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@ARTICLE{Daum:302109,
author = {A.-K. Daum$^*$ and L. Schlicker$^*$ and M. A. Schneider and
T. Muley and U. Klingmüller$^*$ and A. Schulze$^*$ and M.
Thomas and P. Christopoulos and H. Sültmann$^*$},
title = {{C}ancer-associated fibroblasts promote drug resistance in
{ALK}-driven lung adenocarcinoma cells by upregulating lipid
biosynthesis.},
journal = {Cancer $\&$ metabolism},
volume = {13},
number = {1},
issn = {2049-3002},
address = {London},
publisher = {Biomed Central},
reportid = {DKFZ-2025-01241},
pages = {28},
year = {2025},
note = {#EA:B063#LA:B063#},
abstract = {Targeted therapy interventions using tyrosine kinase
inhibitors (TKIs) provide encouraging treatment responses in
patients with ALK-rearranged lung adenocarcinomas, yet
resistance occurs almost inevitably. In addition to tumor
cell-intrinsic resistance mechanisms, accumulating evidence
suggests that cancer-associated fibroblasts (CAFs) within
the tumor microenvironment contribute to therapy resistance.
This study aimed to investigate CAF-driven molecular
networks that shape the therapeutic susceptibility of
ALK-driven lung adenocarcinoma cells.Three-dimensional (3D)
spheroid co-cultures comprising ALK-rearranged lung
adenocarcinoma cells and CAFs were utilized to model the
tumor microenvironment. Single-cell RNA sequencing was
performed to uncover transcriptional differences between
TKI-treated homotypic and heterotypic spheroids. Functional
assays assessed the effects of CAF-conditioned medium and
CAF-secreted factors on tumor cell survival, proliferation,
lipid metabolism, and downstream AKT signaling. The
therapeutic potential of targeting metabolic vulnerabilities
was evaluated using pharmacological inhibition of lipid
metabolism and by ferroptosis induction.CAFs significantly
diminished the apoptotic response of lung tumor cells to ALK
inhibitors while simultaneously enhancing their
proliferative capacity. Single-cell RNA sequencing
identified lipogenesis-associated genes as a key
transcriptional difference between TKI-treated homotypic and
heterotypic lung tumor spheroids. CAF-conditioned medium and
the CAF-secreted factors HGF and NRG1 activated AKT
signaling in 3D-cultured ALK-rearranged lung tumor cells,
leading to increased de novo lipogenesis and suppression of
lipid peroxidation. These metabolic adaptations were
critical for promoting tumor cell survival and fostering
therapy resistance. Notably, both dual inhibition of ALK and
the lipid-regulatory factor SREBP-1, as well as co-treatment
with ferroptosis inducers such as erastin or RSL3,
effectively disrupted the CAF-driven metabolic-supportive
niche and restored sensitivity of resistant lung tumor
spheroids to ALK inhibition.This study highlights a critical
role for CAFs in mediating resistance to ALK-TKIs by
reprogramming lipid metabolism in ALK-rearranged lung cancer
cells. It suggests that targeting these metabolic
vulnerabilities, particularly through inhibition of lipid
metabolism or induction of ferroptosis, could provide a
novel therapeutic approach to overcome resistance and
improve patient outcomes.},
keywords = {3D cell culture (Other) / Cancer-associated fibroblasts
(Other) / EML4-ALK (Other) / Lipid metabolism (Other) / Lung
adenocarcinoma (Other) / Therapy resistance (Other)},
cin = {B063 / HD01 / A410 / W120 / B200},
ddc = {610},
cid = {I:(DE-He78)B063-20160331 / I:(DE-He78)HD01-20160331 /
I:(DE-He78)A410-20160331 / I:(DE-He78)W120-20160331 /
I:(DE-He78)B200-20160331},
pnm = {312 - Funktionelle und strukturelle Genomforschung
(POF4-312)},
pid = {G:(DE-HGF)POF4-312},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:40524253},
pmc = {pmc:PMC12168422},
doi = {10.1186/s40170-025-00400-7},
url = {https://inrepo02.dkfz.de/record/302109},
}