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Updated: May 28, 2025

In vitro Organoid Culture of Primary Mouse Colon Tumors
Published on: May 17, 2013
Oncofetal reprogramming drives phenotypic plasticity in WNT-dependent colorectal cancer
Slim Mzoughi1,2, Megan Schwarz3,4,5, Xuedi Wang6
1Center for OncoGenomics and Innovative Therapeutics (COGIT), Center for Therapeutics Discovery, Department of Oncological Sciences and Pharmacological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. slim.mzoughi@mssm.edu.
Abstract:
Targeting cancer stem cells (CSCs) is crucial for effective cancer treatment, yet resistance mechanisms to LGR5+ CSC depletion in WNT-driven colorectal cancer (CRC) remain elusive. In the present study, we revealed that mutant intestinal stem cells (SCs) depart from their canonical identity, traversing a dynamic phenotypic spectrum. This enhanced plasticity is initiated by oncofetal (OnF) reprogramming, driven by YAP and AP-1, with subsequent AP-1 hyperactivation promoting lineage infidelity. The retinoid X receptor serves as a gatekeeper of OnF reprogramming and its deregulation after adenomatous polyposis coli (APC) loss of function establishes an OnF 'memory' sustained by YAP and AP-1. Notably, the clinical significance of OnF and LGR5+ states in isolation is constrained by their functional redundancy. Although the canonical LGR5+ state is sensitive to the FOLFIRI regimen, an active OnF program correlates with resistance, supporting its role in driving drug-tolerant states. Targeting this program in combination with the current standard of care is pivotal for achieving effective and durable CRC treatment.
Insights
Targeting cancer stem cells (CSCs) in colorectal cancer (CRC) is key, but resistance persists. Oncofetal reprogramming drives plasticity and drug tolerance in CRC, suggesting new therapeutic strategies.
Area of Science:
- Oncology
- Molecular Biology
- Gastroenterology
Background:
- Targeting cancer stem cells (CSCs) is vital for effective colorectal cancer (CRC) treatment.
- Mechanisms of resistance to LGR5+ CSC depletion in WNT-driven CRC are not fully understood.
Purpose of the Study:
- To investigate the mechanisms underlying CSC plasticity and drug resistance in CRC.
- To identify novel therapeutic targets for overcoming treatment resistance in CRC.
Main Methods:
- Analysis of mutant intestinal stem cell (SC) identity and phenotypic plasticity.
- Investigation of oncofetal (OnF) reprogramming pathways involving YAP, AP-1, and retinoid X receptor.
- Assessment of the correlation between OnF program activity and resistance to chemotherapy (FOLFIRI).
Main Results:
- Mutant intestinal stem cells exhibit plasticity, transitioning through a spectrum of phenotypes.
- Oncofetal reprogramming, driven by YAP and AP-1, initiates this plasticity and promotes lineage infidelity.
- Deregulation of retinoid X receptor after APC loss creates a sustained OnF 'memory'.
- An active OnF program is associated with resistance to FOLFIRI, indicating its role in drug tolerance.
Conclusions:
- Oncogenic reprogramming and stem cell plasticity are key drivers of therapeutic resistance in colorectal cancer.
- Targeting the oncofetal program in conjunction with standard chemotherapy may improve treatment efficacy and durability in CRC.
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