Cancer Research

Precision oncology lacks scalable tools to assess, at the patient level, systems-level tumor microenvironment (TME) programs driving therapeutic resistance. To address this gap, we trained a weakly-supervised deep learning model that uses routine H&E whole-slide images (WSIs) to derive quantitative activity for therapeutically-relevant TME phenotypes, spanning immune, metabolic, and tumor cell-intrinsic programs. Using 3111 breast cancer H&E WSIs with matched bulk transcriptomics, our model accurately infers these biological states, defined by pathway enrichment scores (AUROC>0.80; PCC>0.64). Validation spanned three levels: (i) tissue-matched multiplexed immunofluorescence, showing concordance between inferred functional states and immune cell fractions (p=0.006-0.106), (ii) blinded reader assessments, confirming localization of phenotype-specific morphology (p<3x10-5), and (iii) multi-institutional patient cohorts, where model-derived phenotypes stratified for clinical response (p<0.045). Unlike methods requiring resource-intensive spatial profiling data for training, our approach leverages widely-available therapeutic outcomes or bulk profiling as slide-level labels to assess functional biology. This strategy offers a scalable complement to spatial Omics for investigating therapeutic resistance across the pan-cancer landscape through using WSIs and clinical outcomes from massive legacy biobanks.

Oncogenic KRAS mutations exhibit a striking tissue-restricted tropism, occurring with high frequency in pancreatic, colorectal, and lung adenocarcinomas while remaining rare in other lineages. The molecular basis for why these specific tissues are uniquely permissive to KRAS transformation, and how this context shapes therapeutic vulnerabilities, remains poorly defined. Here, we utilized CRISPR-mediated genome engineering to generate endogenous, conditional KRAS-mutant isogenic cell line models across three primary permissive lineages (lung, colon, and pancreas) and the non-permissive breast lineage. Integrated genome-wide CRISPR fitness screens and comparative transcriptome analyses revealed that KRAS-driven synthetic lethal (SL) dependencies are profoundly shaped by their tissue of origin. Strikingly, we observed minimal overlap in SL hits across lineages, with only three genes shared among the permissive lines, suggesting that the KRAS oncogene operates through divergent, context-specific genetic networks. Mechanistically, we show that KRAS activation induces a universal MYC-driven metabolic signature, but the specific machinery required to sustain this state is lineage-restricted. We identified a dependency on the diphthamide synthesis pathway to maintain translational fidelity amidst a KRAS-induced hyper-translational state. These findings demonstrate that even when driven by the same oncogene, tumors exhibit distinct regulatory landscapes and unique genetic vulnerabilities. Our results provide a framework for developing lineage-aware therapeutic strategies, moving beyond universal KRAS inhibition toward targeted interventions tailored to a tumors specific tissue context. SIGNIFICANCE STATEMENTWhile KRAS mutations drive a significant portion of human malignancies, their prevalence is strikingly restricted to specific lineages, namely pancreatic, colorectal, and lung tissues. This tissue-restricted tropism suggests that oncogenic KRAS does not operate in a vacuum but requires a permissive, tissue-specific molecular landscape to sustain tumorigenesis. By integrating comparative transcriptome analyses with functional genomics across four isogenic lineages, we demonstrate that KRAS synthetic lethal dependencies are not universal but are hardwired to the cell of origin. This work establishes a framework for tissue lineage-aware oncology, shifting treatment paradigms from targeting the KRAS mutation alone to targeting the specific genetic networks, defined by the tissue of origin, that sustain KRAS-driven growth.

Distant metastasis is the leading cause of mortality in many cancers. Although metabolic reprogramming is recognized as a hallmark of cancer, how tumor-intrinsic metabolic enzymes regulate tumor-immune crosstalk during metastatic progression remains poorly understood. Here, using a high-throughput functional CRISPR-Cas9 screen targeting metabolic genes in an orthotopic 4T1 murine mammary carcinoma model of spontaneous lung metastasis, we identify a selective enrichment of arginase 2 (ARG2)-deficient tumor cells in metastatic lungs of immunocompetent but not RAG1-deficient mice, indicating a lymphocyte-dependent mechanism. Loss of ARG2 enhances spontaneous lung metastasis without affecting primary tumor growth. Further, metastatic outgrowth in the lung is not affected when tumor cells are injected intravenously, indicating that ARG2 regulates an early stage of the metastatic cascade. Mechanistically, ARG2 deficiency upregulates nitric oxide synthase 2 (NOS2), resulting in increased nitric oxide production, accumulation of cytosolic DNA, and activation of the cGAS-STING-NF-{kappa}B pathway, leading to upregulation of inflammatory cytokines. ARG2-deficient tumors exhibit an immunosuppressive tumor microenvironment characterized by enrichment of Th17 cells and reduced anti-tumor immune populations. Functionally, Th17 cells enhance tumor cell migration in vitro and promote spontaneous lung metastasis in vivo. Genetic deletion of NOS2 attenuates cytosolic DNA accumulation, reduces STING-NF-{kappa}B activation, restores anti-tumor immunity, and suppresses ARG2 deficiency-driven metastatic burden in vivo. Collectively, these findings define a tumor cell-intrinsic ARG2-NOS2 axis that regulates inflammatory signaling and the tumor microenvironment to promote metastasis, highlighting a targetable vulnerability in metastatic breast cancer.

Mono-ADP-ribosylation (MARylation) is emerging as an important regulator of anti-cancer immunity and immunosuppressive tumor microenvironment (TME). Our previous studies showed that PARP11, one of several enzymes that facilitate MARylation, regulates the activities of intratumoral cytotoxic T lymphocytes (CTLs) and regulatory T cells (Tregs). Here, we demonstrate that stimuli such as adenosine, epinephrine, or glucagon-like peptide-1 (GLP1) induced PARP11 in cancer cells. Upregulation of PARP11 in cancer cells led to PARP11-mediated MARylation, ubiquitination, and accelerated degradation of MHC-I through the autophagy-lysosomal pathway. Induction of PARP11 protected cancer cells from killing by specific CTLs and stimulated tumor growth and progression. Genetic ablation of PARP11 attenuated MHC-I MARylation, ubiquitination, and interaction with autophagy receptors. Pharmacologic inhibition of PARP11 in pancreatic ductal adenocarcinoma (PDAC) cells restored their MHC-I levels, sensitized them to killing by CTLs, inhibited tumor growth, and impeded their initial resistance to chemotherapy and their acquired resistance to targeted therapy with RAS inhibitors. Moreover, inhibition of PARP11 prevented hyperprogressive disease in a mouse melanoma model treated with immune checkpoint inhibitors (ICBs), suggesting that PARP11 is a major therapeutically actionable driver of immunosuppression in tumors. SYNOPSISInduction of PARP11 in the tumor microenvironment mediates immunosuppression. This study reports that PARP11-driven MARylation and ubiquitination of MHC-I in cancer cells drives immune evasion, tumor growth and resistance to therapies.

Pancreatic ductal adenocarcinoma (PDAC) exhibits a desmoplastic stroma with context-dependent tumor-restraining and tumor-promoting functions, highlighting the need to selectively reprogram stromal states. Although intratumoral coagulation activity is frequently observed, its role in driving these states remains unclear. Here, we identify extravascular coagulation as a tumor-amplified regulatory module that stabilizes pro-fibrotic stromal states via tumor-intrinsic protease-activated receptor-1 (PAR1) signaling. To establish clinical relevance and enable mechanistic interrogation, we combined human tumor bioinformatics with a cross-scale experimental workflow integrating microphysiological tumor-stroma (MPTS) models and in vivo systems to define and test this regulatory axis. Analysis of The Cancer Genome Atlas (TCGA) revealed heterogeneous F2R (PAR1) expression across tumors, with elevated expression associated with fibrotic transcriptional programs and reduced survival. Consistently, thrombin induced coordinated pro-fibrotic programs in tumor cells and cancer-associated fibroblasts (CAFs), which were recapitulated in microphysiological models where tumor-intrinsic PAR1 was required for amplification of extracellular matrix deposition and CAF activation. Mechanistically, PAR1 signaling amplified tumor-stroma communication, in part through induction of TGF-{beta}1-dependent pathways, establishing a reinforcing feedback loop that stabilizes fibrotic remodeling. Pharmacologic inhibition of PAR1 suppressed pro-fibrotic CAF states, reprogrammed stromal states and attenuated tumor progression across microphysiological and in vivo models. These findings establish extravascular coagulation as a systems-level regulator of stromal state architecture in PDAC and define a cross-scale framework for targeting tumor-stroma regulatory circuits.

Chemotherapy and radiation reduce tumor burden but leave behind residual cells that survive via therapy-induced senescence (TIS). These cells constitute a latent reservoir fueling recurrence, yet strategies for their selective elimination are lacking. Here, we identify lysosomal ferrous iron accumulation as a conserved hallmark and actionable vulnerability of TIS tumor cells. Across diverse models, senescent tumor cells exhibit marked hypersensitivity to ferroptosis induction. In breast cancer PDX models, sequential ferroptosis induction following chemotherapy significantly delays recurrence, while dual inhibition of GPX4 and FSP1 produces durable, often complete, eradication of residual tumors without overt toxicity. Mechanistically, activation of the TFEB-HO-1 axis in TIS tumor cells drives ferrous iron accumulation, thereby priming cells for ferroptosis. Together, these findings establish ferrous iron accumulation as a defining feature of TIS and position ferroptosis induction as a potent senolytic strategy to eliminate therapy-refractory residual disease. Statement of significanceSenescent tumor cells remaining after treatment can drive cancer recurrence yet remain poorly understood and therapeutically intractable. Here, we identify lysosomal ferrous iron accumulation as a universal hallmark of therapy-induced senescence and demonstrate that ferroptosis induction functions as an effective senolytic strategy. Our findings provide mechanistic and translational support for the "one-two punch" therapeutic paradigm.

Aberrant epigenetic reprogramming together with dysregulated mTOR signaling are hallmarks of cancer, where altered chromatin methylation and nutrient-sensing pathways cooperate to drive tumor progression. S-adenosylmethionine (SAM), the universal methyl donor, is essential for these processes, yet how tumors sustain elevated SAM availability to support oncogenic transmethylation reactions remains poorly defined. Here, using prostate cancer (PCa) as a model system, we identify nicotinamide N-methyltransferase (NNMT) as a critical metabolic-epigenetic regulator and tumor suppressor. Using a prostate-specific Nnmt knockout mouse model, we demonstrate that NNMT loss accelerates PCa progression, particularly in the context of Pten deletion, resulting in infiltrating carcinoma and reduced survival. Mechanistically, NNMT functions as a "SAM-sink," and its loss increases intracellular SAM abundance, thereby activating mTORC1 signaling through SAMTOR-dependent sensing and broadly enhancing chromatin methylation. In human PCa, recurrent genomic deletions of NNMT occur in up to 7% of cases, and NNMT protein expression is largely absent in primary tumors and metastases. NNMT-deficient PCa cells exhibit elevated SAM:SAH ratios, increased histone methylation, and heightened mTORC1 activity, enabling sustained tumor growth even under dietary methionine-restriction (MR). Notably, combined MR and pharmacologic mTORC1 inhibition synergistically suppresses the growth of NNMT-deficient tumors, revealing a previously unrecognized therapeutic vulnerability. Collectively, these findings establish NNMT as a key tumor suppressor that constrains SAM-driven epigenetic and signaling programs in PCa and suggest a rational, diet-based therapeutic strategy for advanced cancers with NNMT loss.

BRAF-targeted therapy (BRAFi/MEKi) and immune checkpoint blockade (anti-PD-1/anti-CTLA-4) have transformed the treatment of BRAF-mutant metastatic melanoma. While most patients who respond to targeted therapy eventually progress, a subset derives durable benefit, and biomarkers to identify this subset would inform optimal treatment selection. In this study, we analyzed pre-treatment tumor samples from a clinically annotated cohort of 155 patients with BRAF-mutant metastatic melanoma treated with first-line BRAFi/MEKi and followed for up to five years. We stratified patients into durable responders (PFS [&ge;] 24 months) and rapid progressors (PFS < 6 months with progression) and found that a global metric of tumor genomic heterogeneity, rather than individual gene alterations, distinguished these groups. Combining genomic heterogeneity with baseline tumor burden (e.g., lactate dehydrogenase (LDH) or radiographic lesion dimensions), we developed a parsimonious model that predicted durable responders with high precision and specificity. Notably, the analogous population of patients treated instead with immunotherapy were not durable responders, suggesting that the selected predictors of durable responders are targeted therapy specific. Spatial profiling of a subset of pre-treatment biopsies (n = 47) demonstrated that high intratumoral, but not peritumoral, CD8+ T-cell infiltration correlated with prolonged survival on BRAF-targeted therapy and served as an independent predictive factor when considered with genomic heterogeneity and features of clinical tumor burden. Together, these findings highlight the distinct baseline intrinsic and extrinsic features underlying durable response to BRAF-targeted therapy and support their potential implication in guiding treatment selection for patients with BRAF-mutant metastatic melanoma. One-Sentence SummaryIntegrated clinical, tumor genomic, and immune microenvironmental features predict durable responses to BRAF-targeted therapy.

Oncogenic KRAS mutations promote tumorigenesis by constitutive activation of multiple, well-characterised signalling pathways. However, there is significant heterogeneity across mutant KRAS tumours in terms of mutation present, mutant allele abundance and downstream signalling strength. It is unclear whether these variations can impact responses to specific therapies. Here, we demonstrate that [~]20% of lung adenocarcinomas (LUAD) show an increase in mutant KRAS dosage (KRASmutant allele fraction > KRASwild-type). Furthermore, we show that KRAS mutant dosage can directly influence clinical outcome and therapeutic susceptibilities in lung cancer. Our findings show that mutant KRAS copy gains specifically affect platinum lung cancer response, promoting resistance to this standard-of-care therapy. Importantly, increases in KRAS mutant dosage are also associated with an increased vulnerability to pS6K inhibition, due to the unique metabolic rewiring of these cells. Together, we show that mutant KRAS dosage contributes to the phenotypic heterogeneity of mutant KRAS NSCLC and that assessment of mutant KRAS content or signalling strength can help optimise treatments strategies for these patients.

Resistance of cancers to targeted therapies is traditionally framed as a tumor-intrinsic phenomenon, mediated by tumor cell-intrinsic or microenvironmental mechanisms. Here, we identify a tumor-extrinsic, systemic resistance mechanism resulting from hyperactivation of the hepatic cytochrome P450 enzyme, CYP3A4. This tumor-extrinsic resistance mechanism can function independently of, or in tandem with, tumor-intrinsic resistance. Focusing on experimental mouse models of targetable lung cancer, we find that xenobiotic-mediated induction of CYP3A4 results in accelerated drug metabolism and a drastic reduction in systemic and tumor-drug exposure in vivo. CYP3A4 activation can be triggered by chemically unrelated xenobiotics, leading to resistance to a wide range of targeted therapies, including ALK, EGFR, and KRASG12C inhibitors. Retrospective analysis of clinical cohorts suggests that variability in CYP3A4 activity might be a major contributor to variability in clinical outcomes. While higher CYP3A4 activity leads to sub-therapeutic tumor drug exposure and shorter progression-free survival, reduced drug metabolism is expected to result in supratherapeutic exposure and increased systemic toxicity. To address the consequences of abnormal CYP3A4 activity, we utilized mathematical modeling to demonstrate that drug concentrations can be restored through the optimization of dosing amounts and intervals. Further, we show that tumor sensitivity to targeted therapies can be rescued through pharmacological inhibition of CYP3A4. Our findings establish systemic metabolic variability as a bona fide resistance and toxicity driver, providing a translational framework for personalized dosing to maximize both safety and efficacy.

Intracellular iron homeostasis is increasingly recognized as a regulator of cancer cell behavior, but how iron distribution influences extracellular matrix (ECM) organization and invasion remains poorly understood. Here, we show that loss of divalent metal transporter 1 (DMT1/SLC11A2) disrupts intracellular iron homeostasis and promotes cancer cell invasion through an iron-ER-ECM axis. In MDA-MB-231 cells, DMT1 knockout (KO) reduced total iron content but increased the labile iron pool (LIP) in both 2D and 3D culture models, indicating altered intracellular iron distribution. Across transcriptomic and phenotypic readouts, DMT1-dependent effects were more evident in 3D than in 2D models, with DMT1 KO inducing endoplasmic reticulum (ER) stress and impaired collagen/ECM organization. Functionally, the DMT1-loss phenotype was marked by reduced 2D motility, whereas in 3D spheroid models DMT1 KO cells displayed enhanced invasive outgrowth in both Matrigel and collagen matrices. Iron chelation further modulated this phenotype in a DMT1-dependent manner. Pharmacologic induction of ER stress phenocopied the loose spheroid architecture and invasive behavior, supporting ER stress as a mechanistic link between altered iron handling and ECM destabilization. Together, these findings identify intracellular iron distribution, rather than total iron abundance alone, as a determinant of ECM integrity and context-dependent cancer cell invasion. Significance StatementOur study identifies an iron-ER-ECM axis through which intracellular iron homeostasis regulates cancer cell invasion. Total cellular iron content alone is insufficient to predict invasive behavior without considering how iron is distributed within the cell. By preserving intracellular iron homeostasis and ER function, DMT1 supports collagen synthesis and maintains ECM integrity. In contrast, DMT1 loss disrupts these processes, promoting formation of loosely aggregated spheroids and enhanced invasion in 3D tumor models despite reduced total iron levels. These findings challenge the assumption that lowering bulk iron uniformly suppresses invasive phenotypes and instead highlight intracellular iron trafficking as a potential therapeutic target for limiting cancer cell invasion.

BackgroundIn RAS-mutant tumors, ERK phosphorylates the mitochondrial fission GTPase DRP1 to promote mitochondrial fission. DRP1 activity is tumor-promoting in pancreatic and other RAS-driven cancers, but its role in therapeutic resistance is unknown. MethodsWe developed a panel of patient-derived pancreatic cancer cell lines resistant to the MEK inhibitor trametinib. We used immunofluorescence imaging, in vitro growth assays and orthotopic xenografts to determine the role of DRP1 in trametinib resistance. ResultsWe find that trametinib-resistant cells exhibit increased expression and phosphorylation of DRP1 compared to sensitive counterparts. Quantitative analysis of mitochondrial structure reveals that mitochondria in resistant cells are morphologically distinct and relatively smaller than sensitive cells treated with trametinib. Genetic and pharmacological inhibition of both c-Myc and CDK6 are sufficient to block DRP1 phosphorylation in resistant cells, suggesting that activation of a c-Myc-CDK6 signaling axis drives reactivation of mitochondrial fission in the absence of MAPK signaling. Importantly, deletion of DRP1 leads to either growth inhibition or re-sensitization to trametinib in resistant lines. ConclusionThese findings suggest DRP1 contributes to drug resistance, and that inhibition of mitochondrial fission might be a promising therapeutic strategy to combat resistance to MAPK and RAS inhibitors.

Loss of tumor suppressor gene (TSG) activity is pervasive across cancers and linked to worse clinical outcomes, yet therapeutic efforts aimed at restoring TSGs have remained elusive. One underexplored avenue to address this problem is the targeting of metabolic signaling pathways that actively enforce tumor suppressive programs. Ceramide (Cer), the central hub of the sphingolipid (SL) metabolic network, has long been thought to have tumor suppressive functions, though its mechanistic roles remain incompletely defined. Here, we identify neutral sphingomyelinase-2 (nSMase2) as a critical mediator of Cer-dependent tumor suppression. We show that nSMase2 is frequently suppressed in breast cancer (BC) and its restoration inhibits tumorigenesis. Biologically, this was linked to the suppression of anchorage-independent growth (AIG) and to restraint of the HIPPO pathway effector TAZ, but not its paralog YAP. Taken together, these findings define a previously unrecognized metabolic tumor suppressor pathway, clarify ambiguities in both SL and HIPPO signaling networks, and highlight reactivation of nSMase2-Cer signaling as a potential therapeutic strategy in BC.

Peritoneal carcinomatosis is a major cause of death in gastric cancer, yet effective therapies remain limited. Tumor-derived soluble factors are increasingly recognized as key regulators of the peritumoral microenvironment. Here, we nominate osteopontin (SPP1) as a tumor-derived mediator that orchestrates macrophage-driven immunoregulation in gastric peritoneal carcinomatosis. Using integrated analyses of human clinical datasets and murine models, we demonstrate that tumor-secreted SPP1 promotes macrophage recruitment and induces tolerogenic IL-10 production. Clinically, SPP1 correlated with inferior overall survival and progression-free survival in gastric cancer. In syngeneic murine models of gastric peritoneal carcinomatosis, intracavitary pharmacologic inhibition of SPP1 restricted peritoneal dissemination, impaired macrophage infiltration and suppressed IL-10 production. Consistent with these findings, macrophage depletion phenocopied antitumor effects of SPP1 inhibition, resulting in decreased metastatic burden. Collectively, these findings define a mechanism of tumor-macrophage crosstalk that promotes peritoneal dissemination and provide a rationale for therapeutic targeting of SPP1 in gastric peritoneal carcinomatosis.

Neuroendocrine prostate cancer (NEPC) persists in a profoundly hypoxic microenvironment, yet the mechanisms enabling tumor adaptation to this metabolically challenging niche remain undefined. Here, we identify the lipid kinase PIKfyve as overexpressed in NEPC, functioning as a central node in a stress-lipid kinase axis that drives adaptation to persistent endoplasmic reticulum (ER) stress. Mechanistically, NEPC requires PIKfyve-mediated lysosomal degradation and lipid recycling to maintain metabolic homeostasis under hypoxia. PIKfyve inhibition disrupts lysosomal function, leading to ER stress accumulation and activation of a compensatory, sterol regulatory element-binding protein (SREBP)-dependent de novo lipogenesis program essential for NEPC survival. This stress-lipid axis creates a synthetic vulnerability between PIKfyve and fatty acid synthase (FASN), where dual inhibition synergistically amplifies ER stress, triggers the terminal unfolded protein response, and induces tumor cell death. These findings reveal a metabolic adaptation in NEPC and provide preclinical evidence that co-targeting PIKfyve and FASN can overcome hypoxia-associated stress adaptation.

Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest cancers, with limited treatment options and poor survival rates. It is characterised by strong driver mutations, epigenetic reprogramming, and a dense tumour microenvironment (TME). A defining feature of the PDAC TME is its fibrotic stroma, which is largely composed of cancer-associated fibroblasts (CAFs). Distinct CAF populations have been implicated in PDAC progression, but the mechanisms that govern their crosstalk with the cancer cells are poorly understood. We generated genetically engineered pancreatic stellate cells (PSCs) modelling interleukin-1 (IL-1)-dependent inflammatory CAFs (iCAFs) and transforming growth factor-{beta} (TGF-{beta})-dependent myofibroblastic CAFs (myCAFs) to investigate how distinct stromal populations shape the epigenetic landscape of pancreatic ductal adenocarcinoma (PDAC). We found that iCAFs, but not myCAFs, promoted gemcitabine resistance in epithelial tumour cells and identified STAT1 as a critical mediator of iCAF-tumour cell crosstalk. Mechanistically, STAT1 drove the induction of interferon (IFN)-responsive genes, while blockade of IFN-{beta} attenuated iCAF-mediated transcriptional reprogramming. Genetic ablation of STAT1 in tumour cells abolished iCAF-induced chemoresistance and associated transcriptional changes. In an orthotopic in vivo model, STAT1 knockout significantly prolonged survival following gemcitabine treatment, supporting a central role for STAT1 signalling in stromal-driven therapy resistance. We provide a comprehensive analysis on how IL-1-dependent iCAFs contribute to epigenetic reprogramming in PDAC and uncover a previously undescribed role for STAT1 in stromal-epithelial interactions. These findings reveal distinct, non-overlapping mechanisms by which CAF subtypes modulate tumour behaviour and identify STAT1 as a therapeutic vulnerability that can be exploited to sensitise PDAC to standard chemotherapy. Significance statementThis study establishes that the epigenetic landscape of PDAC is differentially shaped by iCAF- and myCAF-like PSCs and defines STAT1 as a mediator of iCAF-induced chemoresistance and transcriptional reprogramming. We demonstrate that genetic ablation of STAT1 sensitises tumours to gemcitabine in vivo, extending survival and positioning STAT1 as an actionable target to overcome stromal-mediated therapy resistance in PDAC.

Pancreatic ductal adenocarcinoma (PDAC) is characterized by a dense, desmoplastic microenvironment that drives disease progression, yet conventional models fail to capture this complex tumor-stroma coevolution. Here, we utilize the chick chorioallantoic membrane (CAM) platform to investigate tumor-stroma interactions using murine PDAC cell lines and patient-derived organoids (PDOs). Integrating single-cell RNA sequencing and spatial transcriptomics, we show that the CAM microenvironment supports the emergence of complex tumor ecosystems while preserving patient-specific characteristics. Within five days, in ovo tumors faithfully recapitulated the structural and molecular features of parental tumors. Histological analysis revealed the rapid recruitment and spatial organization of heterogeneous host cancer-associated fibroblast (CAF) populations, showcasing distinct myofibroblastic and inflammatory stromal states. Crucially, the model preserved intrinsic tumor heterogeneity and permitted functional interrogation of subtype-specific extracellular matrix remodeling and metastatic dissemination. Together, our findings demonstrate that the CAM provides a highly permissive niche for tumor-stroma coevolution. As a rapid, scalable, and biologically relevant platform, this in ovo model offers a powerful approach for studying stromal composition, metastatic progression, and patient-specific tumor biology in pancreatic cancer.

Adipose tissue is the dominant stromal component of the breast, yet whether breast tumors exploit adipocyte plasticity to support cancer growth remains unclear. Here, we show that breast tumors actively disturb adipocyte differentiation, generating an immature tumor-adjacent adipose niche enriched in pre-adipocytes that directly promotes tumor progression. In human breast cancer samples, adipocytes located near tumors acquire a pre-adipocyte-like state. Functional studies demonstrate that pre-adipocytes enhance tumor cell proliferation both in vivo and in vitro. Mechanistically, we identify tumor-intrinsic RET signaling as a key regulator of this interaction. The RET receptor is a clinically relevant target expressed in breast cancer. RET drives a PDGF-B-dependent paracrine program that maintains pre-adipocytes in the tumor milieu. In turn, pre-adipocytes provide RET ligands that reinforce oncogenic signaling in tumor cells. Disruption of the RET-PDGF-B axis limits tumor progression. Together, our findings reveal an active tumor-driven mechanism by which breast tumors regulate adipocyte linage states to sustain growth and identify a novel targetable pathway controlling tumor- adipose tissue communication.

Cancer-associated fibroblasts (CAFs) are now recognized as key regulators of tumor progression and therapeutic resistance, yet the cancer cells-fibroblasts crosstalk that ultimately promotes chemoresistance remain incompletely understood. Here, we show that direct physical contact between small cell lung cancer (SCLC) cells and lung fibroblasts induces early resistance to standard-of-care chemotherapeutic agents, etoposide and cisplatin. Using both 2D and 3D co-culture models, we demonstrate that early acquired therapy resistance entails cell-cell contact and cannot be recapitulated by conditioned media alone. Mechanistically, direct interaction promotes transcriptional reprogramming in cancer cells, including upregulation of YAP1 and epithelial-to-mesenchymal transcription factors (EMT-TFs), which partially mediate the resistant phenotype. A high-throughput drug screening identified idarubicin as a compound that retains efficacy despite fibroblast-mediated protection, suggesting it could bypass microenvironment-induced resistance early on. Together, our findings identify direct tumor-fibroblasts contact as an early driver of chemoresistance and highlight a potential therapeutic strategy targeting cell-cell interactions within the tumor microenvironment.

Durable therapeutic efficacy remains a major barrier to improving outcomes for patients with pancreatic ductal adenocarcinoma (PDAC). An immunosuppressive tumor microenvironment (TME) is a hallmark of PDAC and has been demonstrated to be a dominant driver of therapeutic resistance. The aberrant glycan CA19-9 is prevalent in PDAC and drives tumor progression, but the paracrine mechanisms by which it contributes to TME remodeling are unknown. To address this, we mapped TME changes and performed functional analyses using a genetically engineered mouse model (GEMM) harboring KrasG12D mutation and inducible CA19-9 expression. Elevation of CA19-9 led to expansion of antigen-presenting cancer associated fibroblasts (apCAFs) and regulatory T cells (Tregs), which can drive immunosuppression. Antibody blockade of CA19 -9 resulted in significant restoration of normal histology and decreased apCAF and Treg populations. We dissected the paracrine signaling mechanisms that drive this TME remodeling in vitro using mouse and human organoid mono- and co-culture models as well as in vivo using GEMMs and syngeneic orthotopic transplantation models. CA19-9 induced IL1a and TGFb expression, reprogramming pancreatic mesothelial cells into apCAFs in vitro, which in turn directly ligated naive Cd4+ T cells resulting in Treg differentiation in co-cultures. Antibody blockade of IL1a and TGFb in mice led to reduced apCAF and Treg differentiation. We previously reported that CA19-9 modification of the secreted Fbln3 protein increased Egfr engagement and now find that the induction of IL1a and TGFb expression by CA19-9 is dependent on Fbln3 hyperactivation of EGFR signaling. Genetic depletion of Fbln3 led to reduced tumor progression and increased Cd8+ T cell infiltration in mice. Together these findings identify a previously unknown signaling axis driving immunosuppressive phenotypes in PDAC, uncovering multiple potential nodes to relieve the immunosuppressive pressures within the PDAC TME.