Low-order assemblies drive oncogenic RTK fusion signaling without condensation

Receptor tyrosine kinase (RTK) fusions are a large class of oncoproteins found in [~]5% of cancers. Key questions remain, however, about how RTK fusions transmit oncogenic signals, including how these largely cytoplasmic proteins activate downstream pathways that originate at the plasma membrane. Fusions are multimeric and can form mesoscale condensates in cancer cells, and condensation has been implicated as an essential mechanism to enable signal transmission from the cytoplasm. However, whether condensates play a causal role, or whether smaller diffuse assemblies are sufficient to transduce signals, has been challenging to establish. Here we apply advanced microscopy, single-cell analysis, and synthetic fusions to determine the principles by which multimerization and condensation drive signaling from cytoplasmic RTK fusions. For EML4-ALK, a prominent fusion that forms condensates, we found poor correlation between condensation and signaling. By contrast, EML4-ALK activity was abundant in the diffuse phase, and the kinetics of diffuse-phase activity aligned more closely with downstream Erk signaling than did kinetics of signaling within condensates. Synthetic RTK fusions showed that cytoplasmic ALK or RET fusion dimers--and even constitutively active monomers--were sufficient to induce strong Ras-Erk signaling despite the absence of condensates, and diffuse fusions were sufficient to transform cells in vitro and in subcutaneous tumor models. A panel of various other cancer-driving RTK fusions showed that low-order multimerization was universal across fusions, whereas mesoscale condensation was rare and did not correlate with signaling. Our results suggest that low-order fusion multimerization is sufficient to drive its phosphorylation, which is necessary and sufficient to trigger downstream oncogenic signaling.