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Serial single cell genomics reveals convergent subclonal evolution of resistance as patients with early stage breast cancer progress on endocrine plus CDK4 6 therapy nature cancer

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Article Published: 03 June 2021Serial single-cell genomics reveals convergent subclonal evolution of resistance as patients with early-stage breast cancer progress on endocrine plus CDK4

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Article Published: 03 June 2021

Serial single-cell genomics reveals convergent subclonal evolution

of resistance as patients with early-stage breast cancer progress

on endocrine plus CDK4/6 therapy

Jason I Griffiths, Jinfeng Chen, Patrick A Cosgrove, Anne O’Dea, Priyanka Sharma, Cynthia Ma,

Meghna Trivedi, Kevin Kalinsky, Kari B Wisinski, Ruth O’Regan, Issam Makhoul, Laura M Spring,

Aditya Bardia, Frederick R Adler, Adam L Cohen, Jeffrey T Chang, Qamar J Khan & Andrea H.

using single-cell RNA sequencing of serial biopsies from the FELINE clinical trial of endocrinetherapy (letrozole) alone or combined with the CDK inhibitor ribociclib Despite differences insubclonal diversity evolution across patients and treatments, common resistance phenotypes

emerged Resistant tumors treated with combination therapy showed accelerated loss of estrogensignaling with convergent upregulation of JNK signaling through growth factor receptors In

contrast, cancer cells maintaining estrogen signaling during mono- or combination therapy

showed potentiation of CDK4/6 activation and ERK upregulation through ERBB4 signaling

These results indicate that combination therapy in early-stage estrogen receptor-positive breast

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cancer leads to emergence of resistance through a shift from estrogen to alternative growth mediated proliferation.

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Data availability

Raw single-cell RNA-seq data are available through Gene Expression Omnibus under accession

provided with this manuscript as individual Excel files (one per figure) and listed in the Inventory.Code for Figs 1–6 is available on our GitHub repository at

https://elkssl99cd2175108d157588c04758296d1cfcelksslnature.casb.nju.edu.cn:4443/U54Bioinformatics/FELINE_project All other data supporting the findings of this study are available fromthe corresponding author on reasonable request Source data are provided with this paper

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Acknowledgements

We thank the anonymous patients from the trial that made this study possible A.H.B., J.G., J.C.,J.T.C., P.C and F.A were supported by the National Cancer Institute of the National Institutes ofHealth (NIH) under award number U54CA209978 The content is solely the authors

responsibility and does not necessarily represent the official views of the NIH The

High-Throughput Genomics Shared Resource was supported by the NIH award number P30CA042014.The Integrative Genomics Core was supported by NIH award number P30CA33572 J.T.C was

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supported by a Cancer Prevention Research Institute of Texas Core Facility Support Award

(RP170668)

Author information

1 Jinfeng Chen

Present address: State Key Laboratory of Integrated Management of Pest Insects and

Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing, China

2 These authors contributed equally: Jason I Griffiths, Jinfeng Chen

3 These authors jointly supervised this work: Andrea H Bild, Qamar J Khan

Affiliations

1 Department of Medical Oncology and Therapeutics Research, City of Hope National

Medical Center, Duarte, CA, USA

Jason I Griffiths, Jinfeng Chen, Patrick A Cosgrove & Andrea H Bild

2 Department of Mathematics, University of Utah, Salt Lake City, UT, USA

Jason I Griffiths & Frederick R Adler

3 Division of Medical Oncology, University of Kansas Medical Center, Westwood, KS, USA

Anne O’Dea, Priyanka Sharma & Qamar J Khan

4 Division of Oncology, Washington University School of Medicine, St Louis, MO, USA

Cynthia Ma

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