28.2.2018 Elsa

Tumor Architecture and Notch Signaling Modulate Drug Response in Basal Cell Carcinoma

Volume 33, Issue 2, p229–243.e4, 12 February 2018


Graphical abstract
https://doi.org/10.1016/j.ccell.2017.12.015 |


  • Hedgehog pathway inhibitors are effective against BCC, but tumor cells often persist
  • Tumor basal and suprabasal cells differ in gene expression and drug response
  • Inhibiting Notch promotes tumor persistence, but not drug resistance, upon treatment
  • Latently activating Notch is sufficient to regress already established tumors


Hedgehog (Hh) pathway inhibitors such as vismodegib are highly effective for treating basal cell carcinoma (BCC); however, residual tumor cells frequently persist and regenerate the primary tumor upon drug discontinuation. Here, we show that BCCs are organized into two molecularly and functionally distinct compartments. Whereas interior Hh+/Notch+ suprabasal cells undergo apoptosis in response to vismodegib, peripheral Hh+++/Notch basal cells survive throughout treatment. Inhibiting Notch specifically promotes tumor persistence without causing drug resistance, while activating Notch is sufficient to regress already established lesions. Altogether, these findings suggest that the three-dimensional architecture of BCCs establishes a natural hierarchy of drug response in the tumor and that this hierarchy can be overcome, for better or worse, by modulating Notch.


Although therapeutics targeting the Hedgehog signaling pathway are highly effective at treating basal cell carcinoma (BCC), cancer cells frequently persist and regenerate the primary tumor once treatment is stopped. Our findings suggest that persistent cancer cells likely originate from the tumor periphery and display low Notch pathway activity. In contrast, cancer cells located at the interior of the tumor mass activate Notch and are efficiently eliminated by drug treatment. These findings suggest that the cellular architecture of BCC, likely determined by contact with the surrounding basement membrane, may influence whether tumor cells persist or are destroyed in response to therapy.


One thought on “28.2.2018 Elsa”

  1. Not going to cover this but was in the same issue:

    An Epigenetic Switch: From Senescent Melanocytes to Malignant Melanoma (and Back)

    Re-engaging Senescence in Melanoma by Targeting H3K9 Demethylases

    “Oncogene-induced senescence is an important barrier during melanomagenesis. In this issue of Cancer Cell, Yu et al. show how elevated expression of structurally unrelated H3K9 demethylases disables senescence and constitutes a liability that can be exploited to restore senescence in melanoma by pharmacological inhibition of these epigenetic regulators.”


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