Journal of Experimental & Clinical Cancer Research

ContextImmunotherapy based on immune checkpoint inhibitors (ICI) revolutionized the treatment of triple-negative (TN) breast carcinomas (BC), but remains more challenging in HR+/HER2- BCs. Because invasive lobular carcinomas (ILC) generally exhibit low immune infiltration, ICIs were largely overlooked in this pathological type. The only clinical trial of ICIs dedicated to ILCs showed disappointing results, notably in HR+/HER2- cases. The immune landscape of HR+/HER2- ILCs has been poorly described. High level of tumor-infiltrating lymphocytes (TIL) was associated with worse prognosis in HR+/HER2- ILCs. A better characterization of the immune landscape of HR+/HER2- ILCs could clarify the poor efficiency of ICIs and the negative prognostic value of TILs, and reveal complementary targets able to increase immunotherapy efficiency. MethodWe comprehensively characterized the immune landscape of HR+/HER2- ILCs, comparatively to HR+/HER2- invasive ductal carcinomas (IDC), by applying multi-omics and multi-scale analysis (gene expression at the bulk and single-cell levels, and protein-based spatial analysis) to clinical samples. ResultsWhile the overall level of immune infiltration was comparable between both pathological types, the quality of immune infiltrate differed markedly. Comparatively to HR+/HER2- IDCs, HR+/HER2- ILCs were enriched in immune cells and tertiary lymphoid structures with anti-tumor potential, presented more spatial proximity between cancer cells and CD8+ cytotoxic T cells, and stronger theorical vulnerability to ICIs. However, in HR+/HER2- ILCs, anti-tumor response was defective; CD8+ cytotoxic T cells failed to fully unleash their cytotoxic function and CD4+ helper T cells evidenced a pro-tumoral and naive phenotype. Furthermore, antigen-presenting compartment was defective, altogether embedded in a stronger immunosuppressive environment, enriched in immunoregulatory cancer-associated fibroblasts (iCAF). ConclusionThis study contributes to explain the lesser efficiency of PD-1/PD-L1-based ICIs in HR+/HER2-ILCs by comparison with HR+/HER2- IDCs, by shedding light on a complex ecosystem where tumor cells shape a distinctive stroma that contribute to prevent anti-tumor immune response activation. Altogether, our findings further support the rationale for combining iCAF-targeting strategy with an ad hoc immunotherapy (such as an anti-VTCN1/B7-H4 antibody-drug conjugates for example). Graphical abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=150 SRC="FIGDIR/small/728418v1_ufig1.gif" ALT="Figure 1"> View larger version (26K): org.highwire.dtl.DTLVardef@c62294org.highwire.dtl.DTLVardef@86392org.highwire.dtl.DTLVardef@c10748org.highwire.dtl.DTLVardef@c543da_HPS_FORMAT_FIGEXP M_FIG C_FIG HighlightsO_ST_ABSWHAT IS ALREADY KNOWN ON THIS TOPICC_ST_ABSO_LIImmune cells infiltrate both HR+/HER2- IDC and HR+/HER2- ILC tumors, but current ICIs are less effective in HR+/HER2- ILCs than HR+/HER2- IDCs. C_LI WHAT THIS STUDY ADDSO_LIThe anti-tumor immune response is mobilized but not effective in HR+/HER2- ILCs. C_LIO_LIA complex ecosystem - composed of immunoregulatory cancer-associated fibroblasts, high levels of TGFa, prostaglandin, acidosis, and a lack of antigen-presenting cells - prevents anti-tumor CD8+ cytotoxic T cell activation in HR+/HER2- ILCs. C_LI HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE, OR POLICYO_LITargeting the PD-1/PD-L1 axis is not the appropriate therapeutic strategy for HR+/HER2- ILCs. A more complex approach should be considered, notably those combining other immune-based strategies and iCAF targeting, which may offer a better chance to eradicate HR+/HER2- ILC tumor cells. C_LI

Structural AbstractO_ST_ABSBackgroundC_ST_ABSTriple-negative breast cancer (TNBC) represents a major clinical challenge due to its aggressiveness, heterogeneity and limited availability of effective targeted therapy. We investigated whether LRP-1, a multifunctional cell-surface endocytic and signaling receptor, contributes to TNBC progression. MethodsUsing CRISPR-Cas9, LRP-1-deficient murine 4T1 and human HS578-T TNBC cells were used. Functional consequences were assessed through migration, invasion, and 3D spheroid assays, imaging of focal adhesions and actin organization, atomic force microscopy, and plasmin activity assays. Global molecular reprogramming was analyzed by label-free quantitative proteomics and secretomics. LRP-1-deficient or proficient 4T1 cells were implanted orthotopically in immunocompetent mice; tumor progression was monitored longitudinally while peritumoral collagen architecture and immune microenvironment composition were characterized by second harmonic generation imaging and immunohistochemistry. ResultsWe show that LRP-1 loss reduces TNBC aggressiveness, as reflected by decreased migration and invasive capacity, reduced spheroid evasion, and significant morphological changes in focal adhesion and actin structure. LRP-1-deficient cells became stiffer and showed lower LOXL-4 levels, while pericellular proteolytic activity remained unchanged, suggesting other proteases mechanism. Multi-omic analysis revealed alterations in extracellular matrix (ECM), epithelial-mesenchymal transition, and inflammatory pathways. In vivo, LRP-1-deficiency reduced tumor progression and peritumoral collagen deposition, while increasing CD8+ T and Natural Killer cell infiltration, together with a cytokine profiling compatible with a more immune-permissive microenvironment. ConclusionsLRP-1 act as a key contributor in TNBC progression through matrix remodeling, mechano-adaptation, and immune exclusion. Positioning it as a candidate biomarker for TNBC patients who are likely to benefit from stroma-targeting therapies. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=113 SRC="FIGDIR/small/732906v2_ufig1.gif" ALT="Figure 1"> View larger version (60K): org.highwire.dtl.DTLVardef@1b595c2org.highwire.dtl.DTLVardef@7b208aorg.highwire.dtl.DTLVardef@1956e54org.highwire.dtl.DTLVardef@17e55d0_HPS_FORMAT_FIGEXP M_FIG C_FIG

AbstractO_ST_ABSBackgroundC_ST_ABSGlioblastoma (GB) is the most aggressive primary brain tumor, characterized by therapy resistance, attributed to a multitude of epi-genetic changes resulting in phenotypic plasticity with altered cell states. To uncover druggable epigenetic vulnerabilities, we disturbed GB-derived spheres and observed coordinated repression of the aberrantly activated hemopoietic stem-like cell signature, dominated by HOXA genes. This signature has been associated with poor prognosis and resistance to therapy in GB. Here we investigate biological vulnerabilities associated with the deregulated epigenetic landscape in high-HOX GB. MethodsGB-derived spheres (GS) were treated with an inhibitor of Bromodomain and extra-terminal motif proteins (BETi) (JQ1) or transduced with inducible constructs to genetically modulate HOXA10 expression (shRNA for knockdown, ectopic HOXA10). Functional effects were evaluated through proliferation, neurosphere formation, and senescence assays. Epigenomic profiling incorporated RNA-seq, ChIP-seq, ATAC-seq, promoter capture MicroC, and DNA methylation. ResultsBETi-mediated rapid, coordinated downregulation of the HOX-signature, suggested direct transcriptional regulation. Knockdown of HOXA10 alone yielded similar effects, decreasing expression of HOXA genes, reducing proliferation, self-renewal capacity, and triggering senescence. Conversely, ectopic HOXA10 expression was ineffective in reactivating the HOXA cluster, or reverse BETi-mediated biological effects. Integrative epigenomic analysis of high-HOX-GS revealed concerted activation of the HOXA region, with broad domains of H3K27ac/H3K4me3 associated with super-enhancer activity, open chromatin (ATAC) and focal DNA hypomethylation. Architectural changes included altered CTCF interactions and increased promoter-anchored looping. ConclusionThese results position the HOX-signature as a potential therapeutic target and offer a mechanistic rationale for disrupting BET-dependent transcriptional regulation in high-HOX GB. Key pointsO_LIEpigenetic activation of stem cell-related high-HOX signature in GB is associated with a super-enhancer encompassing the HOXA locus. C_LIO_LITargeting this vulnerability by BETi or HOXA10 knockdown results in concerted repression and loss of stemness features. C_LI Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=74 SRC="FIGDIR/small/727851v1_ufig1.gif" ALT="Figure 1"> View larger version (21K): org.highwire.dtl.DTLVardef@5bf4b9org.highwire.dtl.DTLVardef@11fa405org.highwire.dtl.DTLVardef@497a2eorg.highwire.dtl.DTLVardef@1f47084_HPS_FORMAT_FIGEXP M_FIG C_FIG Created in BioRender. Chiesi, D. (2026) https://BioRender.com/eknk0ez Importance of studyGlioblastoma (GB) are the most aggressive brain tumors in adults that are difficult to treat, due to their high plasticity resulting invariably to resistance to therapies. Here we report on the identification of epigenetic vulnerabilities that may be leveraged in combination therapies. Disturbing GB-derived stem-like cells with epigenetic drugs, we uncovered that a HOXA gene dominated hematopoietic stem cell-related signature, previously associated with aggressiveness and treatment resistance, can be repressed in a coordinated manner, resulting in loss of stem cell features. Analysis of the underlying epigenetic landscape revealed that the HOXA region was activated in high-HOX glioblastoma through the formation of a super-enhancer. This feature presents a particular vulnerability that may be leveraged by BETi as strategy of a combination therapy.

BackgroundTumor-associated macrophages (TAMs) are key drivers of the immunosuppressive tumor microenvironment (TME), supporting tumor progression through diverse functions. However, mechanistic studies of TAM polarization remain limited by the lack of physiologically relevant human model systems that capture stromal-immune interactions and macrophage heterogeneity. MethodsWe established advanced human co-culture systems that integrate healthy donor-derived macrophages with patient-derived organoids and tumoroids (PDOs and PDTs), as well as matched normal fibroblasts (NFs) and cancer-associated fibroblasts (CAFs). These multicellular models enabled the investigation of interactions among stromal, epithelial, and immune cells within tumor and adjacent normal tissue environments. ResultsThe co-culture systems recapitulated distinct macrophage states associated with tumor and adjacent normal environments and identified fibroblasts as major regulators of macrophage phenotypes. CAFs promoted macrophage metabolic remodeling characterized by altered lipid handling and enrichment of TAM-like signatures. Mechanistically, we identified thrombospondin 1 (TSP1) as a CAF-secreted factor linked to metabolic priming. Recombinant TSP1 induced transient lipid accumulation followed by mitochondrial remodeling. In tumor co-culture conditions, CD36 inhibition reduced lipid accumulation in macrophages, supporting a role for TSP1-linked lipid crosstalk in stromal-immune interactions. ConclusionOur study establishes advanced patient-derived co-culture models as a platform to investigate human TAM biology and stromal-immune interactions in CRC. Using these systems, we identify a fibroblast-associated TSP1-lipid axis linked to macrophage metabolic remodeling and TAM-like polarization, highlighting stromal metabolic communication as a potential targetable feature of the CRC microenvironment. Graphical abstract O_FIG O_LINKSMALLFIG WIDTH=176 HEIGHT=200 SRC="FIGDIR/small/728363v1_ufig1.gif" ALT="Figure 1"> View larger version (51K): org.highwire.dtl.DTLVardef@16d60aborg.highwire.dtl.DTLVardef@1e593e7org.highwire.dtl.DTLVardef@15124b0org.highwire.dtl.DTLVardef@3fca92_HPS_FORMAT_FIGEXP M_FIG C_FIG

High grade serous ovarian cancer patients initially respond to platinum-based chemotherapy, but usually relapse within two years and ultimately develop therapy resistance. Management of response and effective clinical decisions are currently based on unspecific biomarkers and limited imaging techniques, illustrating the clear clinical need for reliable predictors of response. In this work, we evaluated the performance of patient-derived organoids generated from ascitic fluid and functionally tested in parallel to the patients clinical course, in the prediction of treatment response, and guiding clinical decision-making in a patient-specific manner. Ascites derived organoids reliably recapitulated the histological and molecular features of a paradigmatic HGSOC patient with an apparent dissociated response, and demonstrated chemoresistance months before laparoscopy confirmed persistent inoperable disease with poor pathological response. Drug screening identified alternative therapeutic options, while multi-omics provided additional insights into the tumor-specific biological features, to assist in the personalized clinical management in ovarian cancer.

The development of cancer immunotherapies is hindered by the lack of human-relevant models that accurately translate to patient outcomes. We combine patient-derived colorectal tumor organoids (PDOs) and cancer-associated fibroblasts (CAFs) into floating extracellular matrix drops to form miniature colorectal tumors. These SHaking Organoid COcultures (SHOCOs) maintain immune cells in numbers, states and functional interactions that are more physiologically accurate than traditional PDO-based co-culture models. Immunocompetent SHOCOs treated with T-cell bispecific antibodies exhibited a robust anti-tumor response, in a concentration- and duration of treatment-dependent manner. By varying the stromal content, we found that fibroblasts present a physical barrier that hinders intratumoral T-cell infiltration. We also demonstrate that tumor-associated stroma can be exploited therapeutically in potentiating anti-tumor immune responses. SHOCOs could aid the battle against cancer both by providing fundamental insights into immune and stromal tumor biology, and by catalyzing the discovery of novel therapeutic approaches. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=143 SRC="FIGDIR/small/729459v1_ufig1.gif" ALT="Figure 1"> View larger version (78K): org.highwire.dtl.DTLVardef@1aed309org.highwire.dtl.DTLVardef@a11696org.highwire.dtl.DTLVardef@1d1d74dorg.highwire.dtl.DTLVardef@18e2c3f_HPS_FORMAT_FIGEXP M_FIG O_FLOATNOFigure 0C_FLOATNO / Graphical Abstract: Illustration of the SHOCO Model. (A) Overview of the components used in creating SHOCOs and the complex tumor microenvironment they replicate. Epithelial cells (pink), CAFs (red), CD8 T cell (blue), CD4 T cell (green). Characteristics of SHOCOs: (B) Emphasizing the role of CAFs in contracting and creating a denser microenvironment. (C) CAFs act as a physical barrier, preventing CD8 T cells from reaching tumor niches. (D) SHOCOs maintain a substantial myeloid population (violet) capable of performing antigen presentation. (E) T cells within SHOCOs mount an anti-tumor cytotoxic immune response as a result of immunotherapy. Granzymes (orange), cleaved Caspase-3/7 (yellow). C_FIG

Dendritic cells (DCs) are central orchestrators of antitumor immunity. Several DC subsets--including conventional type 1 (cDC1), conventional type 2 (cDC2), plasmacytoid DCs (pDCs), and mature DC populations--play distinct roles in immune surveillance, tumor control, immunotherapy response and prognosis. Recent findings suggest that cDC1 are spatially closed to CD8 T-cell and contribute to tertiary lymphoid structure formation in lung cancer. However, how other DC subsets interact with cDC1 to shape the tumor microenvironment (TME) remains largely unknown. Here, we analyzed the spatial distribution of major DC subsets, including cDC1, cDC2, mature DC and pDC, together with CD8 T cells in a cohort of anti-PD1-treated NSCLC patients and we deciphered the corresponding immune microenvironment behavior by paired transcriptomic analysis. We found that, while other DC subsets populated the stroma, cDC2 were localized both in the stroma and in tumor nests. Moreover, unlike other DC subsets, cDC2 abundancy did not affect ICB response both at transcriptomic and in situ analysis. We described spatial organization of DCs in megaclusters characterized by distinct proportions of DC subsets. Patients enriched in megaclusters involving variable proportion of pDC, cDC1 and mature DC, exhibited pro-inflammatory transcriptomic programs while those enriched in cDC2-based megaclusters showed limited immune activation features. Globally, DC in lung cancer were structured around three distinct DC spatial patterns, namely cDC1-driven, cDC2-driven and DC-Scattered, each defined by unique compositions of DC megaclusters, immune features and pathways activation profiles. Among them, the cDC1-driven pattern was associated to prolonged anti-PD1 response in two independent cohorts.

BackgroundMesothelioma (Me) is an aggressive cancer with limited response to conventional therapies. The tumors harsh microenvironment contributes to immune escape and therapy resistance and the effects of ICIs on Me are still unclear. Adenosine, an immunosuppressive molecule produced from AMP by the enzyme CD73, accumulates in hypoxic tumor areas. Elevated CD73 and adenosine receptor A2B (A2Br) levels on Me cells are linked to worse patient outcomes, indicating their important role in disease progression and potential as targets for treatment. AimThis study characterizes the Me-ME (micro environment) and evaluates the efficacy of TT-4 (A2B inibitor) and AB680 (CD73 inibitor), alone or with aPD-1, using 3D models in vitro and in vivo. MethodsCD73 and A2B receptor levels were quantified in tumor and normal samples using qRT-PCR and IHC. Cells lines were treated with CoCl2 to mimic hypoxia, then CD73, A2Br and related markers were analyzed. MSTO-211H and REN cells were silenced for CD73, grown as spheroids and adenosine release was measured. Co-culture spheroids of MSTO-211H and Jurkat cells were treated with AMP and CD73 inhibitor, then analyzed for viability and immune markers. An orthotopic Me model was established by injecting AB1-B/c-LUC cells and monitored by in vivo imaging. Proteomic analysis of spheroids was conducted to identify proteins and pathways involved. ResultsHypoxia boosts CD73 and A2Br expression in Me cells, leading to adenosine production via CD73. In 3D co-cultures, AB680 lowered Me cell viability and enhanced activation of Jurkat T cells. In mice, combining aPD-1 therapy with A2Br or CD73 inhibitors strongly reduced tumor growth. Proteomics identified 93 proteins influenced by adenosine signaling through A2B. ConclusionTargeting the adenosine pathway alongside PD-1 blockade offers a promising new immunotherapy strategy for Me.

Inflammation-driven tumor implantation, such as port-site metastasis (PSM) following laparoscopic gynecologic surgery and peritoneal seeding during post-surgical recurrence, represents an aggressive clinical problem that remains poorly understood and lacks targeted therapies. To address this, we developed a non-surgical Mesothelium-Inflammation/Injury-Metastasis (MIM) model and investigated the role of the IL-1{beta}/IL1R1/MYD88/IRAK1/4 axis and NLRP3 in epithelial ovarian cancer (EOC) seeding at inflamed or injured sites. This model created by a needle injury recapitulates inflammation-driven peritoneal seeding and mimics PSM and inflammation associated dissemination in peritoneum during recurrence. Seeding was dependent on Il1r1 but not Nlrp3, despite its role in regulating IL-1{beta} production, as Il1ra-/- and Nlrp3-/- mice phenocopied wild-type C57BL/6 mice. Given the limited antitumor efficacy of IL-1{beta}-targeting agents such as Anakinra and Canakinumab, we focused on IRAK4 as a therapeutic target. IRAK4 knockdown significantly prolonged survival, reduced tumor cell adhesion, downregulated E-cadherin and Wnt4, and induced S-phase/mitotic arrest. This led to the development of UR241-2, a small-molecule IRAK4 inhibitor, which was validated through molecular simulations, hotspot analysis, nanoBRET, global kinome profiling, and NF-{kappa}{beta} reporter assays. UR241-2 inhibited NF-{kappa}{beta} nuclear translocation and blocked IL-1{beta}-induced IRAK4 phosphorylation. UR241-2 exhibited favorable drug-like properties, including absence of CYP or hERG inhibition, and acceptable CaCo-2 permeability, plasma protein binding, microsomal stability, and pharmacokinetics. In vivo, UR241-2 reduced SKOV3 xenograft growth, suppressed mesothelial seeding, and increased MHC-II macrophages and activated neutrophils in syngeneic high-grade epithelial ovarian HGS3 tumors. RNA-seq revealed enrichment of neutrophil activation signatures and suppression of extracellular matrix (ECM) gene programs. Together, these findings establish a role for the IL-1{beta}/IL1R1/IRAK4 axis in inflammation-driven PSM and peritoneal seeding and ECM regulation in EOC, and demonstrate that IRAK4 inhibition activates antitumor immune responses, providing a therapeutic strategy to block metastatic seeding and improve tumor control.

While prostate cancer (PC) is defined as immunologically cold, limiting the efficacy of immune checkpoint inhibitors, therapeutic vaccination targeting tumor-associated antigens represents an attractive strategy to promote disease control in low volume metastatic patients. The UV1 cancer vaccine is based on immunization with tripeptide fragments from human telomerase reverse transcriptase (hTERT) and a phase II clinical trial demonstrated induction of robust T cell response in men with de novo metastatic castration-sensitive prostate cancer (mCSPC). Comparison with long-term survival data of non-metastatic CSPC patients as reference showed that despite metastatic disease at diagnosis, UV1-treated patients who mounted an early vaccine-induced immune response achieved progression-free and overall survival comparable to non-metastatic patients. We examined biological determinants of clinical benefit following UV1 vaccination including tumor transcriptome and T cell receptor (TCR) profiling from circulating and tissue resident T-cells of the 22 men enrolled. Analysis of diagnostic and post-UV1 treatment biopsies revealed that low baseline exhaustion of T cells and higher CD8+ T cell abundance are associated with early immune response to the vaccine and longer survival. Moreover, we identified specific TCR motifs relative to early responders, that can indicate potential benefit from UV1 vaccination. These findings indicate that baseline intratumoral T cell exhaustion state and repertoire shape responsiveness to hTERT vaccination and long-term outcome. Overall, our study underlines how baseline immune profiling may be used as a companion biomarker to predict mCSPC patients most likely to benefit from therapeutic vaccination.

Recent studies have suggested that S6 kinase 1 (S6K1) contributes to DNA repair (DR). However, the specific pathways and mechanisms involved in this regulation remain unclear. Moreover, it has not been investigated whether S6K2, a functional homologue of S6K1, also contributes to DR. In this study, we investigated the function of both S6K1 and S6K2 (S6K1/2) proteins in DR and demonstrate that both are important for efficient Homologous Recombination-mediated repair (HR). Double knockout of S6K1/2 prevented the formation of BRCA1 and RAD51 foci and increases sensitivity to DNA-damaging agents such as PARP1 inhibitors, cisplatin, and X-ray irradiation. In addition, double knockout of S6K1/2 increased markers of genomic instability, while single knockout had little effect on HR markers and genome stability, which suggests that one kinase can compensate for the loss of the other. Mechanistically, we show that S6K1/2 regulate BRCA1 protein stability, limiting its degradation by the proteasome. Finally, pharmacological inhibition of S6K1/2 sensitised HR-proficient breast cancer cells to Olaparib. Our findings clarify the role of S6K1/2 proteins in HR and suggest that targeting these kinases may be a therapeutic strategy to enhance PARP inhibitor efficacy in HR-proficient tumours.

BackgroundTumor-associated neutrophils (TANs) are emerging as functionally heterogeneous and plastic cells in the tumor microenvironment. In immunologically cold tumors, elevated neutrophil abundance correlates with poor prognosis and resistance to immune checkpoint inhibition (ICI). Whether distinct anti-tumoral neutrophil states can be induced by different immunotherapies and how they relate to treatment efficacy remains unclear. MethodsUsing the syngeneic MOC2-huEGFR (M2h) mouse model of head and neck squamous cell cancer (HNSCC), we treated tumor-bearing mice with agonistic anti-CD40 monoclonal antibody (mAb) (aCD40), TNF, Cetuximab, or a combination of all three, designated Neutrophil Activating Therapy (NAT). In addition to evaluating anti-tumor efficacy, we performed single-cell multiomics RNA and protein sequencing, followed by bioinformatics analyses and flow cytometry validation. NAT-induced anti-tumor efficacy and related neutrophil states were also assessed in another cold tumor model, 9464D-GD2 neuroblastoma. Murine treatment-induced neutrophil gene signatures were then evaluated using clinical, proteomic, and transcriptomic data from HNSCC patients. ResultsFive transcriptionally distinct neutrophil states (N0-N4), including precursor state CD49d+ N4, were identified using the M2h model. N0 neutrophils (immunosuppressive/quiescent) dominated untreated tumors, but not in successful treatments. ISG+ N1 neutrophils and CCR3+ N3 neutrophils expanded by aCD40, TNF, and NAT treatment with anti-tumoral gene signatures and found more interacting with CD8+ T cells from bioinformatics analysis. N2 neutrophils reflected a recently established hypoxia-adapted state found in all treatments. ICAM1 (CD54) emerged as a marker of treatment-induced neutrophil activation, discriminating N1, N2, and N3 neutrophils from N0 neutrophils, validated by flow cytometry. In the 9464D-GD2 neuroblastoma model, NAT treatment also reduced the N0 dominance seen in untreated tumors in the HNSCC model but failed to induce anti-tumoral neutrophil states. In 23 HNSCC patients who received ICI therapy, ICAM1 protein expression in neutrophils trended toward association with responder status (TMA-level p=0.029), and ICAM1 neutrophil gene expression also trended toward association with improved overall survival in TCGA data (HR=0.75, p=0.059). ConclusionsDistinct immunotherapy-induced neutrophil states are defined by transcriptional profiles enriched in different functional pathways, associated with both anti-tumor and pro-tumor signatures. ICAM1 identifies activated neutrophils and potentially serves as a biomarker of ICI response in HNSCC, warranting further clinical validation. WHAT IS ALREADY KNOWN ON THIS TOPICNeutrophil heterogeneity has received increasing attention, with studies identifying antitumoral neutrophil populations, either at baseline or induced by treatment. Several effective treatment regimens involve an anti-CD40 agonist (aCD40) antibody, among them Neutrophil Activating Therapy (NAT), which combines aCD40, TNF, and a tumor antigen binding antibody designed to reprogram neutrophils. NAT could thus be particularly effective in cold, myeloid-rich tumors that are largely unresponsive to conventional immunotherapies such as checkpoint blockade, enacting these anti-tumoral effects through similar and different mechanisms; however, this has not been tested. WHAT THIS STUDY ADDSThis study adds a single-cell multi-omics framework for defining treatment-induced neutrophil heterogeneity in MOC2-huEGFR and 9464D-GD2 tumors, two immunologically cold models. It highlights ICAM1/CD54 and interferon-stimulated genes as markers of a dominant antitumor neutrophil state, while showing that neutrophil state composition variy across tumor models. HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE, OR POLICYThese results support the efficacy of a myeloid-modulating therapy built around aCD40 and TNF in a cold murine head and neck cancer model, and to a lesser extent in a cold murine neuroblastoma model. ICAM1/CD54 expression in neutrophils was also identified as a promising marker of antitumor activity and treatment response. More broadly, this work suggests that incorporating aCD40 and/or TNF into existing treatment regimens could improve outcomes, while ICAM1/CD54-high neutrophils may serve as a useful therapeutic readout.

PurposeBladder cancer (BLCA) is a heterogeneous tumor type. Only one third of muscle-invasive (MIBC) patients respond to immune checkpoint inhibitors (ICIs). Reliable resistance markers are needed to guide clinical decisions. We investigated the nerve growth factor receptor (NGFR) in BLCA and analyzed its correlation with disease progression and response to immunotherapy. Experimental DesignWe analyzed NGFR expression in BLCA cell lines, organoids, mouse models and patient samples. The cohorts used were The Cancer Genome Atlas (TCGA), enriched in muscle-invasive bladder cancer (MIBC) (n=407); IMvigor210, representing MIBC patients treated with ICIs (n=348); and UROMOL2, as a non-muscle-invasive bladder cancer (NMIBC)-specific cohort (n=535). IMvigor010 was also included (n=728). Patients were stratified by NGFR expression quartiles. We analyzed survival and tumor subtypes and performed stromal deconvolution and functional profiling. We assessed stemness- and invasion-related features in SCaBER cells. ResultsNGFR marks a basal tumor cell subcluster and is independently associated with poor prognosis in TCGA and IMvigor210. NGFR-high tumors show stromal content enriched in cancer-associated fibroblasts, lower neoantigen burden, higher CD8+ T effector signature together with an immune-excluded phenotype, and a CAF-specific TGF{beta} signature. In the immunotherapy-treated cohort, high NGFR expression was also associated with poorer outcome. Functionally, NGFR appears to promote a stem-like/pro-invasive program in BLCA cells. ConclusionsNGFR identifies a basal-like BLCA subpopulation linked to poor survival, while its association with immunotherapy response requires further validation. In addition, our in vitro analyses support a role of NGFR in stem-like and invasive traits, highlighting its relevance as a biomarker in BLCA.

Osteosarcoma (OS) and Ewing sarcoma (EWS) are the most common malignant bone tumors in children and adolescents, with survival rates around 25% in metastatic disease and few advances in treatment in decades. High DDX3 expression has been reported across various sarcoma subtypes. Depending on the context, DDX3 appears to have opposing roles in regulating the tumor immune microenvironment. Within macrophages, DDX3 promotes inflammatory cytokine expression and supports immune cell function. In contrast, in tumor cells DDX3 suppresses a pro-inflammatory state by unwinding dsRNAs, preventing a Type I interferon response. We show that inhibiting DDX3 with RK-33 leads to dsRNA accumulation, inducing a Type I interferon response and broader inflammatory gene expression changes across multiple sarcoma models, shifting macrophage polarization toward a pro-inflammatory M1-like phenotype. To evaluate whether this innate immune microenvironmental remodeling could translate into clinical benefit, we assessed the therapeutic efficacy of RK-33 alone or in combination with mifamurtide, an immunostimulant, in immune competent mouse models of osteosarcoma, with metastatic burden as the primary outcome. We found that in the absence of MYC over-expression, the combination treatment significantly reduced metastatic spread. These findings support targeting DDX3 as a novel innate immune based therapeutic strategy and highlight that the tumors molecular landscape critically influences therapeutic responsiveness.

Tumours reshape their surrounding extracellular matrix (ECM), creating a microenvironment with altered chemical and mechanical properties. Integrins detect these changes, linking the ECM to the intracellular cytoskeleton and promoting cell survival, motility, invasion and differentiation, and further ECM remodelling. However, the molecular mechanisms by which tumours remodel their ECM are not well understood. Here, we found that the cytokine oncostatin M (OSM) promotes breast cancer progression by activating ECM remodelling and integrin signalling in cancer cells, as shown by combining complementary in vitro, in ovo and in vivo models, and transcriptomic and proteomic analyses. We demonstrated that OSM induces fibrosis, characterized by increased collagen deposition and hydroxylation, together with activation of ECM and ECM-associated proteins and modifiers such as fibronectin, tenascin C, LOX, PLOD2 and collagen prolyl hydroxylases. OSM also promoted the expression of integrins. Integrin alpha 5 (ITGA5) was identified as an important mediator of OSM-effects. ITGA5 blockade, by means of small interference RNA and therapeutic inhibition with a blocking peptide, abrogated OSM-induced cancer cell migration, invasion and in vivo tumour growth. In addition, OSM blockade with a specific inhibitor reduced tumour growth in an immunocompetent mouse model. Our results are clinically relevant as the expression of integrins and matrisome genes strongly correlated with OSM and its receptor OSMR in breast cancer clinical samples; and co-expression of OSMR and ITGA5 associated with decreased survival in basal breast cancer patients. Collectively, our data reinforce the potential of the OSM-ITGA5 axis as a therapeutic target in this breast cancer subtype, which shows the highest mortality rates.

Pleural mesothelioma (PM) is a rare, aggressive cancer primarily caused by asbestos exposure and remains resistant to conventional chemotherapy. Although dual immune checkpoint inhibition (anti-PD-1/anti-CTLA-4) is now approved as first-line therapy, clinical benefit is limited to a small subset of patients, necessitating the need for alternative strategies. Oncolytic viruses (OVs) represent a promising approach as they selectively infect and lyse tumor cells while reprogramming the immunosuppressive tumor microenvironment (TME) into an immunostimulatory state. In PM, we previously showed that the attenuated Schwarz strain of measles virus (MV) oncolytic activity is mainly dependent on alterations in the type I interferon (IFN-I) pathway, rendering tumor cells sensitive to infection. Recently, we showed that monocytes/macrophages exposed to MV produce IFN-I, which protects PM cells via paracrine IFNAR signaling. This underscores the necessity of modeling the TME to accurately evaluate OV efficacy. Conventional rodent models are non-permissive to MV, and availability of fresh human PM tissue is scarce. We therefore developed a humanized 3D "vascularized mesothelioma-on-chip" (VMOC) model using microfluidic chips. It comprises two perfusable endothelial-lined parental vessels flanking a central secondary microvascular network (MVN), generated using human umbilical vein endothelial cells (HUVECs) embedded in fibrin and co-cultured alongside PM cells and primary human lung fibroblasts (hLFs). We characterized the integrity and functionality of the endothelial compartment as well as the cellular heterogeneity in VMOC using single-cell RNA sequencing. After administration of MV via the endothelial network, we observed infection and death of PM cells in addition to a strong activation of the type I interferon pathway and production of multiple inflammatory mediators. The VMOC model enables in vitro study of both MV infection and TME reprogramming, paving the way for a better understanding of the role of the TME in the response to treatment and for supporting the development of more personalized, targeted therapies for PM.

BackgroundPancreatic ductal adenocarcinoma (PDAC) is the paradigmatic immunotherapy-refractory cancer, with a 5-year survival of approximately 12% and minimal benefit from immune checkpoint blockade (ICB). The dominant mechanistic explanation classifies PDAC as a T cell-excluded "cold" tumor, implying that no functional anti-tumor T cells are available for checkpoint release. Whether this Block-strategy view is correct has not been re-examined under integrated evasion-framework analysis. MethodsWe applied a previously developed 16-module immune evasion framework to TCGA-PAAD (n=183), integrated with hub-cytokine analysis (IL-10/TGF-{beta}), Kv1.3-immune channelome data, and clinical trial mapping (12,007 trials). Single-cell validation used two independent PDAC cohorts retrieved through TISCH2: PAAD_CRA001160 (Peng 2019, 35 samples [24 PDAC + 11 adjacent normal], 57,443 cells) and PAAD_GSE154778 (Lin 2020, 16 samples, 14,953 cells), examined for CD8A, TOX, PRF1, KCNA3, and FAP expression by cell type. ResultsPDAC scored highest in CAF Wall (z=0.768) and Platelet Cloak (z=0.663) modules; strategy classification yielded Brake -- not Block -- driven by a positive KCNA3-survival relationship (HR=0.649, 95% CI 0.43-0.97, p=0.037). Single-cell qualitative analysis of TISCH2 violin plots showed that CD8 exhausted T cells (CD8Tex) carried (i) high CD8A, (ii) the highest TOX expression among annotated cell types, (iii) preserved PRF1, and (iv) high KCNA3 expression. FAP was strongly localized to fibroblasts (peak [~]3.0 vs. <0.5 elsewhere). The pattern was reproduced in the second cohort. The optimal three-module attack (MHC restoration + CAF disruption + VEGF blockade) suppressed 10 of 16 evasion modules in silico (62.5%); zero of 370 PDAC immunotherapy trials test this combination. ConclusionsPDAC may not be T cell-cold but T cell-trapped: CD8 T cells with intact Kv1.3 channels appear immobilized behind a FAP-positive cancer-associated fibroblast wall. ICB monotherapy is mechanistically insufficient because the brake is engaged on T cells that cannot reach the tumor. The framework predicts that triple-targeted intervention -- checkpoint release + CAF wall disruption + vascular normalization -- is the minimum effective strategy. This is a hypothesis-generating computational analysis; prospective experimental and clinical validation are required.

Background: Immune checkpoint inhibitors have transformed cancer treatment, yet a large number of patients fail to respond. Identifying molecular characteristics that predict response before treatment initiation remains an unmet need. Towards that end, this study presents a large-scale integrative analysis of existing single-cell and bulk tissue datasets, aimed at identifying predictive features while providing insights into their cellular origin and potential function within the tumor microenvironment. Methods: A stepwise analysis was performed using single-cell RNA-sequencing data from 60 melanoma patients at baseline, separated into discovery (n=41) and validation (n=19) sets. An integrated bulk transcriptomics dataset (n=128) from melanoma patients and a bladder cancer dataset (n=298) were used for further validation. Results: Integrative analysis of melanoma single-cell datasets revealed that responders exhibit distinct molecular profiles across multiple cell types compared to non-responders. Notably, these included downregulation of the TNFR superfamily and other immunosuppressive genes (TNFRSF18, TNFRSF9, TNFRSF4, LGALS1, BATF, IL12RB2, LINGO1, DUSP4, SDC4, VCAM1) in T-cells. By investigating the findings from the immune cell populations in the bulk tumor context, 13 transcripts were found to be consistently associated with response across all cohorts. These were differentially expressed in T-cells (SELL, EPB41, CD96, UHFR2, LINGO1, LGALS1), B-cells (ALDH5A1), NK cells (PLEC, PDGFRB) and Monocytes (TLR10, ST6GAL1, IKZF1, MPRIP). A predictive model based on these features effectively discriminated responders from non-responders in melanoma (AUC=0.73). The model maintained significant predictive power in an independent bladder cancer dataset (IMvigor210; AUC=0.64). Of high clinical relevance, it demonstrated enhanced performance in identifying responders among patients with low tumor mutational burden (AUC=0.75). Conclusion: Our study reveals pre-treatment molecular features related to immune-cancer crosstalk that are associated with response to immunotherapy. A 13-gene model demonstrates potential added clinical value in stratifying responders, particularly in patients with low tumor mutational burden, meriting further validation.

The scaffold protein FRS2 is central to FGFR signaling, linking receptor activation to MAPK/ERK and PI3K/AKT pathways. Elevated FRS2 expression correlates with aggressive tumor phenotypes and poor prognosis across multiple cancers, including the pediatric cerebellar tumor medulloblastoma (MB). Here, we characterized FRS2s subcellular localization and interactome in MB cells, employing live-cell imaging, phosphoproteomics, immunoprecipitation, and APEX2-based proximity labeling. We found that increased FRS2 expression is associated with increased motile and invasive behavior in MB tumor cells. We furthermore identified novel candidate FRS2-associated proteins involved in actin cytoskeleton remodeling, cell junction assembly, and translation initiation, which indicate a growth factor-dependent reorganization of the FRS2 signalosome. Our data furthermore indicate a regulatory role of FRS2 in directing subcellular distribution of the cell junction and cell motility regulator TJP1. Our findings highlight the relevance of FRS2 as a mediator of cell motility and invasiveness and provide candidate proteins associated with FRS2 that are involved in cellular processes governing migration and invasion. This study thus provides a framework for exploring the FRS2 interactome as a possible target to attenuate FGFR-driven oncogenic processes with next-generation therapeutic strategies.

Primary trastuzumab resistance remains a major challenge in the treatment of HER2-positive breast cancer, with limited therapeutic options highlighting the need for deeper mechanistic insight. Here, integrative analysis of epigenomic and three-dimensional chromatin architecture reveals widespread remodeling of the regulatory landscape in resistant cells. Alterations in promoter-associated histone modifications?particularly H3K4me3 and H3K27me3?together with changes in active enhancer activity and promoter-enhancer interactions, appear to be key drivers of transcriptional reprogramming underlying resistance. As an illustrative example, SGK1 exhibits epigenetic activation in resistant cells, characterized by increased promoter H3K4me3 and enhanced chromatin interactions, consistent with its role in supporting cell survival, proliferation and metastasis. Overall, our findings highlight epigenetic and chromatin structural alterations as central mechanisms of primary trastuzumab resistance, providing a framework for novel therapeutic strategies development.