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Molecular Cancer

Springer Science and Business Media LLC

Preprints posted in the last 30 days, ranked by how well they match Molecular Cancer's content profile, based on 16 papers previously published here. The average preprint has a 0.01% match score for this journal, so anything above that is already an above-average fit.

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Ouro-seq: Improved Recovery of Full-Length circRNAs from Samples with Limited RNA Content

Wever, B. M. M.; Burgt, Y. v. d.; Mouliere, F.; Pegtel, D. M.; Bleeker, M. C. G.; Steenbergen, R. D. M.; Moldovan, N.

2026-08-18 cancer biology 10.64898/2026.08.14.744779 medRxiv
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Circular RNAs (circRNAs) are an emerging class of RNAs with biomarker potential, but their detection in liquid biopsies is challenging due to low abundance. We developed Ouro-seq, a novel long-read sequencing protocol optimized for full-length circRNA recovery. Applied to urine, cervico-vaginal self-samples from cervical cancer patients, and plasma from lung cancer patients and controls, Ouro-seq recovered 2-5 times more and substantially longer circRNA molecules than conventional methods. Plasma contained predominantly exonic circRNAs, while urine and cervico-vaginal samples were dominated by previously undercharacterized intergenic circRNAs. We also identified extensive alternative circularization and splicing events. Functional analysis revealed distinct specialization patterns: exonic circRNAs showed enhanced miRNA sponging potential, while circRNAs from unplaced genomic scaffolds demonstrated greater peptide-coding capacity. This study establishes Ouro-seq as a valuable tool for comprehensive circRNA characterization in low-yield clinical samples and advances circRNA biology understanding with potential biomarker discovery and disease monitoring applications. MotivationWhile circular RNAs (circRNAs) constitute a minor fraction of total RNA, they may play critical roles in cancer development. CircRNA concentrations are typically too low for detection by Oxford Nanopore Long-Read Sequencing (LRS), particularly in samples with limited RNA content, such as liquid biopsies. Consequently, LRS-based circRNA analysis from liquid biopsies remains unexplored. To overcome these technical limitations, we developed an optimized circRNA enrichment method utilizing short-amplicon suppression, enabling circRNA profiling from urine, plasma, and cervico-vaginal samples.

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CRISPR-Mediated Targeting of BRAF Oncogenes in Pediatric Low-Grade Glioma

George, C. A.; Brown, M. E.; Rana, P.; Killebrew, D. A.; Wilson, R. C.

2026-08-13 cancer biology 10.64898/2026.08.12.744431 medRxiv
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SummaryA catch-all intronic guide RNA pair excises the KIAA1549--BRAF oncofusion across its major variants, with productive junction excision confirmed by gain-of-function PCR in patient-derived glioma cells. An allele-specific guide selectively disrupts BRAF V600E, in patient-derived pediatric low-grade glioma cells. Pediatric low-grade glioma (pLGG) is the most common brain tumor of childhood, accounting for 30--50% of all pediatric central nervous system malignancies1. The disease is almost universally driven by activating mutations in the BRAF serine/threonine kinase: a chromosomal tandem duplication generating the KIAA1549--BRAF oncofusion in approximately 70% of cases, or the BRAF V600E gain-of-function point mutation in approximately 15%2. Current targeted pharmacotherapies, including the RAF inhibitor tovorafenib, require continuous dosing, are not allele-specific, and carry risks of long-term toxicity in children. A one-time genomic intervention that permanently disables the oncogenic BRAF alteration while preserving wild-type BRAF signaling represents a compelling therapeutic alternative. In this study, we describe the design and experimental validation of allele-specific CRISPR guide RNAs targeting both the KIAA1549--BRAF oncofusion and the BRAF V600E point mutation. For the oncofusion, we developed a double-cut intronic excision strategy in which a guide RNA targeting KIAA1549 intron 14 is paired with a guide RNA targeting BRAF intron 11. Because the genomic breakpoints of all four major fusion variants (KB 16:9, 15:9, 16:11, and 15:11) fall within these introns, a single guide pair can address the full landscape of fusion heterogeneity in a single intervention. For BRAF V600E, we exploited a unique PAM sequence created by the pathogenic TBA transversion at codon 600, enabling allele-specific SpCas9 and AsCas12a guide designs that distinguish the mutant from the wild-type allele at single-nucleotide resolution. We screened guide RNA candidates by ribonucleoprotein (RNP) nucleofection in A375 human melanoma cells (BRAF V600E homozygous) and in patient-derived 3635 PXA glioma cells (BRAF V600E heterozygous). The top KIAA1549 intron 14 guide, K9_i14_A_Cas9, achieved 66% indel frequency in A375 cells. The top BRAF intron 11 guides, B_i11_A_Cas9 and B_i11_D_Cas9, achieved 84% and 85% indel frequency, respectively. For BRAF V600E, the best allele-specific SpCas9 guide achieved l57% editing in A375 cells and l74% editing in 3635 PXA patient-derived glioma cells. Dual-cut excision of the KIAA1549--BRAF junction was confirmed by a gain-of-function PCR assay designed to detect the excision junction amplicon ([~]191 bp) produced by NHEJ-mediated rejoining of the KIAA1549 intron 14 and BRAF intron 11 cut ends.

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Functional proteomics identifies targetable cancer-associated fibroblast programs in head and neck cancer

Prieto-Fernandez, L.; Martinez-Carrillo, A.; de Villalain, L.; Garcia-Torre, A.; de Luxan-Delgado, B.; Hermida-Prado, F.; Navarro-Lerida, I.; Ribas, C.; Garcia-Escudero, R.; Rodrigo, J. P.; de Vicente, J. C.; Rodriguez-Santamarta, T.; Garcia-Pedrero, J. M.; Alvarez-Teijeiro, S.

2026-08-21 cancer biology 10.64898/2026.08.18.745234 medRxiv
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Head and neck squamous cell carcinoma (HNSCC) remains clinically challenging, with limited molecularly targeted options and a strong dependence on the tumor microenvironment. Cancer-associated fibroblasts (CAFs) are major stromal regulators that shape tumor progression, extracellular matrix remodeling, invasion, and therapeutic response. However, how CAF heterogeneity and plasticity translate into distinct tumor-promoting functions and targetable vulnerabilities remains insufficiently defined. Here, we integrated patient-matched primary CAFs and normal fibroblasts with 3D functional assays, tumor-stroma co-culture models, quantitative extracellular matrix analysis, whole-proteome profiling, and pharmacological perturbation. Primary fibroblast populations displayed marked interpatient heterogeneity and context-dependent plasticity in invasion, contractility, and responsiveness to tumor-derived signals, whereas enhanced fibronectin-rich matrix deposition and disorganization emerged as a conserved CAF-associated feature. Both normal fibroblasts and CAFs promoted HNSCC cell invasion in a population-dependent manner, whereas CAFs consistently induced less compact and more dispersed tumor nest architectures. Integrative functional analyses identified distinct CAF phenotypes characterized by either invasive and matrix-remodeling activity or high responsiveness to tumor-derived cues. Proteomic profiling revealed recurrent enrichment of adhesion, cytoskeletal, and extracellular matrix programs and guided the selection of pharmacological inhibitors aimed at modulating specific CAF-mediated pro-tumoral functions. Pharmacological targeting selectively altered these functions: CHI3L1 inhibition disrupted fibronectin matrix deposition, broad phosphodiesterase inhibition increased matrix alignment, and FZD7 inhibition consistently blocked tumor-induced CAF invasion across all tested populations. These findings define functionally distinct and pharmacologically targetable CAF programs in HNSCC and support stromal-directed interventions as a rational component of future combination treatment strategies.

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RERE and the Mediator complex cooperate with EWSR1::FLI1 in the reprogramming of Translation and Alternative Splicing, the latter being a therapeutically targetable vulnerability in Ewing sarcoma

Cuervas, I.; Bonnal, S.; Andrades, E.; Mateo-Lozano, S.; Sanchez-Jimenez, M.; Berenguer-Molins, P.; Acedo-Terrrades, A.; Bodalo-Torruella, M.; Perera-Bel, J.; Gimeno, R.; Roldan, M.; Prada, E.; Valcarcel, J.; Mora, J.; Hernandez-Munoz, I.

2026-08-13 cancer biology 10.64898/2026.08.13.744586 medRxiv
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Ewing Sarcoma (ES) is an aggressive neoplasm arising in bones and soft tissues driven by the oncogenic fusion EWSR1::FLI1. Through epigenetic deregulation, EWSR1::FLI1 generates de novo super-enhancers that control the expression of key genes for tumor cell maintenance. By an integrative in silico analysis, we identified the subunit of the Mediator complex MED13L and RERE, a member of the atrophin family of arginine-glutamic acid dipeptide repeat-containing proteins, as genes regulated by EWSR1::FLI1-bound super-enhancers. We confirmed that EWSR1::FLI1 regulates MED13L and RERE expression in ES cell lines and showed that these proteins are highly expressed in Ewing primary tumors. Besides the well-established role of the Mediator complex in transcriptional regulation given its association with the RNA polymerase II, in ES cells the DNA binding sites of MED13L overlap with those of RERE and EWSR1::FLI1 in genes that control protein translation and alternative splicing (AS). Accordingly, the expression of various spliceosome components is co-regulated by MED13L, RERE and the oncogene, leading to AS in ES cells. We identified RBM39, a splicing factor downregulated after MED13L and RERE depletion, as a direct transcriptional target of EWSR1::FLI1. Consistently, in vitro viability experiments using indisulam, which induces selective DCAF15-dependent proteosome degradation of RBM39, demonstrate ES cells highly and specifically sensitive to RBM39 inhibition. In vivo experiments with mice xenografted with ES cells show complete tumor regression with indisulam, highlighting the potential of this approach as a novel and promising therapeutic strategy for Ewing sarcoma. STATEMENT OF SIGNIFICANCEEwing sarcoma (ES) is characterized by FET::ETS oncoproteins that act as pioneer transcription factors. Here, we identified two genes controlled by EWSR1::FLI1-bound super-enhancers, MED13L and RERE, and characterized the mechanism by which these proteins cooperate with the oncogene to regulate RNA metabolism and ribosomal processes in ES cells. These findings have led to the identification of the splicing factor RBM39 as a vulnerability in ES, as supported by the extraordinary sensitivity of these tumors to monotherapy with RBM39 degrader indisulam.

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Atypical MDM2 p53 Regulation and Chemosensitivity Induced by Proximal PAS Deletion

Kim, M.; Yoon, C.; Jun, J.; Lee, Y.; Chung, H.; Kim, Y.

2026-08-24 cancer biology 10.64898/2026.08.23.746494 medRxiv
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This study proposes a novel therapeutic strategy to suppress cancer growth by modulating the MDM2-p53 axis via Alternative Polyadenylation (APA). MDM2 normally promotes tumorigenesis by ubiquitinating and degrading the tumor suppressor p53. In cancer cells, preferential use of proximal polyadenylation signals (PAS) results in shortened 3'UTRs, allowing oncogenic transcripts like MDM2 to evade nuclear sequestration mediated by Inverted Alu (IRAlu) double-stranded RNA structures. We hypothesized that forcing distal PAS usage would elongate the MDM2 mRNA, promoting its nuclear retention and reducing protein translation, thereby restoring p53 activity. Using CRISPR-Cas9, we targeted and deleted the most frequent proximal PAS in the MDM2 3'UTR of A549 cells. Successful genome editing was confirmed via PCR. As expected, Western blot analysis showed a significant reduction in MDM2 expression in PAS-edited cells. However, experimental outcomes contradicted our initial hypothesis: edited cells exhibited higher viability under doxorubicin treatment compared to wild-type cells. Furthermore, despite decreased MDM2 levels, a concurrent reduction in phosphorylated p53 (p-p53) was observed. These unexpected results suggest that MDM2 3'UTR elongation may trigger a non-canonical regulatory mechanism that bypasses the traditional MDM2-p53 interaction. This study highlights the complexity of post-transcriptional regulation and suggests that APA-mediated gene modulation can induce unforeseen compensatory survival pathways in cancer cells, necessitating further investigation into the broader functional landscape of elongated 3'UTRs.

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Multimodal spatial-omics reveal the heterogeneity and intercellular network characteristics of papillary craniopharyngiomas.

Jiang, Y.; Luo, H.; Zheng, H.; Li, C.; Zan, X.; Xu, J.; Chen, Y.

2026-08-24 cancer biology 10.64898/2026.08.20.746031 medRxiv
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Despite significant advancements in microsurgical techniques in recent years, the treatment and prognosis of craniopharyngiomas remain unsatisfactory. As a central nervous system tumor located adjacent to important brain structures such as the hypothalamus-pituitary axis and accompanied by a highly inflammatory microenvironment, the tumor heterogeneity and tumor microenvironment characteristics of papillary craniopharyngiomas (PCPs) remain unclear. In this study, we integrated multimodal single-cell and spatial profiling from PCP tissue and peripheral blood mononuclear cells (PBMCs) to elucidate the tumor heterogeneity and microenvironment characteristics of PCP. Our single-cell and spatial analyses defined four specific tumor cell states in PCP, representing specific transcriptional regulatory programs and spatial heterogeneity characteristics during tumor progression. By constructing a spatial niche composed of tumor, immune, and stromal cells, we analyzed the cellular and spatial ecosystem of PCP at multiple levels to further assess the communication relationships between different tumor cell states and microenvironment cells. This study established a multidimensional molecular atlas of PCP from the perspectives of cell state, spatial structure, and microenvironment interactions, providing a foundation for understanding its biological behavior and exploring new intervention strategies.

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A blood-based signature of cytoskeletal and extracellular remodeling for risk stratification of intraductal papillary mucinous neoplasms

Patterson, L. L.; Ballaro, R.; Chen, Y.; Vilchis Celis, A.; Zuo, M.; Chellakkan Selvanesan, B.; Flores Villanueva, A.; Irajizad, E.; Koay, E.; Kim, M. P.; Reinhart-King, C.; Tran, T.; Maitra, A.; Zhang, J.; Schmidt, C. M.; Hanash, S.; Fahrmann, J. F.

2026-08-11 oncology 10.64898/2026.08.09.26360008 medRxiv
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Abstract Background: Intraductal papillary mucinous neoplasms (IPMNs) are recognized as precursor lesions to pancreatic ductal adenocarcinoma (PDAC). However, the molecular programs underlying progression from low-grade dysplasia to advanced disease remain incompletely characterized. Herein, we performed an integrated plasma and tissue-proteomic analyses coupled with spatial and single-cell transcriptomics to identify biologically coherent remodeling programs reflected in circulation that distinguish IPMN by dysplasia grade and invasive disease. Methods: Using the O-link proximity extension assay platform, a panel of 1,104 proteins were quantified in plasma samples collected from patients with low-grade (LG) IPMN (n=30), high-grade (HG) IPMN with or without associated PDAC (IPMN/PDAC; n=40) and PDAC without IPMN (n=8). Predictive performance of individual biomarkers were assessed; likelihood ratio testing was performed to identify protein biomarkers that were complementarity with CA19-9 for risk of malignancy of IPMN. Findings were intersected with available spatial (N= 13) and single-cell (N= 6) transcriptomic datasets of IPMN tissues as well as mass spectrometry-based proteomic profiles of an independent set of resected human IPMN tissues (N= 9). Results: A total of 28, 43, and 35 circulating proteins were found to be differential in HG, IPMN/PDAC, and HG + IPMN/PDAC cases compared to LG IPMN. Among differential proteins were known PDAC-associated markers CEACAM5, CTRC, and REG3A as well as several biomarkers reflecting cytoskeletal and extracellular matrix remodeling and inflammatory processes. Focusing on cytoskeletal and ECM-related proteins and using likelihood ratio testing, an OR rule considering CA19-9, BGN, and ITGB1BP1 achieved overall sensitivity of 48.7% for HG + IPMN/PDAC, including 38.1% sensitivity for HG IPMN, at an overall specificity of 90%, which was improved compared to that of CA19-9 alone (overall sensitivity of 28.2%; McNemar Exact test 1-sided p-value: 0.011). Integrated proteomic and spatial transcriptomic datasets of IPMN tissues revealed coordinated alterations cytoskeletal and ECM remodeling and elevated matrix stiffness as prominent features associated with IPMN/PDAC, which paralleled concordant increases in BGN and ITGB1BP1. Cell-type of origin analyses based on spatial and single-cell data further revealed fibroblasts and myeloid cells as primary contributors to expression levels of BGN whereas ITGB1BP1 was primarily expressed in neoplastic epithelium. Conclusion: Advanced IPMN dysplasia and invasive disease are characterized by coordinated tissue remodeling programs that are systemically reflected in circulating proteomic profiles. Blood-based biomarkers identified through our study, such as BGN and ITB1BP1, have potential to improve upon CA19-9 for risk stratification of IPMN to better guide clinical management.

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Spatial multi-omics analysis reveals vimentin-high macrophages-endothelial cells niche shapes CAFs heterogeneity in colorectal cancer metastasis

Li, M.; Xu, B.; Wu, J.; Zhang, Z.; Chen, B.; Chen, Y.; Li, D.; Tu, X.; Wang, K.; Yang, Z.; Li, Y.; Tan, Y.; Huang, J.; Ni, Y.; Chen, Z.; Chen, Y.; Qiu, J.; Zeng, S.; Liang, L.

2026-08-27 cancer biology 10.64898/2026.08.26.747355 medRxiv
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The spatial architecture of the tumor microenvironment (TME) is pivotal in the progression of colorectal cancer (CRC) liver metastasis. By applying high-plex spatial multi-omic mapping and neighborhood analysis to a discovery cohort of colorectal cancer primary tumor (PT) and paired liver metastases (LM), we identified a specialized vimentin-high macrophages-endothelial cells niche that orchestrates cancer-associated fibroblast (CAF) phenotypes. Mechanistically, in primary tumors, vimentin-high macrophages secrete INHBA to activate the ACVR2/TGF-{beta} axis in endothelial cells, driving CAFs toward a myCAF phenotype. Conversely, in liver metastases, these macrophages secrete CXCL9 to trigger the PI3K-Akt/NF-[kcy]B/CXCL12 cascade in endothelial cells, directing CAFs toward an iCAF state. Clinically, high niche activity predicts poor survival. Divergent endothelial signaling in primary versus metastatic lesions exposes site-specific stromal vulnerabilities for therapeutic targeting, with architectural features discernible from routine histopathology. These findings reveal a site-specific regulatory mechanism of the macrophage-endothelial niche, offering a novel and clinically significant biomarker for CRC prognosis.

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Integrated single-cell profiling of RNA and DNA interactomes reveals targetable chromatin architectures in cancer

Deforzh, E.; Zhang, Y.; Mnatsakanyan, H.; John, A.; Kinsey, A.; Zheng, Z.; El Khayari, A.; Badr, C. E.; Krichevsky, A. M.

2026-08-13 cancer biology 10.64898/2026.08.12.744478 medRxiv
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The human genome is pervasively transcribed into protein-coding and regulatory non-coding RNAs whose functions are coordinated within higher-order nuclear architectures. However, direct mapping of RNA-RNA and DNA-DNA interaction networks in complex human tissues at single-cell resolution has remained a major challenge. Here, we present SCIENCE-seq, a multimodal single-cell interactomics platform enabling simultaneous detection of RNA-RNA interactions and chromatin DNA-DNA contacts within individual cells. Applied to primary glioma specimens, SCIENCE-seq reveals cancer-specific interactions organized by lncRNAs and centered on key oncogenic drivers, including EGFR, hTERT, SOX2, CDK6, CDC42, CD47, and HOX loci. These datasets uncover previously unrecognized molecular relationships between premature lncRNAs and pre-mRNAs that regulate transcription, alternative splicing, and polyadenylation. Notably, we identify a glioma-specific trans-chromosomal HOX hub driven by five interacting lncRNAs. Targeting specific RNA and DNA interactions using steric antisense oligonucleotides (ASOs) or CRISPRi selectively suppresses oncogenic programs in malignant cells while sparing normal tissue, establishing chromatin interactomes as actionable therapeutic targets.

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Suppression of RIPK3 by EZH2 contributes to cigarette smoking-induced chemoresistance in lung cancer

Liu, R.; Zhang, A.; Yang, J.; Xiao, G.; Chen, D.

2026-08-10 cancer biology 10.64898/2026.08.07.743587 medRxiv
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Lung cancer remains the leading cause of cancer-related mortality worldwide, with cigarette smoking (CS) representing its primary risk factor. In addition to promoting tumorigenesis, chronic CS exposure contributes to chemotherapy resistance, although the underlying mechanisms remain poorly understood. Here, we established a long-term CS exposure model by repeatedly treating Lewis lung carcinoma (LLC) cells with cigarette smoke extract (CSE). After 4 months of exposure, CSE-treated cells exhibited enhanced proliferation, migration, and resistance to chemotherapy-induced cell death. Mechanistically, chronic CSE exposure suppressed receptor-interacting protein kinase 3 (RIPK3) expression by upregulating the epigenetic regulator enhancer of zeste homolog 2 (EZH2), which promoted repressive histone methylation at the RIPK3 promoter. Loss of RIPK3 impaired chemotherapy-induced cell death primarily by inhibiting ferroptosis rather than necroptosis. Importantly, genetic depletion or pharmacological inhibition of EZH2 restored RIPK3 expression and sensitized lung cancer cells to gemcitabine treatment both in vitro and in vivo. Furthermore, analysis of human lung cancer datasets revealed an inverse correlation between EZH2 and RIPK3 expression, with RIPK3 levels progressively decreasing with smoking history. Collectively, these findings identify the EZH2/RIPK3 axis as a critical mediator of smoking-associated chemoresistance and uncover a previously unrecognized role for RIPK3 in ferroptosis regulation. Targeting EZH2-mediated RIPK3 suppression may represent a promising therapeutic strategy to overcome chemoresistance in lung cancer patients with a history of smoking.

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Noncoding regulatory mutations contribute to the aberrant gene expression in neuroblastoma

Jones, B.; Seth, G.; Robertson, A.; Sen, A.

2026-08-19 bioinformatics 10.64898/2026.08.10.743941 medRxiv
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Comprehensive analyses of whole-genome and exome sequencing data from high-risk neuroblastoma tumors have revealed relatively few recurrent, clinically actionable protein-coding driver mutations at initial diagnosis. This observation suggests that noncoding genetic variation, which can alter regulatory sequences like promoters, enhancers and insulators and influence gene expression, may play a critical role in neuroblastoma tumorigenesis. By integrating allele-specific expression (ASE) with somatic mutation profiles from two independent neuroblastoma patient cohorts, we identified a significant and reproducible enrichment of noncoding single-nucleotide variants (SNVs) within regulatory regions of neuroblastoma-specific ASE (NB-ASE) genes. Notably, 63% of these variants disrupted transcription factor binding sites (TFBSs), with FOXJ2 being the most frequently affected transcription factor (TF) across both cohorts. Supporting a functional link between FOXJ2 TFBS SNVs and gene expression dysregulation, NB-ASE genes harboring these variants were significantly enriched among FOXJ2 co-expression partners. These findings nominate FOXJ2 dysregulation via TFBS mutations as a potentially crucial molecular mechanism contributing to aberrant gene expression profiles of neuroblastoma. To prioritize high-impact regulatory mutations associated with NB-ASE genes, we also performed extensive deep learning-based functional predictions and identified 297 TFBS mutations predicted to significantly alter chromatin state. Among these were variants predicted to deactivate enhancers regulating the tumor suppressor genes CASZ1 and PRDM11, both detected in tumors lacking copy-number alteration at the locus, suggesting an alternative, copy number-independent mechanism of downregulation. Collectively, our findings demonstrate that integrating ASE with somatic mutation profiles is a powerful strategy for detecting and interpreting regulatory variations in cancer genomes.

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Targeting the FBXL12-FANCD2 Pathway Disrupts Replication Stress Tolerance in MYCN-Driven Neuroblastoma

Chou, J.; Malyukova, A.; Bordonaro, A. S.; Dygon, K.; Litzenburger, L.; Dalani, E.; Xiao, J.; Tümmler, C.; Mermelekas, G.; Seniveratne, J.; Paolino, M.; Rantala, J.; Orre, L. M.; Marshall, G.; Johnsen, J. I.; Wickström, M.; Brunner, A.; Sangfelt, O.

2026-08-31 cancer biology 10.64898/2026.08.29.745966 medRxiv
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MYCN amplification drives replication stress in high-risk neuroblastoma, yet how MYCN-amplified tumour cells tolerate this stress to sustain proliferation remains poorly understood. Here we show that FBXL12, an SCF ubiquitin ligase substrate receptor that targets the Fanconi anaemia protein FANCD2 for degradation at replication forks, as well as the broader Fanconi anaemia and replication stress transcriptional program are elevated in high-risk and MYCN-amplified neuroblastoma. High FBXL12 expression independently predicts poor survival across neuroblastoma patient cohorts. FBXL12 loss stabilizes FANCD2 on chromatin, elevates ATR-dependent replication stress signalling and DNA damage during S phase, and impairs proliferation of MYCN-amplified neuroblastoma cells in vitro and in vivo. Mechanistically, MYCN directly engages the FBXL12-FANCD2 complex and antagonises FBXL12-mediated degradation of FANCD2 at replication forks, revealing that the oncogenic driver of replication stress also actively preserves the chromatin-bound FANCD2 pool required to tolerate it. Beyond S phase, FBXL12 loss disrupts FANCD2-dependent mitotic DNA synthesis and transmits unresolved replication intermediates into daughter cells. FBXL12-deficient cells consequently show transcriptional activation of MYC target gene, ATR, and mTOR signalling programs, and this pathway-concordant state confers differential sensitivity to ATR, and mTOR-targeting compounds, nominating candidate therapeutic strategies for this disease subset. Together, these findings define a MYCN-FBXL12-FANCD2 axis as a clinically relevant vulnerability in high-risk neuroblastoma.

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An MLL-Independent Function of Menin Promotes Resistance to MAPK-Targeted Therapy

Srivaths, A.; AlHalawani, A.; Djajawi, T. M.; Huber, A.; Gerak, C.; Jenkins, L.; Crake, R.; Needham, K.; Sen, B.; Rivera, I. S.; Khoshdoozmasouleh, N.; Mielke, L. A.; Neil, L.; Pal, B.; Mariadason, J. M.; Kearney, C. J.; Vervoort, S. J.

2026-08-26 cancer biology 10.64898/2026.08.24.746076 medRxiv
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BRAF mutant colorectal cancer (CRC) remains difficult to treat despite the clinical use of combined BRAF and EGFR inhibition, highlighting a need to define tumour-intrinsic mechanisms that limit therapeutic response. Here, using genome-wide CRISPR-Cas9 screening in BRAF-mutant CRC cells, we identify MEN1, encoding the chromatin-associated protein Menin, as a selective determinant of sensitivity to combined encorafenib and cetuximab (EC). MEN1 loss markedly enhanced EC-mediated inhibition of cell proliferation and ERK activity while having comparatively little effect in untreated cells, and re-expression of Menin restored resistance. Transcriptomic and chromatin profiling revealed that Menin supports the transcriptional response associated with MAPK signalling. Menin occupied promoters of MAPK/BRAF-responsive genes and EC treatment caused widespread displacement of Menin from chromatin. Phosphoproteomic analysis demonstrated extensive remodelling of MAPK signalling following EC treatment, whereas proximity proteomics showed that the Menin-associated protein complexes remained largely intact despite loss of Menin chromatin occupancy. Importantly, MLL1 loss did not reproduce the sensitising effect of MEN1 deletion, and pharmacological Menin inhibition with revumenib failed to phenocopy either genetic MEN1 loss or acute Menin degradation, indicating that this phenotype is independent of Menin-MLL activity. Together, these findings identify a previously unrecognised, MLL-independent role for Menin in buffering the response of BRAF-mutant CRC cells to MAPK pathway inhibition and suggest targeting Menin, rather than disruption of its interaction with MLL, may provide a strategy for enhancing the response to BRAF-targeted therapy for CRC.

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YAP-TEAD-driven CPA4 promotes NF2-deficient meningioma growth

Mineji, K.; Petrosky, K.; Otsuji, R.; Makino, Y.; Kibe, Y.; Uchida, E.; Hagita, D.; Singaravelan, N.; Ishi, Y.; Yamaguchi, S.; Chang, L.-S.; Gadd, S.; Hashizume, R.

2026-08-07 cancer biology 10.64898/2026.08.05.743013 medRxiv
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Neurofibromin 2 (NF2) deficiency is a driver of meningioma and other cancers, yet transcriptional effectors that sustain NF2-deficient tumors remain poorly defined. We identify carboxypeptidase A4 (CPA4) as an effector of YAP-TEAD signaling in NF2-deficient meningioma. Transcriptomic profiling identified CPA4 as a consistently upregulated effector. Across patient cohorts and specimens, CPA4 expression was enriched in NF2-mutant and chromosome 22q-deleted meningiomas and associated with higher tumor grade and chromosome 1p loss. CPA4 depletion impaired proliferation, disrupted cell-cycle, DNA-replication, and DNA-repair programs, suppressed intracranial tumor growth, and prolonged survival. Integrated epigenomic and functional assays identified CPA4 as a direct YAP-TEAD transcriptional target. CPA4-high meningioma models exhibited preferential sensitivity to YAP-TEAD inhibition, while verteporfin and the clinical-stage TEAD inhibitor VT3989 reduced CPA4 expression, suppressed orthotopic tumor growth, and prolonged survival. These findings uncover a targetable YAP-TEAD-CPA4 dependency in NF2-deficient meningioma and identify CPA4 as a potential biomarker for TEAD- directed therapy. STATEMENT OF SIGNIFICANCECPA4 links NF2 loss to oncogenic YAP-TEAD transcription, sustains meningioma growth, and marks tumor sensitivity to pharmacologic TEAD inhibition. These findings establish CPA4 as a tumor-promoting effector and potential biomarker of an actionable pathway shared across NF2- deficient cancers.

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Identification of miR-615-5p/ID1 axis crucial in the pathogenesis of pancreatic ductal adenocarcinoma (PDAC)

Sarkar, A.; Ray, S.; Ray, A.; Biswas, K.

2026-08-31 cancer biology 10.64898/2026.08.27.747461 medRxiv
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Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy characterized by high metastatic dissemination, therapy resistance, and poor clinical outcome. Inhibitor of differentiation 1 or ID1, is frequently overexpressed in PDAC and is associated with tumour progression and adverse clinical outcome. However, the mechanisms governing its post-transcriptional regulation remain insufficiently characterized. Here, we identify tumour-suppressive miR-615-5p as a regulator of ID1 expression in PDAC. Integrative in-silico target prediction prioritized miR-615-5p based on seed complementarity and thermodynamic stability with the ID1 3' -UTR. Expression analysis of available PDAC clinical datasets revealed reduced miR-615-5p expression associated with increased ID1 expression. Direct association was validated using luciferase reporter assays, where miR-615-5p suppressed 3' -UTR reporter activity of ID1 in a sequence dependent manner, while mutation of the predicted binding site attenuated this effect. Further biotinylated-RIP and AGO2-RIP assays demonstrated the co-enrichment of ID1 transcripts and miR-615-5p with AGO2 associated RISC complexes, while AntimiR mediated inhibition of miR-615-5p perturbs association between miR/ID1 to AGO2, supporting interaction specificity. Functionally, modulation of miR-615-5p altered ID1 expression and impacted PDAC cell migration in vitro. Mechanistic analyses further indicated that the miR-615-5p/ID1 axis influences autophagic flux where miR-615-5p mediated inhibition of autophagy suppresses ID1 dependent cellular migration. Collectively, these findings define a previously uncharacterized miRNA-dependent regulation of ID1 expression and link this axis to autophagy-associated migratory responses in PDAC cells. The study expands the post-transcriptional regulatory landscape of ID1 and provides a possible mechanism where suppression of miR-615-5p leads to ID1 overexpression and subsequent poor clinical outcome in PDAC cells.

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Integrated multi-omic analysis of pediatric metastatic osteosarcoma reveals endothelial cell plasticity and lineage infidelity.

Burks, J.; Wu, Y.; Bhuvaneshwar, K.; Syed, N.; Jung, D.; Sayers, C. M.; Williams, D. O.; Daulatabad, S. V.; Malone, T.; Galindo, J.; Mendez, M.; Cotter, J.; Pavisic, J.; Mukouyama, Y.-S.; Shern, J. F.; Kaplan, R. N.; McEachron, T. A.

2026-08-12 cancer biology 10.64898/2026.08.11.744222 medRxiv
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While recent research has increasingly focused on the role of fibroblasts and macrophages in osteosarcoma, the tumor vasculature remains poorly understood, particularly in metastatic disease. To address this gap, we performed single-nuclei multi-ome (RNA+ATAC) sequencing on 24 human metastatic osteosarcoma specimens. We found that endothelial cells adopt a hybrid endothelial-mesenchymal state resembling endothelial-to-mesenchymal transition (EndMT) and that a subset of diploid endothelial cells expresses osteoblastic transcriptional profiles and gene regulatory networks (GRN). Joint copy-number analysis further identified osteosarcoma cells with endothelial transcriptional programs and GRNs, consistent with vascular mimicry. In vitro assays and syngeneic lineage-tracing experiments validated that tumor educated endothelial cells acquire osteoblast-like features. Together, these findings reveal substantial plasticity among endothelial and osteosarcoma cells in human and murine metastatic osteosarcoma, provide new insight into the how the metastatic microenvironment shapes the tumor vasculature, and challenge current models of osteosarcoma biology.

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NGFR-driven suppression of antigen presentation limits CD8+ T cell immunity and response to checkpoint blockade

Garcia-Agullo, J.; Santos, V.; Majem, B.; Munarriz-Panos, M.; Serrano-Ron, L.; Calvo de Mora, M.; Sanchez-Redondo, S.; Achuela, D.; Acena-Gonzalo, T.; Sentis, I.; Pascual, G.; Blanco-Aparicio, C.; Al-Shahrour, F.; Caleiras, E.; Peset, I.; Rodrigo, J. P.; Garcia-Pedrero, J. M.; Alvarez-Fernandez, M.; Saragovi, H. U.; Nogues, L.; Casanova-Acebes, M.; Aznar-Benitah, S.; Peinado, H.

2026-08-25 cancer biology 10.64898/2026.08.24.746602 medRxiv
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Immune checkpoint blockade has revolutionized cancer therapy; however, numerous tumors remain resistant by adopting cellular states that impede immune recognition. In this study, we identify the nerve growth factor receptor (NGFR) as a regulator of immune evasion in head and neck squamous cell carcinoma (HNSCC). Genetic ablation of Ngfr resulted in impaired tumor growth in immunocompetent MOC2 HNSCC, while pharmacological inhibition with THX-B reduced primary tumor growth and spontaneous metastatic dissemination. Single-cell profiling of MOC2 tumors demonstrated that Ngfr loss redirected tumor cells away from invasive EMT-like states and enhanced antigen-processing and presentation programs. This was accompanied by increased presentation of tumor antigens and expansion of effector CD8+ T-cells in vivo. Functionally, CD8+ T-cell depletion, Batf3 deficiency, and JAK1/2 inhibition restored the growth of Ngfr-deficient tumors, indicating that NGFR loss exposes tumors to CD8+ T-cell-mediated control through a JAK-associated antigen-presentation program. Notably, NGFR blockade sensitized otherwise resistant MOC2 tumors to anti-PD1 therapy, and the combination of THX-B with anti-PD1 significantly improved tumor control and survival. In human HNSCC, spatial profiling revealed that NGFR+ tumor regions exhibited reduced HLA-DR expression and limited CD3+ T-cell infiltration. Notably, an NGFR-associated antigen-presentation signature stratified survival and response in HNSCC patients undergoing immune checkpoint blockade. Interestingly, this signature was also linked to improved outcomes in melanoma patients. We also observed a significant increase in the effector CD8+ T-cell fraction in melanoma NGFR KO tumors linked to a significant decrease in tumor growth. These findings position NGFR as a regulator of tumor immune visibility and support NGFR inhibition as a strategy to enhance immunotherapy response.

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Functional spatial transcriptomics uncover LMO7 as a fusion-regulated and clinically relevant driver of metastasis in Ewing sarcoma

Bursic, V.; Luo, H.; Henon, C.; Mao, L.; Ehlers, A. C.; Yershova, A.; Lego, J.-A. M.; Li, J.; Carreno Gonzalez, M. J.; Arndt, R.; Sastre, A.; Alonso, J.; Dirksen, U.; Hartmann, W.; Kumar Jayavelu, A.; Gerstung, M.; Gruenewald, T. G. P.; Cidre-Aranaz, F.

2026-08-28 cancer biology 10.64898/2026.08.27.747513 medRxiv
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Metastatic dissemination represents the major determinant of poor clinical outcome across cancer entities. Yet, how driver oncogenes shape transcriptional programs facilitating metastasis is poorly understood. In Ewing sarcoma (EwS) - a highly aggressive pediatric bone and soft-tissue sarcoma driven by chimeric FET::ETS transcription factors - low activity of the fusion oncoproteins is thought to promote metastasis, but the underlying molecular mechanisms remain largely elusive. Here, using spatially resolved functional transcriptomics in EwS patient tumors, we identify a distinct transcriptional state at the invasive tumor front, that in contrast to the tumor core, is characterized by lower FET::ETS activity and induction of the multifunctional shuttle LIM domain only protein 7 (LMO7). Integrating these data with clinical information reveals that high LMO7 expression is associated with poor outcomes. Gene network analysis of patient tumors and integrated proteomic and transcriptomic profiling of EwS cell lines following inducible LMO7 silencing highlight LMO7 as a central regulatory hub orchestrating epithelial-mesenchymal transition (EMT) and cytoskeletal remodeling in EwS. Functional experiments demonstrate that LMO7 silencing decreases clonogenicity and migratory capacity in vitro and suppresses primary tumor growth and metastatic dissemination in vivo. Collectively, these findings identify LMO7 as a clinically relevant effector of FET::ETS fusions in EwS, and illustrate how integrating functional, spatial and clinical data can uncover oncogene-driven effectors of metastasis.

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Pheno-MYCN maps the morphological footprint of MYCN amplification in paediatric neuroblastoma

Chai, B.; Fourkioti, O.; Naidoo, R.; De Vries, M.; George, S.; Chesler, L.; Hutchinson, J. C.; Bakal, C.

2026-08-21 cancer biology 10.64898/2026.08.20.745848 medRxiv
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MYCN amplification has long been a prognostic marker in paediatric neuroblastoma, yet is typically assayed in bulk, alongside rather than within the heterogeneous tissue architecture pathologists assess. This leaves a gap: MYCN status alone cannot localise MYCN-associated biology, while morphology alone cannot assign molecular risk. Motivated by our finding that the two together identify high-risk cases missed by either, we developed Pheno-MYCN, a weakly supervised framework linking slide-level MYCN prediction to interpretable morphological sub-populations on routine H&E whole-slide images. The aim is not a stronger classifier: prediction probes what MYCN amplification does to the tissue, its evidence open to pathological scrutiny. Across 189 slides, Pheno-MYCN resolved each into phenotypic clusters that expert review mapped to neuroblastoma morphologies. Cell-level profiling revealed MYCN amplification "marked" every sub-population, through a different feature in each: densely cellular yet disorganised tumour with sparser, less diverse networks; chiefly abundance in necrotic and haemorrhagic regions. MYCN-amplified-like tissue was identifiable per slide from these features alone (AUC 0.93-1.00, leave-one-slide-out) and traced as a continuous gradient within tumours. Thus MYCN amplification leaves a concrete, interpretable footprint that can be read and localised on routine H&E, offering a low-cost means to flag and map it where molecular testing is limited.

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Beyond Navigation - Tissue-contacting Fluorescent Lifetime Imaging reveals a pathology-linked lung cancer phenotype at the point of biopsy

Collins, J. T.; Wang, Q.; Williams, G. O. S.; Stewart, H.; Wood, H. A. C.; Parry, C.; Toogood, C. M.; Bruce, A. M.; Young, V.; Moore, A. M.; Dorward, D. A.; Marshall, A. D. L.; Pellicoro, A.; Bain, L.; Akram, A. R.; Dhaliwal, K.; Stone, J. M.

2026-08-19 cancer biology 10.64898/2026.08.18.745502 medRxiv
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Background: Accurate sampling of suspected peripheral lung cancers depends on access to the lesion and confirmation that the biopsy tool is in contact with target tissue. Current bronchoscopic navigation and imaging techniques can guide instruments to a target but do not provide real-time biological confirmation at the point of sampling. Fluorescence lifetime imaging microscopy (FLIM) provides molecular contrast by measuring fluorescence decay - how long photons continue to be emitted from fluorescent molecules. In the Precision Lung clinical study (ISRCTN15093468), the Prothea Imaging System (Generation 1) identified a candidate tumour-associated phenotype of spatially overlapped low fluorescence lifetime and low intensity (LLLI) from in-vivo imaging. We used this observation as the basis for a reverse-translational study to determine whether the LLLI phenotype is linked to cancer pathology; reproducible with the Imaging System (Generation 2); and distinguishable from normal lung tissue. Methods: Previously reported Precision Lung findings were used as the clinical starting observation and were not re-analysed. Validation was then performed using: (i) pathology linked benchtop FLIM of early-stage non-small-cell lung tissue microarrays encompassing malignant cell clusters of approximately 300 um2, matched to the EoT imaging scale; (ii) five sequential fresh lung-cancer resections imaged at tumour and comparator regions, including visibly blood-rich contact sites, using the (Generation 2) Imaging System; and (iii) systematic mapping of two ventilated non-cancer donor lungs, one from a smoker and one from a non-smoker, across all available lobes. The LLLI phenotype was defined as spatial co-localisation of low intensity and short lifetime. Results: Using a real time fibre based FLIM system, capable of deployment through a working channel of a bronchoscope, the LLLI tumour phenotype was optically identified in freshly resected tumour tissue. The same phenotype was identified in fixed tissue samples with known pathology, and with images taken in the Precision Lung clinical study. Whole human lung controls did not show evidence of the tumour phenotype. Conclusions: This evidence forms a reverse-translational chain that supports the concept of the Prothea Imaging System - as a platform that confirms that the tool is in contact with a region of cancer in the lesion, while preserving continuous access for biopsy or intervention.