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Cancer-associated fibroblasts are associated with neo-adjuvant treatment response in oesophageal adenocarcinoma

Cancer-associated fibroblasts are associated with neo-adjuvant treatment response in oesophageal adenocarcinoma
Cancer-associated fibroblasts are associated with neo-adjuvant treatment response in oesophageal adenocarcinoma

Background: neoadjuvant treatment (NAT) in oesophageal adenocarcinoma (EAC) is characterised by differential responses between patients and treatment modalities. The components of the tumour microenvironment (TME) that contribute to this are unknown. We explored this, focusing on cancer-associated fibroblasts (CAF) an abundant TME component.

Methods: we performed histopathologic, single-cell RNA sequencing and transcriptomic analysis on 26 patients, stratified by pathological response to NAT, and validated a prognostic model in genomic consortia cohorts. Patient-derived cells were used to model CAF phenotypes in vitro.

Results: we observed changes in the TME in response to the NAT received. Specific changes in fibroblasts correlated with treatment response and altered gene expression associated with NAT type. Three myofibroblastic phenotypes dominate the TME, two of which persist in non-responders and could only be partially re-capitulated in vitro using co-culture with cancer cells or TGF-β. A two-gene NAT fibrotic signature was an independent prognostic indicator in chemo/chemoradiotherapy treated patients (HR = 2.47, p = 0.029).

Conclusions: this study provides a compendium of cell phenotypes in EAC across the current NAT treatment pathway that provides insights into CAF biology and cancer progression. MyoCAFs represent an axis to repurpose agents to enhance current therapies and immunotherapy.

0007-0920
Walker, Robert C.
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Breininger, Stella P.
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Sharpe, Benjamin P.
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Harrington, Jack
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Reddin, Ian
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Tse, Carmen
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Rajak, Rushda
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Hayden, Annette
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Rahman, Saqib
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Grace, Ben
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Izadi, Fereshteh
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West, Jonathan
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Secrier, Maria
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Walters, Zoë S.
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Rose-Zerilli, Matthew J.J.
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Underwood, Timothy J.
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OCCAMS Consortium
Walker, Robert C.
c8fbfe1c-349d-497f-b24e-0295c84c4634
Breininger, Stella P.
b6027df8-22a3-4d09-8799-6d14123f9ce4
Sharpe, Benjamin P.
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Harrington, Jack
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Reddin, Ian
b5f50ec1-83fb-4f15-a41f-f9c544d7ccc0
Tse, Carmen
22250af6-10f5-4443-b10e-e7dbba722306
Rajak, Rushda
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Hayden, Annette
3a43aee1-3ff0-4182-956d-b6c7b3a7f8be
Rahman, Saqib
e2b565d4-df7f-4496-8cc3-80fc63a9e4cd
Grace, Ben
eb5ebff2-17c4-4e77-bc08-fb24826d558f
Izadi, Fereshteh
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West, Jonathan
f1c2e060-16c3-44c0-af70-242a1c58b968
Secrier, Maria
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Walters, Zoë S.
e1ccd35d-63a9-4951-a5da-59122193740d
Rose-Zerilli, Matthew J.J.
29603401-e310-4054-b818-8a542c361b9a
Underwood, Timothy J.
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OCCAMS Consortium (2025) Cancer-associated fibroblasts are associated with neo-adjuvant treatment response in oesophageal adenocarcinoma. British Journal of Cancer. (doi:10.1038/s41416-025-03080-8).

Record type: Article

Abstract

Background: neoadjuvant treatment (NAT) in oesophageal adenocarcinoma (EAC) is characterised by differential responses between patients and treatment modalities. The components of the tumour microenvironment (TME) that contribute to this are unknown. We explored this, focusing on cancer-associated fibroblasts (CAF) an abundant TME component.

Methods: we performed histopathologic, single-cell RNA sequencing and transcriptomic analysis on 26 patients, stratified by pathological response to NAT, and validated a prognostic model in genomic consortia cohorts. Patient-derived cells were used to model CAF phenotypes in vitro.

Results: we observed changes in the TME in response to the NAT received. Specific changes in fibroblasts correlated with treatment response and altered gene expression associated with NAT type. Three myofibroblastic phenotypes dominate the TME, two of which persist in non-responders and could only be partially re-capitulated in vitro using co-culture with cancer cells or TGF-β. A two-gene NAT fibrotic signature was an independent prognostic indicator in chemo/chemoradiotherapy treated patients (HR = 2.47, p = 0.029).

Conclusions: this study provides a compendium of cell phenotypes in EAC across the current NAT treatment pathway that provides insights into CAF biology and cancer progression. MyoCAFs represent an axis to repurpose agents to enhance current therapies and immunotherapy.

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s41416-025-03080-8 - Version of Record
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Accepted/In Press date: 29 May 2025
e-pub ahead of print date: 10 July 2025

Identifiers

Local EPrints ID: 504265
URI: http://eprints.soton.ac.uk/id/eprint/504265
ISSN: 0007-0920
PURE UUID: 6ae5d15e-c911-4cda-8165-e50e6466d4f4
ORCID for Benjamin P. Sharpe: ORCID iD orcid.org/0000-0002-7594-1601
ORCID for Ian Reddin: ORCID iD orcid.org/0000-0001-5478-7855
ORCID for Jonathan West: ORCID iD orcid.org/0000-0002-5709-6790
ORCID for Zoë S. Walters: ORCID iD orcid.org/0000-0002-1835-5868
ORCID for Timothy J. Underwood: ORCID iD orcid.org/0000-0001-9455-2188

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Date deposited: 02 Sep 2025 16:53
Last modified: 03 Sep 2025 02:04

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Contributors

Author: Robert C. Walker
Author: Stella P. Breininger
Author: Benjamin P. Sharpe ORCID iD
Author: Jack Harrington
Author: Ian Reddin ORCID iD
Author: Carmen Tse
Author: Rushda Rajak
Author: Annette Hayden
Author: Saqib Rahman
Author: Ben Grace
Author: Fereshteh Izadi
Author: Jonathan West ORCID iD
Author: Maria Secrier
Author: Zoë S. Walters ORCID iD
Author: Matthew J.J. Rose-Zerilli
Corporate Author: OCCAMS Consortium

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