Zhu, Y.; Zhan, X.; Zhang, Y.; Cui, J.; Yu, Z.; Zhu, S.

2026-07-29 cancer biology 10.64898/2026.07.27.740965 medRxiv
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Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers and more evidence suggests that glucose metabolism plays a significant role in the development and progression with glycosylation at multiple sites potentially being a key characteristic. However, the underlying mechanisms remain insufficiently studied. Here, we first confirmed the presence of O-GlcNAc glycosylation modifications at Thr50 on PKM, which is highly expressed in PDAC and strongly correlated with poor prognosis. Further, we found that PKM expression was significantly positively correlated with CDC27 levels, and mutation of the Thr50 O-GlcNAc site in PKM abolished the upregulation of CDC27. We confirmed that O-GlcNAc-modified PKM enhances nuclear translocation of ARNT, which binds to the CDC27 promoter to upregulate its expression. Finally, we demonstrated that reduced expression of CDC27, as a key component of the APC/C complex, leads to downregulation of ubiquitination at the K11 site of PPP2CA, resulting in upregulation of PPP2CA expression, in turn, reduces AKT phosphorylation, ultimately driving PDAC regression by inhibiting aerobic glycolysis. Thus, we delineate a novel O-GlcNAcylation-dependent pathway where PKM drives PDAC progression through ARNT-mediated CDC27 transcriptional activation and AKT-mediated glycolysis.

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Pyrogallol Modulates Abscopal Tumour and Gut Microbial Responses to Localized Irradiation in an Ehrlich Ascites Carcinoma Model

Ray, S.; Armstrong, R. N.; Nagarajan, D.; Shankaran, P.

2026-08-21 cancer biology 10.64898/2026.08.16.745132 medRxiv
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Radiotherapys clinical utility is often limited by radio-resistance, enterotoxicity, and intestinal dysbiosis. This study evaluated pyrogallol--a plant-derived vicinal trihydroxybenzene--as a dual-action radiosensitizer and mucosal protectant in an Ehrlich ascites carcinoma (EAC) BALB/c mouse model subjected to targeted LINAC irradiation (8 Gy). By combining transcriptomic profiling with whole-genome metagenomic sequencing, we interrogated the underlying host-microbiome interactions. Pyrogallol co-treatment significantly augmented radiotherapeutic efficacy, driving marked tumour regression through the upregulation of pro-apoptotic effectors (Bax, Casp3, Casp7) and p53-mediated tumour suppressors (Tp53, p21), alongside Bcl2 repression. Concurrently, pyrogallol blunted oncogenic progression by arresting proliferation (Cdk4, Pcna), inhibiting epithelial-mesenchymal transition (N-cadherin, vimentin), downregulating fibrotic remodelling (Tgf-{beta}, Col1A1, Fibronectin), and attenuating radiation-induced pro-inflammatory cytokine surges (Il-1, Il-6, Il-12). At the gut interface, radiation degraded colonization resistance by depleting homeostatic short-chain fatty acid producers and Clostridium scindens, while fuelling pathobiont blooms (Acinetobacter baumannii, Clostridioides difficile). Pyrogallol reversed this dysbiosis through a distinct ecological shift; despite a reduction in total species richness, the intestinal niche became dominated by the next-generation probiotic Parabacteroides distasonis ([~]94% relative abundance; Berger-Parker index: 0.94). Integrated Spearmans rank correlations demonstrated that host proliferative, EMT, fibrotic, and inflammatory markers aligned positively with pathobiont clusters (Bacteroides caecimuris, B. faecium, A. baumannii). Conversely, tumour regression and anti-inflammatory signatures correlated strongly with pathobiont restriction and P. distasonis enrichment. Overall, pyrogallol emerges as a compelling therapeutic adjuvant that synergistically enhances tumour radiosensitivity while remodelling the gut microbiome into a protective, anti-inflammatory state.

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Tumor γδ T-cell abundance is associated with favorable cancer treatment outcomes

Niu, X.; Kundnani, D. L.; Dicome, M.; Tafoya, L.; Song, L.; Mamedov, M.; Liu, X. S.; Sahu, A. D.

2026-09-01 immunology 10.64898/2026.08.27.747587 medRxiv
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Purpose: Clinical response to immune checkpoint blockade (ICB) remains variable. We asked whether immune-cell populations in the tumor microenvironment (TME) are associated with benefit across treatments and tumor types. Experimental Design: We analyzed pretreatment bulk tumor RNA-seq from ICB cohorts and TCGA. Gene-level effects associated with ICB response or TCGA survival were projected onto Human Primary Cell Atlas profiles of 157 cell types. Cox and mixed-effects models accounted for cancer type, cohort, and therapy, as appropriate. After {gamma}{delta} T cells emerged as a leading population, we adjusted their associations for eight CD8 estimators and evaluated them using TRUST4-based TRG/TRD reconstruction and single-cell RNA-seq. Results: {gamma}{delta} T-cell programs were among the signatures consistently associated with ICB response and favorable TCGA survival. Across ICB cohorts, {gamma}{delta} T-cell abundance was associated with response (n=1,356; OR, 1.38; 95% CI, 1.23-1.56) and overall survival (n=1,074; HR, 0.82; 95% CI, 0.76-0.88), with associations persisting after CD8 adjustment. ICB-response-associated cell-type profiles were strongly concordant with chemotherapy response (r=0.92) and moderately concordant with radiation response (r=0.58); targeted and hormone therapy analyses were underpowered. TRUST4 reconstruction and single-cell RNA-seq provided orthogonal support for the {gamma}{delta} signal. Conclusions: Pretreatment {gamma}{delta} T-cell abundance was associated with favorable ICB outcomes and survival across cancers, while related cell-type programs extended to selected non-immunotherapy response settings. Although associative and context dependent, these findings support prospective evaluation of {gamma}{delta} T-cell abundance as a candidate tumor-immune biomarker.

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Combined celecoxib and NDGA induces a non-canonical, autophagy-independent redox cell death via p62/KEAP1 in colorectal cancer

Yadala, R.; palakurthi, S.; Pawar, S.

2026-10-06 cancer biology 10.64898/2026.09.29.753356 medRxiv
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Colorectal cancer (CRC) exhibits substantial intratumoral heterogeneity, with differences in oncogenic driver mutations and apoptotic competence contributing to therapeutic resistance. Here, we investigated whether combined celecoxib and NDGA treatment (C+N) induces redox-mediated cell death via the p62/KEAP1 axis, offering a therapeutic approach that can overcome genetic diversity in CRC. We used two genetically distinct CRC cell lines, HCT116 and HT29, harbouring KRAS and BRAF mutations respectively, with differing p53 status, as models of tumor heterogeneity. C+N exhibited profound cytotoxicity in both cell lines, independent of COX-2/5-LOX expression and apoptotic competence. Additionally, C+N induced marked oxidative stress with mitochondrial ROS, lipid peroxidation, and labile ferrous iron accumulation, visualized as distinct JC-1 green mitochondrial puncta and FerroOrange red iron puncta in both cell lines. The antioxidant NAC reversed C+N-induced death, but inhibitors of apoptosis, autophagy, necroptosis, or ferroptosis did not, indicating a mechanism distinct from these pathways. Mechanistically, the combination induced p62 Ser349 phosphorylation, promoting KEAP1 degradation and NRF2 stabilization independently of ULK1-mediated autophagy; however, NRF2 stabilization was uncoupled from HO-1 induction. Our work reveals that C+N induces a ULK1/autophagy-independent, redox-mediated cell death mechanism that circumvents apoptotic competence, highlighting redox disruption as a genotype-independent therapeutic strategy to overcome CRC heterogeneity.

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Integrated stress response activation in combination PG3 and cisplatin-treated TP53-mutated head and neck squamous carcinoma cells induces potent apoptotic response

Tian, X.; Srinivasan, P.; El-Deiry, W. S.

2026-09-23 cancer biology 10.64898/2026.09.22.752907 medRxiv
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Cisplatin remains as standard chemotherapy for patients with HNSCC, but rapid development of drug resistance has limited patient benefit. The p53 tumor suppressor plays a central role in the cellular response to DNA damage in cancer, triggering apoptosis to prevent propagation of damaged cells in tumor development. TP53 gene mutations occur in 65-86% of HNSCC. Small molecule PG3 induces the integrated stress response (ISR), leading to apoptosis via the HRI-eIF2-ATF4-PUMA axis. We hypothesized that a combination of PG3 plus cisplatin could increase apoptosis in TP53-mutated HNSCC cells through enhanced induction of the ISR and ATF4. PG3 synergized with cisplatin to inhibit cell viability, leading to potent apoptosis in TP53-deficient cells. The effect was regulated through the HRI-ATF4-NOXA pathway. Furthermore, we identified that cisplatin activates HRI and leads to the degradation of CReP (constitutive repressor of eIF2 phosphorylation) via E3 ligase {beta}-TrCP, contributing to the induction of the ISR. We noted decreased ATF4 levels after treatment with cisplatin, CPT, or PG3 and cisplatin. Thus, combined therapy of PG3 plus cisplatin likely results in adaptation and acquired resistance via degradation of ATF4. We targeted the degradation mechanism of ATF4 by inhibiting {beta}-TrCP1, CK1{delta}, or CK2, respectively. Each approach successfully blocked ATF4 degradation induced by cisplatin or PG3 plus cisplatin and enhanced apoptosis. Our results provide a rational strategy for triple treatments, involving an ISR inducer, a DNA damaging drug, and a {beta}-TrCP inhibitor/CK1{delta} inhibitor/CK2 inhibitor, to achieve potent and prolonged anti-tumor effects and overcome chemoresistance in HNSCC.

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Extracellular Vesicles Derived from L-MYC Neural Stem Cells Mediate Neuroprotection in 3D Models of Chemotherapy- and Radiation-Induced Neurotoxicity

Nunes, L. G. A.; Vasquez, I.; Enright, B.; Chen, L.; Patel, S.; Rockne, R. C.; Yoon, S.; Gutova, M.

2026-08-28 cancer biology 10.64898/2026.08.26.747380 medRxiv
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Background/Objectives: Cancer survivors frequently experience long-term neurocognitive impairments following chemotherapy and cranial irradiation, yet experimental models that enable mechanistic investigation of therapy-induced neurotoxicity at the transcriptional level remain limited. This study aimed to develop a human three-dimensional (3D) neural tissue model derived from L-Myc immortalized neural stem cells (LMNSCs) and use transcriptomic profiling to identify molecular pathways underlying chemotherapy- and radiation-induced neural injury and extracellular vesicle (EV)-mediated recovery. Methods: LMNSCs were differentiated in a 3D, methylcellulose-based culture to generate neural tissue containing neurons, astrocytes, and oligodendrocytes. Cultures were exposed to methotrexate (MTX) or ionizing radiation to induce neural injury and subsequently treated with LMNSC-derived EVs. Neural injury and repair mechanisms were evaluated by immunocytochemistry and bulk transcriptomics. Results: MTX and irradiation induced dose-dependent injury, exhibited by loss of neuronal complexity and reduced glial populations. LMNSC-EV treatment promoted recovery of neuronal and glial populations following MTX- and irradiation-induced injury. Transcriptomic analysis of irradiated cultures revealed activation of inflammation, DNA damage, and stress-response pathways, which were attenuated after treatment with LMNSC-EVs. Conclusions: LMNSC-based 3D neural tissue provides a human-relevant platform for modeling cancer therapy-induced neurotoxicity. Furthermore, LMNSC-EVs represent a promising cell-free regenerative therapeutic that restores injury-associated inflammatory, stress, and metabol-ic transcriptional programs after radiation-induced neural injury.

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Autophagy-Mediated Antitumor Effects of BCG and Imiquimod in Oral Squamous Cell Carcinoma

Abdelmoneim, N. A. S. A.; Moussa, M. N.; Elmorsy, A. A.; Elnouaem, M. I.; Ramadan, O. R.; Abdelhamid, H. M.; Mehanna, R. A.; Awaad, A. K.; Omar, E. M.; Afifi, M. M.

2026-07-31 cancer biology 10.64898/2026.07.30.741756 medRxiv
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AbstractAutophagy and Toll-like receptor (TLR) signaling are both implicated in cancer progression, but whether they act as tumor suppressors or promoters remains unclear. To explore this relationship, we investigated the role of autophagy downstream of therapeutic TLR activation in oral squamous cell carcinoma (OSCC). Using the FDA- approved TLR agonists Bacillus Calmette-Guerin (TLR2/4) and imiquimod (TLR7), we assessed their effects in vitro on SCC-4 cells and in vivo in a chemically induced OSCC hamster model. Both agents, alone or in combination with each other or with Monophosphoryl Lipid-A induced robust autophagy, as measured by LC3B staining in vitro and flow cytometry in vivo. Autophagy induction correlated with reduced tumor volume and prolonged survival, with outcomes comparable to cisplatin, the current standard chemotherapeutic, but with less treatment-associated morbidity and mortality. Autophagy was also associated with cisplatin antitumor effects. Notably, imiquimod produced the most pronounced and sustained autophagic and antitumor effects. To our knowledge, this is the first study to directly link the therapeutic efficacy of TLR agonists in OSCC to autophagy modulation, providing both mechanistic and translational insights into their potential as immunotherapeutic agents.

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10-Nitro-oleic acid improves survival following gamma irradiation and modulates hematopoietic and intestinal responses

Pereckova, J.; Vichova, R.; Toufar, J.; Chrenko, D.; Pospisil, J.; Perecko, T.

2026-10-01 pharmacology and toxicology 10.64898/2026.09.25.754470 medRxiv
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Acute radiation syndrome remains a major consequence of high-dose ionizing radiation exposure, and effective pharmacological countermeasures are limited. Nitro-fatty acids possess anti-inflammatory and cytoprotective properties, suggesting potential effectiveness in radiation injury. Here, we investigated the radioprotective effects of 10-nitro-oleic acid (10-NO2OA) in mouse models of total body irradiation (TBI). C57BL/6 mice were exposed to either sublethal (4 Gy) or LD50-level (7.5 Gy) gamma irradiation and treated with 10-NO2OA according to pre-irradiation, post-irradiation, or combined treatment regimens. Survival, hematological responses, bone marrow cells (BMCs)/colony-forming units (CFU), plasma granulocyte colony-stimulating factor (G-CSF), NRF2-responsive signaling, and intestinal responses were evaluated. Administration of 10-NO2OA before and after irradiation significantly improved 30-day survival following 7.5 Gy TBI (57% vs. 20% in vehicle-treated controls). In contrast, post-irradiation treatment alone was ineffective, whereas pre-irradiation treatment alone produced a non-significant trend toward improved survival. The protective effect was absent in BALB/c mice, indicating strain dependence. Although 10-NO2OA did not prevent long-term radiation-induced cytopenia, it increased neutrophil and platelet counts, elevated plasma G-CSF levels shortly after irradiation, and transiently enhanced BMC counts. In irradiated BMCs, 10-NO2OA activated NRF2-responsive gene expression in vitro and in vivo. Exploratory intestinal analyses revealed improved macroscopic appearance and partial restoration of irradiation-suppressed cytokine and growth factor production. In conclusion, 10-NO2OA improves survival following LD50-level gamma irradiation and is associated with modulation of hematopoietic, cytoprotective, and intestinal responses. These findings identify 10-NO2OA as a promising candidate radioprotective agent and support a multifactorial mechanism of action.

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Targeting MAT2A-S-adenosylmethionine (SAM) Axis Attenuates DNA Damage Response and Cancer Stemness to Increase Platinum Sensitivity in Ovarian Cancer

Zhang, S.; Fu, Z.; Zhou, Y.; Metcalfe, T. X.; Vuong, T. T.; Brubaker, L. W.; Bitler, B. G.; O'Hagan, H. M.; Nephew, K. P.

2026-09-23 cancer biology 10.64898/2026.09.22.753550 medRxiv
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Abstract Metabolic and epigenetic reprogramming drives development of platinum resistance and disease recurrence in high-grade serous ovarian cancer (HGSC), a major clinical challenge in the field. S-adenosylmethionine (SAM) is the universal methyl group donor, synthesized by methionine adenosyltransferase 2A (MAT2A) from methionine. Prior studies have linked altered SAM-dependent DNA methylation to acquired platinum resistance in HGSC, connecting metabolism and epigenetic regulation. However, how MAT2A-driven SAM synthesis coordinates the metabolic-epigenetic remodeling axis to affect platinum sensitivity remains unclear. Here, we report that MAT2A-driven SAM synthesis is required for platinum-induced alterations in DNA methylation and the enrichment of ovarian cancer stem cells (OCSCs). We found that MAT2A upregulation correlated with poor progression-free survival in OC patients, and both pharmacological inhibition and genetic knockdown of MAT2A increased sensitivity to cisplatin. To investigate the underlying epigenetic mechanism, we profiled genome-wide changes in DNA methylation using OVCAR3 treated with cisplatin (15M, 16hr) and/or MAT2A siRNA (48hr), which showed that MAT2A knockdown reversed platinum-induced DNA methylation dynamics. Subsequent analysis revealed enrichment of pathways associated with platinum resistance, DNA repair, and stemness. Mechanistically, inhibiting MAT2A abrogated both the platinum-induced hypermethylation at promoter regions and the SAMTOR-mTOR-S6K-FANCD2 signaling axis, resulting in accumulated R-loops, attenuated DNA repair activation in response to platinum, and enhanced platinum-induced DNA damage and cell death. Using a functional DNA damage reporter assay, we directly showed that MAT2A knockdown reduced DNA repair through homologous recombination (HR) and non-homologous end joining (NHEJ) pathways. By detecting key DNA damage response kinases governing HR and NHEJ signaling, we further demonstrated that MAT2A inhibition abrogated DNA repair activation in response to platinum. Furthermore, single-sample Gene Set Enrichment Analysis of paired primary and recurrent tumors from HGSC patients revealed an association between MAT2A expression and increased OCSC features in recurrent tumors. In vitro, MAT2A inhibition prevented cisplatin-induced enrichment of OCSCs, reduced stemness markers, and inhibited spheroid-forming ability, all of which were rescued by SAM supplementation. Together, our study reveals a previously unrecognized mechanism linking metabolism to epigenetic regulation through platinum-induced remodeling and establishes the MAT2A-SAM axis as a promising therapeutic target to enhance platinum sensitivity by abrogating DNA damage response and OCSC enrichment and ultimately reduce OCSC-driven disease recurrence in HGSC.

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Pharmacological arginine deprivation renders pancreatic cancer cells susceptible to senolysis and inhibition of the integrated stress response

Mainz, L.; Sarhan, M. A. F. E.; Schlicker, L.; Kirner, S.; Morton, J.; Gerhard-Hartmann, E.; Rosenwald, A.; Eilers, U.; Schuelein-Voelk, C.; Schmitz, W.; Baluapuri, A.; Eilers, M.; Wolf, E.; Diefenbacher, M.; Schulze, A.; Rosenfeldt, M. T.

2026-08-04 cancer biology 10.64898/2026.08.03.740778 medRxiv
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Pancreatic ductal adenocarcinoma (PDAC) is almost inevitably fatal and largely resistant to current chemotherapy regimens. Senolysis, i. e. the selective elimination of senescent cells, and the targeting of cancer specific cellular metabolism are two novel treatment approaches that have proven to be effective for a variety of cancer types in pre-clinical studies. We now demonstrate that pharmacological depletion of arginine with pegylated recombinant human arginase 1 (PEG-rhARG1) induced senescence and activated the integrated stress response (IRS) in PDAC cells. Cells treated in such a manner were strikingly susceptible towards senolysis with ABT-263 (navitoclax) and also sensitive towards inhibition of the IRS. These results demonstrate a novel mechanism for an induced sensitivity of PDAC cells that could be exploited for cancer therapy.