bims-necame Biomed News
on Metabolism in small cell neuroendocrine cancers
Issue of 2025–12–21
twenty-two papers selected by
Grigor Varuzhanyan, UCLA



  1. Nat Commun. 2025 Dec 18. 16(1): 11280
      Most neuroendocrine cancers lack caspase 8 protein expression. While this feature was thought to facilitate escape from extrinsic apoptosis, its cancer-regulatory function has remained unexplored. Here, we devise a mouse model of small cell lung cancer (SCLC) recapitulating the lack of expression of caspase 8 seen in humans and uncover an unexpected role for necroptosis-fueled pre-tumoral inflammation resulting in reprogramming towards a neuronal progenitor cell-like state and increased metastatic disease. Notably, transcriptional signatures of this cellular state are enriched in relapsed and metastatic human SCLC. Mechanistically, caspase 8 loss within the pre-tumoral niche promotes inflammation marked by increased recruitment of regulatory T cells (Tregs) which are responsible for the promotion of metastatic disease. Importantly, inactivation of the necroptosis executioner MLKL reverses pre-tumoral inflammation, decreases metastasis as well as neuronal-like reprogramming. Taken together, our findings suggest that pre-tumoral inflammatory cell death contributes to neuronal progenitor mimicry, immunosuppression and increased metastasis in SCLC.
    DOI:  https://doi.org/10.1038/s41467-025-67142-4
  2. Cancer Discov. 2025 Dec 19.
      Neuroendocrine prostate cancer (NEPC) is an aggressive, therapy-resistant subtype of prostate cancer characterized by lineage plasticity. While metabolic and signaling molecules are increasingly recognized as modulators of tumor progression, their role in cell fate transition remains unclear. NE tumors produce and accumulate serotonin, a neurotransmitter that regulates diverse physiological processes. Here, we identify a tumor-intrinsic serotonin axis as key driver of NEPC lineage commitment and progression. NEPC endogenously synthesize serotonin via aromatic L-amino acid decarboxylase (DDC) and reuptake through the transporter SLC6A4. Mechanistically, high level of intracellular serotonin promotes histone serotonylation at H3K4me3Q5, reconfiguring the H3K4me3 chromatin landscape and downstream gene expression, which drives induced NE differentiation and is associated with suppressed androgen receptor signaling. Pharmacological inhibition of 5-HT synthesis using the FDA-approved DDC inhibitor carbidopa significantly impairs tumor growth and prolongs survival in both genetically engineered and patient-derived xenograft models, highlighting histone serotonylation as a druggable vulnerability in NEPC.
    DOI:  https://doi.org/10.1158/2159-8290.CD-25-0974
  3. Cancer Pathog Ther. 2026 Jan;4(1): 51-63
      Neuroendocrine prostate cancer (NEPC) is an aggressive subtype of castration-resistant prostate cancer (CRPC) that is typically resistant to nearly all current therapies. In this study, single-cell RNA sequencing (scRNA-seq) and dataset analyses identified Centrosomal Protein 55 (CEP55) as a critical factor in the transformation from hormone-sensitive prostate cancer (HSPC) to CRPC and, ultimately to, NEPC. Subsequent bioinformatics analyses and validation with clinical samples demonstrated that CEP55 is significantly upregulated in NEPC tissues compared to HSPC and CRPC. Furthermore, while CEP55 show no significant association with the immune microenvironment or cancer-associated fibroblasts (CAFs), our findings indicate that it directly mediates the plasticity of prostate cancer cells, thereby driving NEPC progression. Specifically, in vivo and in vitro experiments confirmed that CEP55 enhances cell proliferation, migration, invasion and the expression of NEPC biomarkers in prostate cancer. Importantly, although cisplatin is the primary treatment for NEPC clinically, CEP55 has been shown to regulate cisplatin resistance through the phosphorylation of CDK1 at the tyrosine 15 (Tyr15) site. In summary, our study identifies a key gene that influences the neuroendocrine differentiation process in prostate cancer, suggesting its potential as an important therapeutic target.
    Keywords:  CEP55; Castration-resistant prostate cancer; Cisplatin resistance; Neuroendocrine prostate cancer; Prostate cancer
    DOI:  https://doi.org/10.1016/j.cpt.2025.06.008
  4. Cancer Res. 2025 Dec 18.
      Small cell lung cancer (SCLC) is an aggressive thoracic disease characterized by rapid proliferation and early metastatic spread. The survival outcomes for SCLC patients remain notoriously poor, underlining that only modest improvements have been achieved in clinical settings to date. However, insights gained from human tumors and preclinical models in recent years have shed light on the heterogeneous molecular profile of SCLC. Numerous research groups have, therefore, begun to stratify SCLC into subgroups based on differential transcription factor expression, the tumor immune microenvironment, and other criteria. Since SCLC subtypes show major differences in their molecular landscape and biological behavior, they may offer unique therapeutic vulnerabilities and serve as a framework for future personalized clinical trials. Here, we summarize impactful classification attempts from the last ten years, highlighting discrepancies and connections between the nomenclature of each study, and expound upon relevant factors of SCLC biology influencing subtype composition and plasticity. This review delves into the implications of subgrouping for understanding and treating SCLC as well as potential future directions for SCLC research.
    DOI:  https://doi.org/10.1158/0008-5472.CAN-25-1483
  5. Sci Rep. 2025 Dec 18.
      Prostate cancer is estimated to contribute to over 35,000 deaths of men residing in the United States, with the majority fatality due to metastatic disease. CDC7 is a kinase that regulates DNA replication and is found elevated during neuroendocrine transdifferentiation in lung and prostate cancer. In this study, we demonstrate that CDC7 is highly expressed in treatment-resistant prostate cancer, with even higher levels observed in treatment-resistant prostate cancer with neuroendocrine phenotype (NEPC). We further identify CDC7 as a critical regulator of prostate tumorigenesis. Downregulation of CDC7 significantly reduces prostate cancer cells growth and invasion in vitro and silencing CDC7 suppresses prostate tumor growth in vivo. Furthermore, we demonstrate that the inhibition of CDC7 using TAK-931, a selective CDC7 inhibitor, significantly reduces the proliferation, migration, and invasion of aggressive prostate cancer cells. TAK-931 treated prostate cancer cells exhibit an abnormal cell cycle profile, suggesting that CDC7 inhibition induces replication stress and promotes apoptosis. Collectively, our findings demonstrate that CDC7 is a regulator of tumor progression in prostate cancer and represents new therapeutic target in advanced prostate cancer.
    DOI:  https://doi.org/10.1038/s41598-025-29574-2
  6. Rev Esp Enferm Dig. 2025 Dec 18. 118
      Clinical decision-making in patients with pancreatic neuroendocrine tumors is complex. The absence of effective biomarkers and the reliance on morphological criteria underlying current predictive models expose patients to a substantial risk of overdiagnosis and overtreatment. The implementation of non-invasive tools that improve the precision of prognostic estimates remains an unmet clinical need.
    DOI:  https://doi.org/10.17235/reed.2025.11255/2025
  7. World J Surg Oncol. 2025 Dec 15.
       BACKGROUND: Small cell neuroendocrine carcinoma of the urinary tract (SCC-UT) is an extremely rare genitourinary tumor, which is highly aggressive, prone to local or distant metastasis and has a very poor prognosis.
    CASE PRESENTATION: This article reports a case of primary small cell neuroendocrine carcinoma of the ureter combined with invasive uroepithelial carcinoma. The patient underwent robot-assisted laparoscopic radical left nephrectomy, full-length ureteral resection, sleeve cystectomy, and pelvic lymph node dissection after exclusion of contraindications to surgery (preoperative assessment confirmed the absence of cardiopulmonary or coagulation abnormalities) and underwent 6 cycles of post operative etoposide/cisplatin adjuvant chemotherapy.
    CONCLUSIONS: This case underscores the potential efficacy of multimodal therapy, combining robot-assisted surgical resection with adjuvant etoposide/cisplatin chemotherapy, in the management of primary small cell neuroendocrine carcinoma. The patient was detected no local or distant metastases, at 9 months postoperatively. However, the follow-up period of only 9 months is relatively short, which limits the long-term assessment of recurrence or survival. These findings provide a reference for clinical decision-making and underscore the potential benefits of multimodal treatment in this rare malignancy.
    Keywords:  Clinicopathological features; Immunohistochemistry; Small cell neuroendocrine carcinoma; Tumor of the urinary tract
    DOI:  https://doi.org/10.1186/s12957-025-04109-1
  8. JCO Glob Oncol. 2025 Dec;11 e2500225
       PURPOSE: Small cell lung cancer (SCLC) is an aggressive neuroendocrine malignancy characterized by poor prognosis. The ADRIATIC trial demonstrated significant survival benefits with durvalumab as maintenance therapy for limited-stage SCLC (LS-SCLC). However, the high cost of durvalumab necessitates an evaluation of its cost-effectiveness.
    METHODS: A partitioned survival model was developed to assess the cost-effectiveness of durvalumab consolidation therapy compared with the standard of care (SOC). The model comprised three mutually exclusive health states: progression-free survival (PFS), progression of disease (POD)/metastasis, and death. Incremental cost-effectiveness ratio (ICER) was calculated as cost per quality-adjusted life year (QALY) gained, with a willingness-to-pay (WTP) threshold of $150,000 in US dollars (USD)/QALY. One-way and probabilistic sensitivity analyses were conducted. Analysis for POD was also stratified into intrathoracic, extrathoracic, and CNS.
    RESULTS: Durvalumab improved overall survival (OS) to 66.1 months and PFS to 40.2 months, compared with 57.8 and 31.8 months for SOC, respectively. The total cost of durvalumab was $163,722 USD versus $25,816 USD for placebo, resulting in an incremental cost of $137,905 USD. Durvalumab provided an incremental QALY gain of 0.36 years, yielding an ICER of $383,069 USD/QALY, exceeding WTP. On stratification, durvalumab in patients with extrathoracic progression nearly met WTP (ICER, $151,137 USD).
    CONCLUSION: Durvalumab remains cost-prohibitive for the overall cohort, exceeding acceptable thresholds despite favorable outcomes. Subgroup analysis, however, indicates that selective use in patients with extrathoracic progression may enhance cost-effectiveness. Overcoming economic barriers will be essential for the sustainable integration of immunotherapy into routine care.
    DOI:  https://doi.org/10.1200/GO-25-00225
  9. Br J Cancer. 2025 Dec 13.
       BACKGROUND: Early metastatic spread represents a challenge in fighting small cell lung cancer (SCLC). The molecular mechanisms underlying metastatic dissemination remain unclear in this devastating disease.
    METHODS: Invasive traits were investigated in 13 SCLC cell lines using 3D-spheroid formation, sprouting assays, co-cultures and a zebrafish xenograft model. Proteomic analysis was performed to unravel metastatic drivers, which were validated by qPCR, growth factor arrays and specific inhibitors.
    RESULTS: Overall, 8 cell lines formed spheroids, and half of these displayed invasive sprouting in collagen. The 'sprouter' SCLC cells, which all had a YAP1-dominant subtype, showed increased migration in zebrafish larvae and penetrated endothelial cell monolayers to a higher extent, thereby mimicking intra- and extravasation. Proteomics revealed differences in adhesion properties, oncogenic pathways and receptor tyrosine kinase signalling. Sprouter cells showed higher expression levels of mesenchymal cell state markers. Stimulation with fibroblast growth factor 2 (FGF2) further induced invasive sprouting, while blocking the FGF/R axis resulted in a significant reduction of sprouting in vitro and in vivo.
    CONCLUSION: The FGF/R axis is a key driver of SCLC metastatic spread in the YAP1-dominant subtype. These data might facilitate the development of potential future therapies targeting FGF/R signalling to prevent SCLC progression and metastasis.
    DOI:  https://doi.org/10.1038/s41416-025-03276-y
  10. Phytochemistry. 2025 Dec 13. pii: S0031-9422(25)00369-3. [Epub ahead of print]244 114746
      To explore bioactive specialized metabolites from marine-derived fungi, four previously undescribed 2-pyridone alkaloids, oxalicpyridones A-D (1-4), two unreported tetramic acids, tolypocladenols G and H (5 and 6), together with five known 2-pyridone derivatives (7-11), were isolated from the marine-derived fungus Penicillium oxalicum SCSIO 41320. Their structures, including absolute configurations, were elucidated by extensive nuclear magnetic resonance (NMR) spectroscopic analysis, X-ray single-crystal diffraction, and calculations of electronic circular dichroism (ECD), 13C NMR, and optical rotation (OR). Additionally, oxalicpyridones A-C (1-3) inhibited the viability of several small-cell lung cancer (SCLC) cell lines in a dose-dependent manner. Among them, oxalicpyridone A (1) not only inhibited proliferation, induced apoptosis, and suppressed metastasis of SCLC cells in vitro, but also significantly inhibited the growth of SCLC cell-derived xenograft tumors in zebrafish in vivo. Collectively, these findings enrich the chemical diversity of marine-derived 2-pyridone alkaloids and provide potential lead compounds for anticancer drug discovery.
    Keywords:  2-pyridine alkaloids; Apoptosis; Metastasis; Penicillium oxalicum; Small cell lung cancer; Zebrafish xenograft tumor
    DOI:  https://doi.org/10.1016/j.phytochem.2025.114746
  11. bioRxiv. 2025 Nov 29. pii: 2025.11.25.690552. [Epub ahead of print]
      Aberrant activation of the androgen receptor (AR) pathway drives prostate cancer (PCa). Androgen deprivation therapy (ADT) and next-generation AR blockade (e.g., enzalutamide) are initially effective, but virtually all patients develop castration-resistant prostate cancer (CRPC), which frequently transitions to treatment-emergent neuroendocrine PCa (tNEPC) following AR suppression. The molecular logic that links AR blockade to lineage plasticity remains incompletely understood. Here, we identify PSMA2 (Proteasome Subunit Alpha 2) as a treatment-induced effector that mechanistically connects AR blockade to tNEPC evolution. Enzalutamide induces PSMA2 expression in AR-expressing PCa cells. Enforced PSMA2 expression accelerates HSP90 turnover, hypersensitizes AR to residual post-castration androgen, drives AR nuclear activity under androgen-poor conditions, and confers enzalutamide resistance. Conversely, PSMA2 silencing stabilizes HSP90, desensitizes CRPC to androgen, and re-sensitizes resistant cells to enzalutamide-induced cell death. Importantly, PSMA2 also promotes lineage plasticity: treatment-induced PSMA2 enhances transcriptional and phenotypic conversion toward tNEPC. Thus, we uncover a single stress-induced node (PSMA2) that both maintains AR-dependent survival under ADT and fuels the neuroendocrine transition. PSMA2 marks an AR-hypersensitized transitional state and is itself a therapeutically actionable driver of tNEPC evolution, revealing an opportunity for rational interception of the lethal ADT-CRPC-tNEPC trajectory.
    DOI:  https://doi.org/10.1101/2025.11.25.690552
  12. Cell Mol Gastroenterol Hepatol. 2025 Dec 11. pii: S2352-345X(25)00247-4. [Epub ahead of print] 101705
       BACKGROUND&AIMS: Insulinomas are rare pancreatic neuroendocrine neoplasms (pan-NENs) characterized by inappropriate insulin secretion. Despite advances in imaging techniques, the reliable identification of insulin-secreting lesions remains challenging. In addition, medical treatment options are limited and have seen little development in recent years, highlighting the unmet need for improved diagnostic tools and therapeutic strategies. This study aimed to identify the molecular mechanisms underlying insulin hypersecretion in insulinomas.
    METHODS: We established a biobank of human insulinoma surgical specimens and matched organoids. Comprehensive transcriptomic analyses-including bulk RNA-seq, single-cell RNA-seq, qPCR, and immunohistochemistry-were conducted to identify genes enriched in insulin-secreting components. Functional validation was performed using MIN6 cells, a xenograft mouse model, and long-term cultured human insulinoma organoids.
    RESULTS: We identified DOCK10 as a gene selectively overexpressed in insulin-secreting components of insulinomas. DOCK10 knockdown impaired glucose-stimulated insulin secretion in both mouse insulinoma cells and patient-derived organoids. Inhibition of the downstream effector Cdc42 with ML141 reduced insulin hypersecretion and improved survival in a MIN6 xenograft mouse model. These findings uncover a previously unrecognized role of the DOCK10-Cdc42 axis in regulating insulin secretion in insulinoma.
    CONCLUSIONS: This study suggests that DOCK10 may serve as a diagnostic marker for insulin-secreting lesions and a potential therapeutic target in insulinoma. It provides mechanistic insights that may inform future strategies for precision diagnostics and treatment of functional pancreatic neuroendocrine tumors.
    Keywords:  DOCK10; Insulin Secretion; Insulinoma; Pancreatic Neuroendocrine Tumor
    DOI:  https://doi.org/10.1016/j.jcmgh.2025.101705
  13. Front Endocrinol (Lausanne). 2025 ;16 1716247
       Background: PRRT with [177Lu]Lu-DOTA-TATE improves survival in advanced GEP-NETs, but fixed-activity dosing may result in undertreatment or unnecessary toxicity. Individualized dosimetry and tandem-PRRT with 90Y/177Lu have been proposed, but prospective randomized evidence is lacking.
    Methods: DUONEN is an ongoing multicenter, randomized phase 3 trial (N = 92 planned; 56 analyzed) comparing standard fixed-activity [177Lu]Lu-DOTA-TATE (arm A) with three dosimetry-guided regimens: arm B (177Lu+90Y, variable 90Y); arm C (177Lu+90Y, variable 177Lu); arm D (variable 177Lu). Organ dosimetry was performed after each cycle, with per-cycle activity modifications to respect kidney (23 Gy) and marrow (2 Gy) thresholds. Safety was assessed by laboratory, renal, and hepatic parameters.
    Results: Activity reductions predominated in arms B and C, while increases were common in arm D. Median cumulative kidney and marrow doses were highest in arm C (29.1 Gy and 0.79 Gy, respectively), driven by 90Y contribution. Hematologic declines were observed across all arms, most prominently in lymphocytes and platelets, and correlated with marrow dose but not with categorical dose modifications. Renal function remained stable, and no clinically relevant hepatotoxicity occurred.
    Conclusions: This interim analysis demonstrates the feasibility and safety of dosimetry-guided PRRT strategies, including individualized 177Lu escalation and tandem 90Y/177Lu. DUONEN provides the first randomized prospective evidence for isotope- and patient-tailored PRRT dosing. Long-term follow-up will clarify their impact on efficacy.
    Clinical trial registration: https://www.clinicaltrialsregister.eu/ctr-search/search?query=eudract_number:2020-006068-99, identifier 2020-006068-99.
    Keywords:  GEP-NET; NET; PRRT; RLT; [177Lu]Lu-DOTA-TATE; [90Y]Y-DOTA-TATE; dosimetry; tandem therapy
    DOI:  https://doi.org/10.3389/fendo.2025.1716247
  14. JCO Precis Oncol. 2025 Oct;9 e2500574
       PURPOSE: Small cell lung cancer (SCLC) is an aggressive neuroendocrine malignancy associated with an exceptionally poor prognosis. A limitation in its standard-of-care management is the absence of practical molecular tools for monitoring disease progression. Circulating tumor DNA (ctDNA) has emerged as a promising biomarker with potential applications in prognostication, early detection of cancer recurrence, refined evaluation of treatment response, and improved disease surveillance.
    MATERIALS AND METHODS: We analyzed serial plasma samples from 81 patients with SCLC using a 105-gene hybrid capture-based next-generation sequencing liquid biopsy assay at three key time points: diagnosis, postchemotherapy, and clinical relapse.
    RESULTS: Extensive-stage (ES) patients demonstrated significantly higher median baseline maximum variant allele frequency (VAFmax) compared with limited-stage cases. Notably, limited-stage patients with VAFmax >40% experienced outcomes similar to those with ES disease. Across the cohort, median VAFmax values declined from 53.30% at baseline to 0.15% during remission and then rose to 38.65% at relapse, reflecting initial therapeutic sensitivity followed by disease recurrence that remained unremitting. Baseline VAFmax correlated with the overall response rate (ORR), progression-free survival (PFS), and overall survival (OS). Moreover, disease-free survival (DFS), defined as the time to relapse from the date of clinical response (evaluated post-4-cycle chemotherapy), was significantly associated with baseline VAFmax and a decline in VAFmax of <99.89% at remission. Relapse genomic profiles largely mirrored baseline alterations, although some patients showed novel mutations.
    CONCLUSION: Median ctDNA VAFmax was strongly associated with OS, PFS, DFS, and ORR. Importantly, patients with detectable residual alterations at completion of prescribed chemotherapy exhibited a markedly shorter DFS, less than that of patients with lower detectable residual alterations, highlighting the potential utility of ctDNA in risk stratification and the value of early trial enrollment for high-risk subgroups.
    DOI:  https://doi.org/10.1200/PO-25-00574
  15. Clin Nucl Med. 2025 Dec 15.
      [18F]FDG PET/CT is widely used in the diagnosis and treatment monitoring of lung cancer, yet its ability to differentiate histologic heterogeneity remains limited. In this case, a 75-year-old man presented with a large pulmonary mass adjacent to a small satellite lesion. Bronchoscopic biopsy of the main lesion revealed small-cell lung cancer (SCLC). After first-line chemotherapy, the primary lesion showed partial response, while the smaller nodule remained stable. Posttreatment [18F]FDG and [68Ga]Ga-DOTA-3P-TATE-RGD PET/CT demonstrated divergent uptake patterns. Rebiopsy of the nodule with discordant tracer uptake confirmed squamous cell carcinoma, indicating synchronous double primary lung cancers. The dual-targeted tracer PET/CT guided precise biopsy and individualized therapy.
    Keywords:  NSCLC; PET/CT; SCLC; SSTR2; integrin αvβ3
    DOI:  https://doi.org/10.1097/RLU.0000000000006258
  16. Clin Nucl Med. 2025 Dec 12.
      A 13-year-old girl with severe Cushingoid features had ectopic ACTH-dependent Cushing syndrome. 18F-FDG PET/CT demonstrated diffusely FDG-avid bilateral adrenal hyperplasia, confirming ectopic ACTH stimulation, and detected a presacral mass with mild uptake. 68Ga-DOTA-NOC PET/MRI revealed intense somatostatin-receptor activity (SUVmax: 56.1), and MRI identified fat and cystic elements, suggesting teratoma. Surgery proved a mature teratoma harboring an ACTH-secreting NET (G1). This rare case demonstrates that in pediatric patients with aggressive-appearing presacral masses and life-threatening hypercortisolism, complementary imaging modalities may be necessary to exclude malignancy while identifying the functional tumor source.
    Keywords:  ; PET/MRI; ectopic ACTH syndrome; neuroendocrine tumor; pediatric sacrococcygeal teratoma
    DOI:  https://doi.org/10.1097/RLU.0000000000006268
  17. bioRxiv. 2025 Nov 26. pii: 2025.11.23.690056. [Epub ahead of print]
      Resistance to androgen receptor (AR)-targeted therapies such as enzalutamide in castration-resistant prostate cancer (CRPC) often arises through lineage plasticity, yet the molecular mechanisms that define this process remain incompletely understood. While previous studies reported that Notch1 and Notch2 exert distinct and sometimes opposing effects in prostate cancer differentiation, the integrated role of Notch pathway activity has not been systematically explored. Here, we identify Notch signaling as a graded Rheostat that governs prostate cancer cell fate transitions. Integrative transcriptomic and functional analyses revealed that intermediate Notch activity maintains a stem-like progenitor state, whereas reduced or elevated signaling drives divergent differentiation trajectories toward luminal or neuroendocrine lineages, respectively. During CRPC progression and enzalutamide resistance, Notch signaling becomes dynamically rewired, peaking in progenitor-like populations that sustain plasticity and survival. Both CRISPR-mediated knockout and pharmacologic inhibition of Notch signaling depleted these progenitor cells and restored enzalutamide sensitivity. These findings demonstrate that the level, rather than the binary presence, of Notch signaling dictates lineage directionality and therapeutic response in CRPC, establishing it as a tunable and actionable driver of resistance.
    DOI:  https://doi.org/10.1101/2025.11.23.690056
  18. J Pathol. 2025 Dec 19.
      High-grade neuroendocrine tumors of the small intestine are separated into two groups: well-differentiated neuroendocrine tumors (NETs, high-grade) and poorly differentiated neuroendocrine carcinomas (NECs). They represent very rare entities, with few molecular data available, and are very challenging to treat. In this study we aimed to describe the molecular profile of these tumors and their spatial and temporal heterogeneity. We collected a national multicenter cohort of high-grade NETs (14 patients) and NECs (11 patients). DNA and RNA were extracted and somatic point mutations, copy number variations, and gene expression levels were studied using high-throughput sequencing of a panel of 571 genes and RNA sequencing, respectively. Additional samples to study spatial or temporal heterogeneity were available for 12 patients, leading to a total of 42 samples analyzed. Differential diagnostic markers were confirmed by immunohistochemistry. NECs resemble their counterparts in other organs, with a relatively high tumor mutational burden (TMB) and frequent alteration of TP53 and RB1, together with organ-specific alterations such as APC. In contrast, high-grade NETs resemble low-grade NETs, with a low TMB but frequent chromosomic alterations. Transcriptomic analysis confirmed that high-grade NETs and NECs are two distinct entities, with specific drivers. Serotonin pathway markers were the most efficient to discriminate high-grade ileal NETs from NECs. Despite variations in the proliferation index, NETs showed little spatial and temporal heterogeneity, suggesting that epigenetic mechanisms play a crucial role in tumor progression. © 2025 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
    Keywords:  NEC; NET; heterogeneity; high grade tumor; ileal neuroendocrine carcinoma; ileal neuroendocrine tumors; molecular profile
    DOI:  https://doi.org/10.1002/path.70004
  19. Histopathology. 2025 Dec 15.
      RB1 was the first identified tumour suppressor gene, named for its crucial role in opposing retinoblastoma oncogenesis. The RB1 gene encodes the retinoblastoma protein pRB, which is a well-known negative regulator of the cell cycle. However, pRB also contributes to cell differentiation by restricting reprogramming and stem cell properties. Accordingly, RB1 inactivation in tumours can induce phenotypic modifications, contributing to tumour progression. Indeed, RB1 pathogenic alterations, either point mutations or deletions, leading to pRB loss of function are observed in 5% of all human cancers. Mutations are much more prevalent in some histologic subgroups, including retinoblastoma, spindle cell lipoma, neuroendocrine prostate cancer and small cell lung carcinoma. In such entities, molecular investigation of tumour samples and mechanistic studies strongly suggest that early RB1 inactivation contributes not only to dysregulation of cell cycle control, but also to the tumour cell phenotype. Among skin carcinomas, RB1 inactivation is the hallmark of primary cutaneous neuroendocrine carcinoma commonly known as Merkel cell carcinoma (MCC), but it has also been described in other tumours including a subset of squamous cell carcinomas, sebaceous carcinomas and the recently described Wnt/beta-catenin-activated non-pilomatrical carcinomas. In this context, we provide a brief overview of the contribution of RB1 inactivation to oncogenesis and tumour cell phenotypes in general and summarise current knowledge regarding RB1-deficient cutaneous carcinomas, highlighting the potential uses of RB1 pathway characterisation for diagnosis, prognosis and therapeutic purposes.
    Keywords:  Merkel cell carcinoma; RB1; Wnt/beta‐catenin non pilomatrical carcinoma; sebaceous carcinoma; squamous cell carcinoma
    DOI:  https://doi.org/10.1111/his.70056
  20. Discov Oncol. 2025 Dec 19.
       OBJECTIVE: To investigate the biological functions of KHDRBS2 and KHDRBS3 in prostate cancer (PCa) progression and their potential roles in regulating androgen receptor splice variant 7 (AR-V7) expression, a key factor in castration-resistant prostate cancer (CRPC).
    METHODS: We performed a comprehensive analysis of publicly available datasets to examine the expression patterns of KHDRBS family members in PCa, including CRPC and neuroendocrine subtypes. In vitro experiments were conducted using AR-positive 22RV1 and AR-negative PC3 cell lines to assess the expression and regulatory interactions of KHDRBS2 and KHDRBS3. Functional assays evaluated their effects on cell proliferation and tumor growth in vivo. Additionally, KHDRBS2 protein levels were manipulated in 22RV1 cells to assess their impact on AR-V7 and full-length AR expression.
    RESULTS: Our dataset analysis revealed distinct expression patterns of KHDRBS2 and KHDRBS3, with higher alteration frequencies in CRPC and neuroendocrine PCa. In vitro, KHDRBS2 and KHDRBS3 exhibited mutually exclusive expression, with KHDRBS2 predominantly found in AR-positive 22RV1 cells and KHDRBS3 in AR-negative PC3 cells. Reciprocal regulation between the two proteins was observed in both cell lines. Functional studies showed that both KHDRBS2 and KHDRBS3 promoted cell proliferation and tumor growth. Notably, silencing KHDRBS2 in 22RV1 cells led to a selective reduction in AR-V7 expression, without affecting full-length AR levels.
    CONCLUSIONS: These findings uncover novel roles for KHDRBS2 and KHDRBS3 in PCa progression, with KHDRBS2 identified as a potential key regulator of AR-V7 expression. Our results provide new insights into AR splice variant regulation and highlight potential therapeutic targets for PCa treatment.
    Keywords:  AR-V7; Alternative splicing; Androgen receptor (AR); Castration-resistant prostate cancer; KHDRBS family; Prostate cancer
    DOI:  https://doi.org/10.1007/s12672-025-04294-1
  21. Cancer Immunol Immunother. 2025 Dec 18. 75(1): 8
       BACKGROUND: Although atezolizumab has demonstrated efficacy in advanced non-small-cell lung cancer (NSCLC), antidrug antibody (ADA) may reduce its effectiveness by lowering drug exposure. We explored the association between ADA levels and clinical outcomes.
    METHODS: We retrospectively analyzed 86 patients with advanced NSCLC who received atezolizumab monotherapy (1200 mg every 3 weeks) between August 2018 and September 2022 at Samsung Medical Center, Seoul, Korea. Blood samples were collected prior to the first and second doses (baseline and week 3). ADA levels were measured by ELISA and correlated with plasma atezolizumab concentrations and clinical outcomes using Kaplan-Meier estimates and Cox proportional hazards models.
    RESULTS: All 86 patients received atezolizumab as a second-line or later treatment (second-line, n = 65; third-line, n = 12; ≥ fourth-line, n = 9). Patients (median age [IQR], 67 [61-73] years; 73 [84.9%] male) showed significantly elevated ADA levels three weeks after treatment (median [IQR] 0 [0-0] vs. 530.3 [146.9-3050.5] ng/mL; p < 0.001). Strong ADA levels (≥ 1000 ng/mL) were observed in 32 (37.2%) patients and were associated with shorter PFS (HR = 1.86, 95% CI: 1.15-3.02, p = 0.010) and OS (HR = 1.92, 95% CI: 1.14-3.23, p = 0.013). Furthermore, patients with high ADA levels exhibited lower atezolizumab concentrations and reduced response rates compared to those with low ADA levels. Importantly, high ADA levels independently predicted poor prognosis in a multivariable analysis adjusted for clinical variables.
    CONCLUSIONS: High ADA levels were linked to lower atezolizumab exposure and worse outcomes. ADA monitoring may help predict prognosis and guide immunotherapy strategies.
    Keywords:  Antidrug antibody; Atezolizumab; Immunotherapy; Non-small-cell lung cancer; PD-L1
    DOI:  https://doi.org/10.1007/s00262-025-04245-3
  22. J Inflamm Res. 2025 ;18 17211-17222
       Purpose: To investigate the predictive value of peripheral blood neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), neutrophil percentage-to-albumin-ratio (NPAR), and D-dimer in the efficacy and prognosis of immunotherapy for extensive-stage small cell lung cancer (ES-SCLC).
    Patients and Methods: A total of 70 ES-SCLC were included. The diagnostic performance of inflammatory indexes and D-dimer in predicting the efficacy and prognosis of immunotherapy was evaluated using receiver operating characteristic curve (ROC). Disease control rate (DCR) was used as the assessment indicator for immunotherapy efficacy, and progression free survival (PFS) > 6 months was used as the judgement indicator for better prognosis. Using Lasso regression and logistic multivariate analysis to predict the efficacy and prognosis of immunotherapy, and the optimal cut-off value was determined according to the area under the ROC curve. Kaplan-Meier survival analysis was applied to compare survival differences between groups.
    Results: At baseline, PLR can predict the efficacy of immunotherapy in ES-SCLC patients, but cannot predict their prognosis. After two cycles of immunotherapy, NLR can not only predict the efficacy and prognosis of immunotherapy, but also be identified as an independent predictor of long-term PFS in multivariate analysis (P<0.01). The long-term PFS rate of the low NLR2 group (<2.2) was significantly higher than that of the high NLR2 group (≥ 2.2) (P<0.001), with median PFS of 4.83 months vs 9.9 months, respectively, P<0.001.
    Conclusion: After two cycles of chemotherapy combined with immunotherapy, the efficacy and prognosis of NLR and ES-SCLC immunotherapy are closely related and can serve as effective and reliable predictive indicators.
    Keywords:  D-dimer; immunotherapy; inflammatory indicators; therapeutic effect prediction
    DOI:  https://doi.org/10.2147/JIR.S557312