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Spatial multi-omics unveils the monoclonal origin, neuroendocrine plasticity, and microenvironment niches in combined small-cell lung cancer - PubMed

3 hours ago
  • #tumor microenvironment
  • #lineage plasticity
  • #spatial multi-omics
  • Combined small-cell lung cancer (cSCLC) is an aggressive subtype with mixed histologic components, managed similarly to SCLC despite poorer prognosis and limited molecular insights.
  • Study uses spatial whole-exome sequencing, spatial transcriptomics, and single-nucleus RNA sequencing on 19 treatment-naïve cSCLC tumors.
  • Different histologic components share a monoclonal origin, but divergence is associated with distinct mutation and copy-number alteration patterns.
  • Spatially exclusive or interspersed tumor domains identified with distinct tumor microenvironment (TME) and immune landscapes.
  • Fibroblast-rich boundaries enriched for an aggressive fibroblast subtype may shape TME and treatment responses.
  • Lineage plasticity observed, including adenocarcinoma-to-SCLC transdifferentiation and SCLC-subtype coexistence.
  • cSCLC Detector, a sensitive mutation-based assay developed to improve cSCLC detection in tissue and liquid biopsies.
  • Findings illuminate cSCLC evolution and heterogeneity, underscoring the need for tailored diagnostic and therapeutic strategies.