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Similar to tumor-initiating cells (TICs), minimal residual disease (MRD) is capable of reinitiating tumors and causing recurrence. However, the molecular characteristics of solid tumor MRD cells and drivers of their survival have remained elusive. Here we performed dense multiregion transcriptomics analysis of paired biopsies from 17 ovarian cancer patients before and after chemotherapy. We reveal that while MRD cells share important molecular signatures with TICs, they are also characterized by an adipocyte-like gene expression signature and a portion of them had undergone epithelial-mesenchymal transition (EMT). In a cell culture MRD model, MRD-mimic cells showed the same phenotype and were dependent on fatty acid oxidation (FAO) for survival and resistance to cytotoxic agents. These findings identify EMT and FAO as attractive targets to eradicate MRD in ovarian cancer and make a compelling case for the further testing of FAO inhibitors in treating MRD.

Original publication

DOI

10.1172/jci.insight.147929

Type

Journal article

Journal

JCI Insight

Publication Date

08/06/2021

Volume

6

Keywords

Fatty acid oxidation, Obstetrics/gynecology, Oncology, Adipocytes, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Carboplatin, Carcinoma, Ovarian Epithelial, Cell Line, Tumor, Cytoreduction Surgical Procedures, Epithelial-Mesenchymal Transition, Fatty Acids, Female, Humans, Middle Aged, Neoadjuvant Therapy, Neoplasm, Residual, Neoplastic Stem Cells, Ovarian Neoplasms, Oxidation-Reduction, Paclitaxel, Transcriptome