Griffiths Jason I, Chi Feng, Farmaki Elena, Medina Eric F, Cosgrove Patrick A, Karimi Kimya L, Chen Jinfeng, Grolmusz Vince K, Adler Frederick R, Khan Qamar J, Nath Aritro, Chang Jeffrey T, Bild Andrea H
Department of Medical Oncology & Therapeutics, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA.
Department of Mathematics, University of Utah 155 South 1400 East, Salt Lake City, UT, 84112, USA.
Mol Syst Biol. 2025 May 8. doi: 10.1038/s44320-025-00104-6.
In early-stage estrogen receptor-positive (ER + ) breast cancer, resistance to endocrine therapy (ET) and CDK4/6 inhibitors (CDK4/6i) often involve a shift away from estrogen-driven proliferation. The nature and source of compensatory growth signals driving cancer proliferation remain unknown but represent direct therapeutic targets of resistant cells. By analyzing single-cell RNA-sequencing data from serial biopsies of patient tumors, we elucidated compensatory growth signaling pathways activated in ET + CDK4/6i-resistant cancer cells, along with the intercellular growth signal communications within the tumor microenvironment. In most patient tumors, resistant cancer cells increased ERBB growth pathway activity during treatment, only partially through ERBB receptor upregulation. Concurrently, fibroblasts within the tumor increased ERBB ligand communication with cancer cells, as they differentiated to a proliferative and mesenchymal phenotype in response to TGF signals from cancer cells. In vitro model systems demonstrated molecularly how therapy induces a mutualistic cycle of crosstalk between cancer cells and fibroblasts, fostering a growth factor-rich tumor microenvironment circumventing estrogen reliance. We show that ERBB inhibition can break this cancer-fibroblasts mutualism, targeting an acquired sensitivity of resistant cancer cells.
在早期雌激素受体阳性(ER + )乳腺癌中,对内分泌治疗(ET)和细胞周期蛋白依赖性激酶4/6抑制剂(CDK4/6i)的耐药性通常涉及从雌激素驱动的增殖转变。驱动癌症增殖的代偿性生长信号的性质和来源尚不清楚,但它们是耐药细胞的直接治疗靶点。通过分析患者肿瘤系列活检的单细胞RNA测序数据,我们阐明了在ET + CDK4/6i耐药癌细胞中激活的代偿性生长信号通路,以及肿瘤微环境内的细胞间生长信号通讯。在大多数患者肿瘤中,耐药癌细胞在治疗期间增加了ERBB生长途径的活性,部分原因是ERBB受体上调。与此同时,肿瘤内的成纤维细胞增加了与癌细胞的ERBB配体通讯,因为它们响应癌细胞的TGF信号而分化为增殖性间充质表型。体外模型系统从分子层面展示了治疗如何诱导癌细胞与成纤维细胞之间相互作用的循环,从而形成一个富含生长因子的肿瘤微环境,规避对雌激素的依赖。我们表明,抑制ERBB可以打破这种癌细胞与成纤维细胞之间的共生关系,针对耐药癌细胞的获得性敏感性。