Lineage-specific intolerance to oncogenic drivers restricts histological transformation

Science. 2024 Feb 9;383(6683):eadj1415. doi: 10.1126/science.adj1415. Epub 2024 Feb 9.

Abstract

Lung adenocarcinoma (LUAD) and small cell lung cancer (SCLC) are thought to originate from different epithelial cell types in the lung. Intriguingly, LUAD can histologically transform into SCLC after treatment with targeted therapies. In this study, we designed models to follow the conversion of LUAD to SCLC and found that the barrier to histological transformation converges on tolerance to Myc, which we implicate as a lineage-specific driver of the pulmonary neuroendocrine cell. Histological transformations are frequently accompanied by activation of the Akt pathway. Manipulating this pathway permitted tolerance to Myc as an oncogenic driver, producing rare, stem-like cells that transcriptionally resemble the pulmonary basal lineage. These findings suggest that histological transformation may require the plasticity inherent to the basal stem cell, enabling tolerance to previously incompatible oncogenic driver programs.

MeSH terms

  • Adenocarcinoma of Lung* / genetics
  • Adenocarcinoma of Lung* / pathology
  • Adenocarcinoma of Lung* / therapy
  • Cell Lineage
  • Epithelial Cells / pathology
  • Humans
  • Lung / pathology
  • Lung Neoplasms* / genetics
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / therapy
  • Molecular Targeted Therapy
  • Oncogenes
  • Proto-Oncogene Proteins c-akt* / genetics
  • Proto-Oncogene Proteins c-myc* / genetics
  • Small Cell Lung Carcinoma* / genetics
  • Small Cell Lung Carcinoma* / pathology
  • Small Cell Lung Carcinoma* / therapy

Substances

  • MYC protein, human
  • Proto-Oncogene Proteins c-myc
  • Proto-Oncogene Proteins c-akt