Cancer Research

Treatments for pancreatic ductal adenocarcinoma (PDAC) often fail because of the cancer's ability to adapt its signaling and metabolic pathways to circumvent treatment mechanisms. PDAC hallmarks that promote treatment resistance (increased fatty acid metabolism, survival signaling, desmoplasia, and macropinocytosis) are extensively regulated by heparan sulfate proteoglycans (HSPGs) and their binding partners. The pro-tumor functions of HSPGs are controlled by site-specific cleavage of their heparan sulfate chains by mammalian heparanase; however, cleavage by bacterial heparinase III (HepIII) represses these functions and prevents downstream, pro-tumor signaling. Using tumor-targeting, attenuated Salmonella typhimurium (strain YS1646), we have limited HepIII transgene expression to tumor tissue. Degradation of tumor cell heparan sulfates by HepIII resulted in decreased macropinocytosis, reduced survival signaling, lipid storage depletion, and decreased expression of translational machinery. This tumor-targeting treatment has the potential to improve the efficacy of several approved pancreatic cancer therapies, which is predicted to increase patient survival.

The basal-like subtype of pancreatic ductal adenocarcinoma (PDAC) is associated with poor outcomes and increased chemoresistance. Expression of high mobility group AT-hook 2 (HMGA2), a chromatin architectural protein, marks basal PDAC cells and associates with specific features of the tumor microenvironment (TME), including more immunosuppressive cancer associated fibroblasts (CAFs) and fewer cytotoxic CD8+ T cells. Expression of HMGA2 by tumor cells leads to upregulation of the immunosuppressive markers interleukin 6 (IL6) and leucine-rich repeat containing protein 15 (LRRC15) in associated fibroblasts. Mechanistically, HMGA2 in the tumor cell binds the interleukin 1 alpha (IL1) promoter and upregulates transcription, increasing IL1 in the TME, in turn inducing immunosuppressive fibroblast polarization, increasing regulatory T cells, and decreasing CD8+ T cells. Blockade of the IL1 signaling axis disrupts this tumor-driven microenvironment phenotype and combines with inhibitors of oncogenic KRAS to improve tumor control.

Bromodomain and extra-terminal (BET) proteins, BRD2, BRD3, BRD4, and BRDT, couple histone acetylation to transcription by recruiting elongation and transcription factor complexes to chromatin. Although BET proteins are promising therapeutic targets, the functions of individual family members remain incompletely understood. We identify BRD2 as a co-targetable vulnerability with PI3K/AKT inhibition in breast cancer. Pan-BET inhibition and BRD2 knockout synergized with PI3K pathway inhibitors in breast cancer cell lines, patient-derived organoids, and in vivo models. BRD2 knockout impaired proliferation of triple-negative breast cancer cells and upregulated signaling and stress-response pathways, including the DNA damage response. Mechanistically, BRD2 is phosphorylated at Ser37 by the mitogen- and stress-activated kinases MSK and RSK, and Ser37 phosphorylation is required for chromatin binding and reader function. Finally, mechanistic digital twin modeling identified BETi-PI3Ki regimens that maintained efficacy while reducing drug exposure. Together, these findings identify BRD2 as a phosphorylation-dependent, co-targetable vulnerability in PI3K-inhibited breast cancer.

Stromal cell composition has been proposed as a potential biomarker in ductal carcinoma in situ (DCIS) for assessing the risk of subsequent recurrence or progression to invasive breast cancer (IBC). However, the characteristics of the tumor microenvironment within DCIS associated with these outcomes remain poorly understood. Here, we perform spatial transcriptomic analyses of 49 primary DCIS specimens from patients with no recurrence, DCIS recurrence, or recurrence as IBC. Cell mapping reveals spatially organized stromal cell gradients within DCIS, with enrichment of TREM2+ macrophages and myofibroblastic cancer-associated fibroblasts (myCAFs) in tumor-proximal niches. Notably, the abundance of TREM2+ macrophages near tumor nests is associated with subsequent recurrence as IBC. Moreover, ligand-receptor pair analysis identifies GRN--SORT1, SPP1--CD44, and LGALS9--CD44 interactions as spatially plausible signaling interactions between TREM2+ macrophages and epithelial cells. Finally, these findings are validated at the protein level by multiplex immunostaining of serial sections. This study characterizes the spatial landscape of the DCIS tumor microenvironment associated with subsequent recurrence, providing a basis for developing biomarkers of disease progression and identifying potential therapeutic targets.

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.

Tumor-associated macrophages (TAMs) contribute to tumor immune evasion and therapeutic resistance. However, the epigenetic and transcriptional regulators that control TAM function remain largely unidentified. Here we investigated the role of the SWI/SNF chromatin remodeling complex in TAMs and whether disruption of SWI/SNF function in TAMs could improve immunotherapy. Pharmacologic inhibition of SWI/SNF ATPase activity improved the efficacy of checkpoint blockade immunotherapy, slowing tumor growth and reprogramming transcription broadly in tumor cells, tumor-infiltrating lymphocytes, and TAMs. To define the role of SWI/SNF in TAMs specifically, we genetically deleted the SWI/SNF subunit Arid1a in myeloid cells and found this was sufficient to suppress tumor progression and enhance checkpoint blockade response. Epigenomic and single cell analyses indicated that SWI/SNF inhibition and ARID1A deletion in TAMs reduced accessibility at enhancers of genes associated with poor prognosis, such as Spp1, and increased accessibility at promoters of interferon-stimulated genes (ISGs). CD86 was elevated on ARID1A-deficient TAMs and the enhanced immunotherapy response required CD86 costimulation and CD8+ T cells. These findings establish ARID1A-dependent chromatin remodeling as a determinant of TAM gene expression programs and show that disruption of myeloid SWI/SNF function improves checkpoint blockade immunotherapy via TAM reprogramming.

Abstract: Background. Class IA PI3K isoforms are candidate therapeutic targets in small-cell lung cancer (SCLC). The transcriptional consequences of isoform-directed inhibitors in SCLC cells have not been compared genome-wide. Methods. We re-analysed GEO series GSE40564: PIK3CA-altered NCI-H69 cells treated for 24 h with vehicle, PIK-75 (p110-directed) or TGX-221 (p110{beta}-directed), three arrays per group (Affymetrix HG-U133 Plus 2.0). Differential expression used limma, with re-processing from raw files and spike-in-anchored normalisation as sensitivity analyses. Gene sets were assessed by effect size, competitive and rotation tests, and size-matched random-set nulls. Isoform dependency was examined in DepMap CRISPR screens. A PIK-75 response score was tested in 81 primary SCLCs against random-signature nulls. Results. PIK-75 reduced SREBP-controlled sterol- and lipid-synthesis genes (SQLE, HMGCS1, HMGCR, LDLR, SCD; log2 fold-change -1.1 to -1.6). Cholesterol, mTORC1, hypoxia and glycolysis gene sets fell far more than size-matched random sets. E2F-target and homologous-repair genes fell more modestly, including BRCA1 (-0.91). The response was broad: 11,645 of 17,458 genes changed at FDR < 0.05, but only 316 decreased and 20 increased significantly beyond two-fold, an asymmetry that persisted under spike-in-anchored normalisation. TGX-221 changed 358 genes, none two-fold. Its set-level effects were four- to nine-fold smaller and depended on two of three replicates. PIK-75 did not induce canonical FOXO targets, and it inhibits kinases other than p110, so the response cannot be attributed to p110 alone. In DepMap, SCLC lines depended more on PIK3CA than on PIK3CB (median Chronos -0.38 vs -0.15), as did other lineages. In patients, the response score was not associated with survival or subtype beyond what random gene signatures achieve (empirical p = 0.14 and 0.11). Conclusion. PIK-75, but not TGX-221, suppresses an SREBP-centred anabolic transcriptional programme in NCI-H69 cells. Attributing this to p110 requires confirmation with selective inhibitors or genetic perturbation.

Pseudoprogression in response to immune checkpoint inhibitor (ICI) therapy can be a complex challenge during treatment response evaluation. Erroneous classification of progression may result in stopping effective treatment for patients, while delayed confirmation of progression can prolong an ineffective treatment course. We develop a mechanistic mathematical model of tumor-immune dynamics under ICI treatment in which observed tumor volume includes contributions from both tumor burden and immune infiltration. We show analytically how pseudoprogression can arise from increased immune infiltration and proliferation as well as continued tumor growth during the ``ramp-up" phase. The model also incorporates circulating tumor DNA (ctDNA) dynamics, which we demonstrate are able to closely fit existing longitudinal tumor and ctDNA data and extract realistic parameter ranges to generate representative in silico data. Using model-generated cohorts, we train a random forest (RF) classifier using longitudinal tumor and ctDNA measurements to distinguish pseudoprogression and true progression, and demonstrate that it improves response classification relative to the Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and provides classification earlier than the immunotherapy-specific iRECIST, even in the presence of tumor measurement noise. This work predicts that paired longitudinal tumor-ctDNA measurements may enable earlier discrimination of true progression from pseudoprogression, and motivates collection of imaging and ctDNA data synchronously during ICI therapy, especially in the setting of suspected disease progression.

PTEN-deficient tumors are widely assumed to be glutamine-dependent, a view that has helped motivate the clinical development of glutaminase inhibitors. Whether glutaminolytic transcription scales with PTEN copy-number loss in human tumors, and by what mechanism, has not been established. We classified TCGA PanCancer Atlas tumors by GISTIC copy number as PTEN intact, hemizygous, or homozygous deletion, and scored a five-gene glutaminolysis signature (GLS, SLC1A5, GOT1, GLUD1, GPT2) against loss severity across fourteen tumor types, testing MYC mediation and chromosome-10 co-deletion as alternative mechanisms, with GLS dependence assessed in DepMap CRISPR data. The signature decreased with PTEN loss in all fourteen types, significantly in twelve, but was not MYC-mediated. The decline tracked chromosomal position rather than pathway membership: GLUD1 and GOT1 flank PTEN on 10q, and thirty-seven neighboring genes carrying no glutaminolysis annotation tracked PTEN copy number just as closely (mean rho 0.843 compared with 0.842), with co-deletion fidelity falling monotonically with distance from PTEN (rho = -0.993). Adjustment for genome-wide aneuploidy left the association intact, whereas conditioning on each gene's own copy number abolished it for the chromosome-10 genes and left the others unchanged. In a natural experiment contrasting PTEN point-mutant, copy-neutral tumors with copy-neutral wild-type tumors, GLUD1 was lower in the mutant group when all cohorts were pooled (P = 1.0 x 10^-8), an effect attributable to endometrial carcinoma, the one lineage in which mutation alone lowered GLUD1; excluding that lineage in a post hoc sensitivity analysis left no detectable difference (P = 0.22, equivalence P = 0.015), whereas hemizygous and homozygous deletion lowered GLUD1 dose-dependently in every analysis. GLS dependence did not differ across dosage tiers. Prostate carcinoma was the sole departure in the negative direction, its off-chromosome-10 decline surviving adjustment for tumor purity, stage, ERG status and proliferation, opposite in direction to the signaling prediction; breast and stomach showed small positive associations. The inverse PTEN-glutaminolysis relationship in this transcript signature is therefore explained predominantly by passenger co-deletion rather than by a PTEN-linked metabolic program, making PTEN copy number unreliable as a stand-alone glutaminolysis biomarker and illustrating a general hazard: any signature scored against a frequently co-deleted locus can be confounded by where its genes sit. We provide a four-step screening procedure: decompose the signature by chromosomal position relative to the driver; test each constituent gene's own copy number against the driver's; compare driver-mutant copy-neutral tumors with copy-neutral wild-type tumors; and check the inferred pathway activity against an independent functional readout.

Pancreatic ductal adenocarcinoma (PDAC) is characterized by a dense desmoplastic microenvironment that promotes therapeutic resistance and disease progression. Here, we investigated the impact of pulsed field ablation (PFA), a non-thermal electroporation-based therapy, on tumor and stromal remodeling in a syngeneic murine PDAC model. PFA induced rapid apoptotic and necrotic tumor cell death, transient neutrophil infiltration, and durable suppression of tumor growth. Single-cell RNA sequencing following repeated PFA treatments revealed enrichment of a classical secretory tumor cell state associated with complement and stress-response pathways and reduced epithelial-to-mesenchymal transition (EMT) programs. Although overall immune composition was largely unchanged, PFA markedly remodeled the stromal compartment, decreasing SMA-positive activation and shifting cancer-associated fibroblasts (CAFs) from tumor-promoting myofibroblastic CAFs toward Dpp4+ complement-secreting CAFs. This transition was accompanied by increased IL-1 signaling potential, reduced Tgfb1 expression, and diminished tumor cell TGF-{beta} response signatures. Serial PFA treatments further suppressed EMT-associated programs, identifying stromal reprogramming as a potential mechanism through which PFA enhances tumor control.

Metastatic melanoma remains highly lethal despite advances in immunotherapy and MAPK-targeted therapy. The Rac1P29S mutation, present in 4-9% of cutaneous melanomas, confers intrinsic resistance to BRAF and MEK inhibitors. Like other small GTPases, Rac1 lacks suitable pockets for small molecule inhibitor binding, motivating indirect approaches to suppressing its activity. We have previously shown that wild-type Rac1 is sensitive to inhibition of de novo GTP biosynthesis in cancer cells, particularly suppression of the rate-limiting inosine monophosphate dehydrogenase (IMPDH) enzymes. Therefore, we asked whether IMPDH inhibition could suppress Rac1P29S and its associated phenotypes in melanoma. We found that IMPDH inhibition reduced Rac1 activity, impaired Rac1-dependent phenotypes, and induced S-phase arrest in Rac1P29S-harboring cells. Moreover, IMPDH inhibition synergized with the BRAF inhibitor vemurafenib and the MEK inhibitor trametinib in Rac1P29S melanoma cells. Dual BRAF and IMPDH inhibition also resulted in enhanced suppression of MEK and ERK phosphorylation in vitro. In syngeneic mouse models, the FDA-approved IMPDH inhibitor mycophenolate mofetil sensitized Rac1P29S-expressing melanoma tumors to trametinib, including tumors made refractory by prior trametinib exposure. We further identified a feed-forward circuit in which Rac1 sustains IMPDH2 expression levels through JNK and c-Jun/AP1 signaling, potentially coupling the GTPase to its own nucleotide supply. These findings establish GTP biosynthesis as a targetable vulnerability in Rac1P29S melanoma and support IMPDH inhibition as a rational partner for MAPK-targeted therapy.

Glioblastomas (GBMs) are uniformly fatal brain tumors resistant to immunotherapy, yet the mechanisms driving immune dysfunction remain poorly understood. Here we identify a tissue-specific mechanism of dendritic cell (DC) dysfunction contributing to GBM immune evasion. We demonstrate that while systemic immunity depends on type 1 conventional DCs (cDC1s), GBMs preferentially accumulate cDC2s with impaired antigen-presenting capacity. Further, microglia-derived GAS6 and PROS1 signaling through the AXL receptor on DCs suppresses DC activation and, critically, migration to tumor-draining lymph nodes. Pharmacologic AXL inhibition enhances DC migration and consequently anti-tumor immunity. Importantly, radiation therapy activates cDC1-mediated endogenous immune responses, which synergizes with mRNA vaccination to promote complete and durable immune-mediated tumor regression. These findings establish DC-mediated immunity as a therapeutic target in brain tumors and reveal a synergistic mechanism for combining radiation with personalized cancer vaccines.

Resistance to CDK4/6 inhibitors limits the durability of therapy for ER+ breast cancer. Despite the identification of mechanisms that regulate resistance, the metabolic adaptations that enable therapeutic escape remain poorly understood. Here, we identify a metabolic-epigenetic circuit that drives resistance by coordinately rewiring amino acid and glucose metabolism. CDK4/6 inhibitor-resistant ER+ tumor cells upregulate the leucine transporter SLC7A5, enhancing leucine uptake. SLC7A5 overexpression is sufficient to confer palbociclib resistance across ER+ cell lines, patient-derived organoids and xenografts. Stable isotope tracing in cell lines and in xenograft tumors revealed that leucine is catabolized through BCAT2 and HMGCL to increase acetyl-CoA levels, and elevated acetyl-CoA promotes H3K27 acetylation at the GLUT1 promoter, upregulating GLUT1 expression and glycolytic activity. Disrupting leucine transport, catabolism, or availability suppresses GLUT1 expression and restores therapeutic sensitivity in resistant models. In patients receiving palbociclib-based therapy, high SLC7A5 expression and coordinated SLC7A5-GLUT1 co-expression are associated with shorter progression-free survival. Together, these findings define a metabolic-epigenetic mechanism linking branched-chain amino acid catabolism to glycolysis and identify a biomarker-associated metabolic vulnerability in advanced ER+ breast cancer.

Isocitrate dehydrogenase (IDH) is the most frequently mutated metabolic enzyme in human cancers. Mutant IDH produces the oncometabolite D-2-hydroxyglutarate (D-2HG), which promotes tumorigenesis in part through epigenetic alterations. Beyond its cell-autonomous effects, tumor-derived D-2HG acts as a potent immunosuppressant that establishes an immune-cold tumor microenvironment. However, the mechanism by which D-2HG is released from tumors remains largely unknown. Here, we identify the SWELL1 (LRRC8A)/LRRC8C-containing volume-regulated anion channel (VRAC) as a principal pathway for D-2HG efflux from IDH-mutant cells. Genetic deletion of SWELL1, the essential VRAC subunit, markedly reduces D-2HG release and reverses associated immunosuppression in an orthotopic mouse model of IDH-mutant glioma. Strikingly, loss of VRAC causes intracellular accumulation of D-2HG, which paradoxically limits tumor cell proliferation by driving epigenetic remodeling and mitochondrial metabolic stress. Pharmacological inhibition of VRAC with dicumarol suppresses IDH-mutant glioma growth, enhances intratumoral T cell activation, synergizes with immune checkpoint blockade, and prolongs survival in tumor-bearing mice. In human IDH-mutant lower-grade gliomas, elevated LRRC8C expression correlates with DNA hypermethylation and an immunosuppressive tumor microenvironment (TME), and predicts poor overall survival. Together, these findings establish VRAC-mediated D-2HG export as a central mechanism regulating both immune evasion and tumor cell fitness, uncovering new therapeutic opportunities across IDH-mutant cancers.

Metastatic progression in triple-negative breast cancer (TNBC) is strongly influenced by epithelial-mesenchymal plasticity (EMP), which enables transitions between epithelial, hybrid epithelial/mesenchymal (E/M), and mesenchymal cell states. While mesenchymal cells are highly invasive and resistant to therapy, hybrid E/M states confer advantages during metastatic colonization. Both mesenchymal and hybrid states therefore contribute to tumor aggressiveness through distinct mechanisms. However, the molecular regulation governing transitions between mesenchymal and hybrid E/M states remains poorly understood. Here, we identify EPHA4 as a regulator of this transition in TNBC. EPHA4 expression is enriched in mesenchymal TNBC cells, and genetic knockout of EPHA4 in MDA-MB-231 xenograft and 4T1 syngeneic models induces a shift toward hybrid E/M phenotypes. This transition reduces cellular invasion while enhancing metastatic colonization, consistent with the clinical observations of decreased EPHA4 expression in secondary metastases compared to primary tumors. Despite compensatory changes in other Eph/ephrin family members following EPHA4 loss, EPHA4 deficiency is sufficient to drive this phenotypic shift. These findings identify EPHA4 as a regulator of cancer cell plasticity in TNBC and highlight the therapeutic complexity of targeting pathways that govern metastatic state transitions.

Oncogenic KRAS drives >90% of pancreatic ductal adenocarcinoma (PDAC), and the pan-RAS inhibitor daraxonrasib doubles overall survival, but adaptive and acquired resistance limit the depth and duration of responses. To systematically map combination vulnerabilities, we developed RAS+, a digenic CRISPR knockout library testing 10,296 pairwise perturbations across oncogenic signaling pathways, and screened 12 cell lines, revealing genotype- and lineage-specific interactions. In KRASmut PDAC, the most differentially effective gene pair was KRAS and FRS2, an adapter coupling FGFR signaling to RAS. Combined KRAS/pan-FGFR inhibition was synergistic and cytotoxic, eradicating tumor cells and overcoming resistance in vitro and deepening and prolonging regressions in vivo. Single-cell analysis identified cancer-associated fibroblasts (CAFs) as a primary source of FGF ligands in PDAC, and CAF conditioned media or individual FGFs promoted resistance. These findings define a stroma-to-tumor adaptive FGFR circuit limiting the effects of KRAS inhibition. Thus, combined KRAS/FGFR blockade may be a strategy to improve responses.

Loss of the Y chromosome (LOY) has been largely unexplored in pancreatic ductal adenocarcinoma (PDAC), and no mechanistic framework previously explained its role in tumor biology. We identify LOY as a recurrent, functionally consequential alteration affecting ~50% of male PDAC patients across two independent cohorts, with strong enrichment in advanced disease and, critically, in the basal subtype, establishing LOY as a clinically actionable biomarker. Comprehensive genomic profiling positions LOY as a distinct genetic event associated with TP53 mutations, implicating it in aggressive tumor evolution. Integrative analyses across bulk tumors, single-cell datasets and CRISPR-engineered PDAC models converge on epithelial-to-mesenchymal transition (EMT) as the dominant LOY-driven program. Y-chromosome deletion alone induces EMT transcriptional states, mesenchymal morphology and enhanced metastatic ability. Mechanistically, LOY disrupts epigenetic regulation through loss of Y-linked chromatin modifiers, reshaping DNA methylation at EMT- and basal-defining loci and reducing chemotherapy sensitivity. These findings establish LOY as a causal genetic driver of PDAC progression and a clinically accessible biomarker with direct therapeutic relevance.

Purpose: Lung metastases are the primary cause of death in osteosarcoma patients and treatment response often vary due to convergence of genetic and phenotypic influences in the context of a dynamic tumor-host tissue environment. The purpose of this study was to determine how dynamic tumor- and host-driven receptor tyrosine kinase (RTK)-ERK signaling interactions contribute to phenotypic drug response heterogeneity. Experimental Design: Live-cell time-lapse microscopy and data-driven dynamical modeling was used to resolve ERK activity, FOSL1/Fra-1 reporter expression, and spatiotemporal cell fate in living, biosensor-expressing osteosarcoma lung metastases ex vivo following MCL1 inhibitor exposure. RTK inhibitors were then evaluated for their ability to suppress adaptive signaling and enhance MCL1 inhibitor efficacy ex vivo and in vivo. Results: MCL1 inhibition induced extensive tumor-cell death; however, persistent ERKhigh/Fra-1high reporter cells emerged and were enriched at the tumor-lung interface, consistent with adaptive resistance. Experimental and computational approaches revealed that tumor-cell lysis amplified fibroblast growth factor receptor (FGFR)-mediated ERK signaling in neighboring cells, promoting a targetable drug-resistant state marked by adaptive ERK induction, FOSL1/Fra-1 expression, and correlated with upregulation of known drug resistance pathways Nrf2 and HMOX1. Combinatorial inhibition of FGFR with fexagratinib, or broad-spectrum RTK inhibitor, pazopanib, suppressed adaptive ERK activation and enhanced MCL1 inhibitor response resulting in greater efficacy ex vivo and in vivo. Conclusions: Tumor-host and tumor-cell-lysis-induced FGFR-ERK signaling contribute to spatiotemporally heterogeneous adaptive resistance in metastatic osteosarcoma. These data support combinatorial targeting of RTK signaling with cytotoxic or targeted agents as a strategy to block adaptive resistance and improve treatment efficacy.

BackgroundCancer-associated fibroblasts (CAF) are major regulators of the tumor microenvironment (TME), yet the pathways governing CAF function remain incompletely understood. Type 2 deiodinase (DIO2, D2), which converts thyroxine (T4) to the active thyroid hormone triiodothyronine (T3), has not been systematically investigated in CAF across different solid tumors. MethodsWe analyzed DIO2 expression using single-cell RNA sequencing (scRNA-seq) from primary thyroid tumors, a large integrated scRNASeq thyroid cancer atlas, and publicly available scRNA-seq datasets representing six additional solid tumor types. Bulk RNA sequencing data from the Oncology Research Information Exchange Network (ORIEN) database were used to examine correlations among DIO2, CAF subtype markers, and overall survival (OS). A genetically engineered TPO-CreERT2/BrafV600E/Trp53-deficient (TBP) mouse model was evaluated for CAF-specific Dio2 expression and pharmacologic inhibition of D2 activity. TBP mice were crossed with Dio2-/- (Dio2 KO) mice to investigate the role of Dio2 in cancer development and progression. ResultsDIO2 expression was highly restricted to CAF and was largely absent from epithelial-derived cancer, immune, and endothelial cells. Across thyroid cancer and six additional malignancies, DIO2 was consistently detected in CAF, demonstrating that CAF-specific DIO2 expression is a conserved feature of multiple tumor types. Within thyroid cancer, DIO2 was enriched in myofibroblastic CAF (myCAF) compared with inflammatory CAF (iCAF), and bulk transcriptomic analyses demonstrated stronger correlations between DIO2 expression and canonical myCAF markers than iCAF markers across numerous cancers. Elevated DIO2 expression was associated with worse OS in pancreatic and bladder cancers, paralleling the adverse prognostic impact of increased myCAF abundance. In contrast, thyroid cancer demonstrated an inverse association attributable to loss of epithelial DIO2 expression during tumor dedifferentiation. The TBP mouse model recapitulated human disease, with Dio2 expression restricted to CAF, robust stromal fibrosis, and measurable D2 enzymatic activity that was suppressed by cefuroxime and lenvatinib. Genetic loss of Dio2 in the TME resulted in significantly reduced tumor growth. Conclusions DIO2 is a conserved marker of CAF, and myCAF, across multiple solid tumors and is associated with adverse clinical outcomes in some cancers. The TBP mouse provides a robust preclinical model to define the mechanistic role of DIO2 in CAF biology and to evaluate DIO2-directed therapeutic strategies targeting the tumor microenvironment.

Pericytes are emerging as dynamic regulators of the tumour microenvironment. Yet, their role in tumour metabolism remains elusive. Here, we investigate whether {beta}3-integrin regulates pericyte metabolic state and shapes stromal-tumour metabolic interactions in breast cancer. By integrating spatial and single-cell transcriptomics from human breast tumours with multi-omics profiling of tumour-derived pericytes in vitro, we identify two {beta}3-integrin-dependent metabolic states. {beta}3-integrin-high pericytes display a metabolically active phenotype characterised by increased glycolysis and enhanced de novo serine/glycine synthesis, supporting collagen production. In contrast, {beta}3-integrin loss induces a lipid-associated state, marked by neutral lipid accumulation and lipid droplets. Mechanistically, {beta}3-integrin regulates this metabolic switch via mTOR signalling. Importantly, these states extend beyond pericytes, with adjacent cancer cells shifting towards fatty acid oxidation and lipid use near {beta}3-integrin-low pericytes. Together, our findings establish {beta}3-integrin as a key metabolic switch in pericytes and highlight their role in driving tumour metabolic plasticity.