ONECUT2 reprograms neuroendocrine fate and is an actionable therapeutic target in small cell lung cancer

Abstract Small cell lung cancer (SCLC) is a highly aggressive malignancy with extremely poor prognosis. SCLC cells exhibit high plasticity and can progress from neuroendocrine (NE) to non-NE phenotypes. This dynamic evolution promotes treatment resistance and relapses, representing a challenge for t...

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Main Authors: Mirian Gutiérrez, Irene Zamora, Raquel Iriarte, María José Pajares, Qian Yang, Chen Qian, Nerea Otegui, Joaquín Fernández-Irigoyen, Enrique Santamaría, Nicolas Alcala, Alexandra Sexton-Oates, Lynnette Fernández-Cuesta, Miguel Barajas, Alfonso Calvo, Luis M. Montuenga, Beatrice Knudsen, Sungyong You, Michael R. Freeman, Ignacio Encío, Mirja Rotinen
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Molecular Medicine
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Online Access:https://doi.org/10.1186/s10020-025-01267-6
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author Mirian Gutiérrez
Irene Zamora
Raquel Iriarte
María José Pajares
Qian Yang
Chen Qian
Nerea Otegui
Joaquín Fernández-Irigoyen
Enrique Santamaría
Nicolas Alcala
Alexandra Sexton-Oates
Lynnette Fernández-Cuesta
Miguel Barajas
Alfonso Calvo
Luis M. Montuenga
Beatrice Knudsen
Sungyong You
Michael R. Freeman
Ignacio Encío
Mirja Rotinen
author_facet Mirian Gutiérrez
Irene Zamora
Raquel Iriarte
María José Pajares
Qian Yang
Chen Qian
Nerea Otegui
Joaquín Fernández-Irigoyen
Enrique Santamaría
Nicolas Alcala
Alexandra Sexton-Oates
Lynnette Fernández-Cuesta
Miguel Barajas
Alfonso Calvo
Luis M. Montuenga
Beatrice Knudsen
Sungyong You
Michael R. Freeman
Ignacio Encío
Mirja Rotinen
author_sort Mirian Gutiérrez
collection DOAJ
description Abstract Small cell lung cancer (SCLC) is a highly aggressive malignancy with extremely poor prognosis. SCLC cells exhibit high plasticity and can progress from neuroendocrine (NE) to non-NE phenotypes. This dynamic evolution promotes treatment resistance and relapses, representing a challenge for targeted therapies in this elusive disease. Here we identify the transcription factor ONECUT2 (OC2) as a driver of plasticity in SCLC, leading to non-NE transcriptional states. OC2 is highly expressed in SCLC tumors compared to normal lung tissue and its expression is associated with heightened clinical stage and lymph node metastasis. We show that OC2 is a repressor of ASCL1, the NE master regulator transcription factor. In addition, OC2 upregulates non-NE programs through activation of c-MYC and Notch signaling. We also demonstrate that OC2 is required for growth and survival of SCLC cells and that it can be targeted with a small molecule inhibitor that acts synergistically with the standard combination of cisplatin and etoposide, providing a novel therapeutic strategy for OC2 active SCLC tumors.
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issn 1528-3658
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publishDate 2025-06-01
publisher BMC
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series Molecular Medicine
spelling doaj-art-b34f2575512b45d0af11cae442e1c9772025-08-20T02:39:24ZengBMCMolecular Medicine1528-36582025-06-0131111610.1186/s10020-025-01267-6ONECUT2 reprograms neuroendocrine fate and is an actionable therapeutic target in small cell lung cancerMirian Gutiérrez0Irene Zamora1Raquel Iriarte2María José Pajares3Qian Yang4Chen Qian5Nerea Otegui6Joaquín Fernández-Irigoyen7Enrique Santamaría8Nicolas Alcala9Alexandra Sexton-Oates10Lynnette Fernández-Cuesta11Miguel Barajas12Alfonso Calvo13Luis M. Montuenga14Beatrice Knudsen15Sungyong You16Michael R. Freeman17Ignacio Encío18Mirja Rotinen19Department of Health Sciences, Public University of NavarreDepartment of Health Sciences, Public University of NavarreDepartment of Health Sciences, Public University of NavarreDepartment of Health Sciences, Public University of NavarreDepartment of Urology and Biomedical Sciences, Cedars-Sinai Medical CenterDepartment of Computational Biomedicine, Cedars-Sinai Medical CenterCenter for Applied Medical Research (CIMA), University of NavarraDepartment of Health Sciences, Public University of NavarreDepartment of Health Sciences, Public University of NavarreRare Cancers Genomics Team (RCG), Genomic Epidemiology Branch (GEM), International Agency for Research On Cancer/World Health Organization (IARC/WHO)Rare Cancers Genomics Team (RCG), Genomic Epidemiology Branch (GEM), International Agency for Research On Cancer/World Health Organization (IARC/WHO)Rare Cancers Genomics Team (RCG), Genomic Epidemiology Branch (GEM), International Agency for Research On Cancer/World Health Organization (IARC/WHO)Department of Health Sciences, Public University of NavarreCenter for Applied Medical Research (CIMA), University of NavarraCenter for Applied Medical Research (CIMA), University of NavarraDepartment of Pathology, University of UtahDepartment of Urology and Biomedical Sciences, Cedars-Sinai Medical CenterDepartment of Urology and Biomedical Sciences, Cedars-Sinai Medical CenterDepartment of Health Sciences, Public University of NavarreDepartment of Health Sciences, Public University of NavarreAbstract Small cell lung cancer (SCLC) is a highly aggressive malignancy with extremely poor prognosis. SCLC cells exhibit high plasticity and can progress from neuroendocrine (NE) to non-NE phenotypes. This dynamic evolution promotes treatment resistance and relapses, representing a challenge for targeted therapies in this elusive disease. Here we identify the transcription factor ONECUT2 (OC2) as a driver of plasticity in SCLC, leading to non-NE transcriptional states. OC2 is highly expressed in SCLC tumors compared to normal lung tissue and its expression is associated with heightened clinical stage and lymph node metastasis. We show that OC2 is a repressor of ASCL1, the NE master regulator transcription factor. In addition, OC2 upregulates non-NE programs through activation of c-MYC and Notch signaling. We also demonstrate that OC2 is required for growth and survival of SCLC cells and that it can be targeted with a small molecule inhibitor that acts synergistically with the standard combination of cisplatin and etoposide, providing a novel therapeutic strategy for OC2 active SCLC tumors.https://doi.org/10.1186/s10020-025-01267-6ONECUT2SCLCTumor heterogeneityPhenotypic plasticityTherapeutic target
spellingShingle Mirian Gutiérrez
Irene Zamora
Raquel Iriarte
María José Pajares
Qian Yang
Chen Qian
Nerea Otegui
Joaquín Fernández-Irigoyen
Enrique Santamaría
Nicolas Alcala
Alexandra Sexton-Oates
Lynnette Fernández-Cuesta
Miguel Barajas
Alfonso Calvo
Luis M. Montuenga
Beatrice Knudsen
Sungyong You
Michael R. Freeman
Ignacio Encío
Mirja Rotinen
ONECUT2 reprograms neuroendocrine fate and is an actionable therapeutic target in small cell lung cancer
Molecular Medicine
ONECUT2
SCLC
Tumor heterogeneity
Phenotypic plasticity
Therapeutic target
title ONECUT2 reprograms neuroendocrine fate and is an actionable therapeutic target in small cell lung cancer
title_full ONECUT2 reprograms neuroendocrine fate and is an actionable therapeutic target in small cell lung cancer
title_fullStr ONECUT2 reprograms neuroendocrine fate and is an actionable therapeutic target in small cell lung cancer
title_full_unstemmed ONECUT2 reprograms neuroendocrine fate and is an actionable therapeutic target in small cell lung cancer
title_short ONECUT2 reprograms neuroendocrine fate and is an actionable therapeutic target in small cell lung cancer
title_sort onecut2 reprograms neuroendocrine fate and is an actionable therapeutic target in small cell lung cancer
topic ONECUT2
SCLC
Tumor heterogeneity
Phenotypic plasticity
Therapeutic target
url https://doi.org/10.1186/s10020-025-01267-6
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