Background: TROP2, a critical cell surface oncogenic signal transducer, is increasingly linked to refractory metastatic colorectal cancer (CRC) and other solid tumours. Robust lactate accumulation within metastatic niches correlates with pathological metastatic progression. Anti-TROP2 antibody-drug conjugates (ADCs) are clinically available but show limited efficacy in advanced metastatic CRC. Elucidating how TROP2 signalling orchestrates molecular and cellular programs enabling CRC metastatic progression would help improve metastasis therapies.
Methods: Tissue microarray, immunohistochemistry, and western blotting delineated TROP2's pathological role in CRC liver metastasis (CRLM). Metabolomics characterised TROP2-mediated metabolic effect. Western blot detected TROP2 responsive lactylation sites. Cell-derived xenograft (CDX), intra-splenic injection models, and patient-derived xenografts (PDX) validated TROP2 or TROP2-induced H3K18 lactylation (H3K18la) in CRLM pathogenesis and Acriflavine therapeutic response. Genome-wide H3K18la profiling was performed by ChIP-seq.
Results: Here, we identify a self-reinforcing positive feedback loop between H3K18la and TROP2 in CRC cells that drives CRC metastatic progression. We show that TROP2 is elevated during CRC metastatic process, with high TROP2 levels in liver metastases predicting increased post-therapy recurrence in two distinct cohorts. We find that H3K18la levels are upregulated in CRC cells in response to TROP2 expression level. TROP2 promotes robust lactate production via the YBX1-HIF-1α signal axis. Targeting glycolytic flux decreases H3K18 lactylation and curbs TROP2-driven CRLM colonisation and progression. Mechanistically, ChIP-seq detection reveals H3K18la deposition at a set of pro-metastatic gene promoters, promoting their expression. Crucially, TROP2-induced H3K18la is found in turn sustaining TROP2 expression, forming a positive feedback loop that further accelerated metastatic progression. Pharmacologic HIF-1α inhibition with acriflavine, an old FDA-approved agent, suppresses TROP2-high CRLM progression in multiple pre-clinical models.
Conclusions: Collectively, we establish H3K18la as a crucial epigenetic driver of TROP2-mediated CRLM progression and propose that disrupting the H3K18la–TROP2 feedback loop offers a novel therapeutic strategy against CRC metastasis.
| [1] |
Siegel RL, Wagle NS, Cercek A, et al. Colorectal cancer statistics, 2023. CA Cancer J Clin. 2023; 73(3): 233-254.
|
| [2] |
Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3): 209-249.
|
| [3] |
O'Reilly DA, Poston GJ. Colorectal liver metastases: current and future perspectives. Future Oncol. 2006; 2(4): 525-531.
|
| [4] |
Van Cutsem E, Cervantes A, Adam R, et al. ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol. 2016; 27(8): 1386-1422.
|
| [5] |
Dexiang Z, Li R, Ye W, et al. Outcome of patients with colorectal liver metastasis: analysis of 1,613 consecutive cases. Ann Surg Oncol. 2012; 19(9): 2860-2868.
|
| [6] |
Sadot E, Groot Koerkamp B, Leal JN, et al. Resection margin and survival in 2368 patients undergoing hepatic resection for metastatic colorectal cancer: surgical technique or biologic surrogate?. Ann Surg. 2015; 262(3): 476-485. discussion 483–5.
|
| [7] |
D'Angelica M, Kornprat P, Gonen M, et al. Effect on outcome of recurrence patterns after hepatectomy for colorectal metastases. Ann Surg Oncol. 2011; 18(4): 1096-1103.
|
| [8] |
Imai K, Allard MA, Benitez CC, et al. early recurrence after hepatectomy for colorectal liver metastases: what optimal definition and what predictive factors? Oncologist. 2016; 21(7): 887-894.
|
| [9] |
Biller LH, Schrag D. Diagnosis and treatment of metastatic colorectal cancer: a review. Jama. 2021; 325(7): 669-685.
|
| [10] |
Lee JC, Mehdizadeh S, Smith J, et al. Regulatory T cell control of systemic immunity and immunotherapy response in liver metastasis. Sci Immunol. 2020; 5(52):eaba0759.
|
| [11] |
Liu X, Deng J, Yuan Y, et al. Advances in Trop2-targeted therapy: novel agents and opportunities beyond breast cancer. Pharmacol Ther. 2022; 239:108296.
|
| [12] |
Mustata RC, Vasile G, Fernandez-Vallone V, et al. Identification of Lgr5-independent spheroid-generating progenitors of the mouse fetal intestinal epithelium. Cell Rep. 2013; 5(2): 421-432.
|
| [13] |
Foersch S, Schmitt M, Litmeyer AS, et al. TROP2 in colorectal carcinoma: associations with histopathology, molecular phenotype, and patient prognosis. J Pathol Clin Res. 2024; 10(5):e12394.
|
| [14] |
Ohmachi T, Tanaka F, Mimori K, et al. Clinical significance of TROP2 expression in colorectal cancer. Clin Cancer Res. 2006; 12(10): 3057-3063.
|
| [15] |
Sawada A, Ohira M, Hatanaka KC, et al. Expression analysis of early metastatic seeding of colorectal cancer. Ann Surg Oncol. 2024; 31(3): 2101-2113.
|
| [16] |
Bessede A, Peyraud F, Besse B, et al. TROP2 is associated with primary resistance to immune checkpoint inhibition in patients with advanced non-small cell lung cancer. Clin Cancer Res. 2024; 30(4): 779-785.
|
| [17] |
Trabolsi A, Kareff SA, Rodriguez E, et al. The genomic, transcriptomic, and immunological landscape of TROP2 in solid tumors. J Clin Oncol. 2023; 41(16_suppl): 3118-3118.
|
| [18] |
Liu S, Hsu EC, Aslan M, et al. Extracellular domain shedding of TROP2 activates EGFR signaling to drive prostate cancer metastasis. Cancer Res. 2025; 85(23): 4632-4647.
|
| [19] |
Cañellas-Socias A, Cortina C, Hernando-Momblona X, et al. Metastatic recurrence in colorectal cancer arises from residual EMP1(+) cells. Nature. 2022; 611(7936): 603-613.
|
| [20] |
Liu X, Ma L, Li J, et al. Trop2-targeted therapies in solid tumors: advances and future directions. Theranostics. 2024; 14(9): 3674-3692.
|
| [21] |
Bardia A, Messersmith WA, Kio EA, et al. Sacituzumab govitecan, a Trop-2-directed antibody-drug conjugate, for patients with epithelial cancer: final safety and efficacy results from the phase I/II IMMU-132-01 basket trial. Ann Oncol. 2021; 32(6): 746-756.
|
| [22] |
Faubert B, Solmonson A, DeBerardinis RJ. Metabolic reprogramming and cancer progression. Science. 2020; 368(6487):eaaw5473.
|
| [23] |
Bergers G, Fendt SM. The metabolism of cancer cells during metastasis. Nat Rev Cancer. 2021; 21(3): 162-180.
|
| [24] |
Gerstberger S, Jiang Q, Ganesh K. Metastasis. Cell. 2023; 186(8): 1564-1579.
|
| [25] |
Zhong X, He X, Wang Y, et al. Warburg effect in colorectal cancer: the emerging roles in tumor microenvironment and therapeutic implications. J Hematol Oncol. 2022; 15(1): 160.
|
| [26] |
Vander Heiden MG, Cantley LC, Thompson CB. Understanding the Warburg effect: the metabolic requirements of cell proliferation. Science. 2009; 324(5930): 1029-1033.
|
| [27] |
Warburg O. On the origin of cancer cells. Science. 1956; 123(3191): 309-314.
|
| [28] |
Guerra E, Trerotola M, Tripaldi R, et al. Trop-2 induces tumor growth through AKT and determines sensitivity to AKT inhibitors. Clin Cancer Res. 2016; 22(16): 4197-4205.
|
| [29] |
Zhang D, Tang Z, Huang H, et al. Metabolic regulation of gene expression by histone lactylation. Nature. 2019; 574(7779): 575-580.
|
| [30] |
Yu J, Chai P, Xie M, et al. Histone lactylation drives oncogenesis by facilitating m(6)A reader protein YTHDF2 expression in ocular melanoma. Genome Biol. 2021; 22(1): 85.
|
| [31] |
Fan W, Zeng S, Wang X, et al. A feedback loop driven by H3K9 lactylation and HDAC2 in endothelial cells regulates VEGF-induced angiogenesis. Genome Biol. 2024; 25(1): 165.
|
| [32] |
Millán-Zambrano G, Burton A, Bannister AJ, et al. Histone post-translational modifications – cause and consequence of genome function. Nat Rev Genet. 2022; 23(9): 563-580.
|
| [33] |
Black JC, Van Rechem C, Whetstine JR. Histone lysine methylation dynamics: establishment, regulation, and biological impact. Mol Cell. 2012; 48(4): 491-507.
|
| [34] |
Shvedunova M, Akhtar A. Modulation of cellular processes by histone and non-histone protein acetylation. Nat Rev Mol Cell Biol. 2022; 23(5): 329-349.
|
| [35] |
Li W, Zhou C, Yu L, et al. Tumor-derived lactate promotes resistance to bevacizumab treatment by facilitating autophagy enhancer protein RUBCNL expression through histone H3 lysine 18 lactylation (H3K18la) in colorectal cancer. Autophagy. 2024; 20(1): 114-130.
|
| [36] |
Zhang C, Zhou L, Zhang M, et al. H3K18 lactylation potentiates immune escape of non-small cell lung cancer. Cancer Res. 2024; 84(21): 3589-3601.
|
| [37] |
Lin X, Lei Y, Pan M, et al. Augmentation of scleral glycolysis promotes myopia through histone lactylation. Cell Metab. 2024; 36(3): 511-525.e7.
|
| [38] |
Pan RY, He L, Zhang J, et al. Positive feedback regulation of microglial glucose metabolism by histone H4 lysine 12 lactylation in Alzheimer's disease. Cell Metab. 2022; 34(4): 634-648.e6.
|
| [39] |
Reyes DK, Pienta KJ. The biology and treatment of oligometastatic cancer. Oncotarget. 2015; 6(11): 8491-8524.
|
| [40] |
Wu M, Neilson A, Swift AL, et al. Multiparameter metabolic analysis reveals a close link between attenuated mitochondrial bioenergetic function and enhanced glycolysis dependency in human tumor cells. Am J Physiol Cell Physiol. 2007; 292(1): C125-C136.
|
| [41] |
Zhou H, Liu Z, Wang Y, et al. Colorectal liver metastasis: molecular mechanism and interventional therapy. Signal Transduct Target Ther. 2022; 7(1): 70.
|
| [42] |
Morikawa K, Walker SM, Nakajima M, et al. Influence of organ environment on the growth, selection, and metastasis of human colon carcinoma cells in nude mice. Cancer Res. 1988; 48(23): 6863-6871.
|
| [43] |
Medico E, Russo M, Picco G, et al. The molecular landscape of colorectal cancer cell lines unveils clinically actionable kinase targets. Nat Commun. 2015; 6: 7002.
|
| [44] |
Xu F, Huang M, Chen Q, et al. LncRNA HIF1A-AS1 promotes gemcitabine resistance of pancreatic cancer by enhancing glycolysis through modulating the AKT/YB1/HIF1α pathway. Cancer Res. 2021; 81(22): 5678-5691.
|
| [45] |
Chen H, Ling T, Chen D, et al. Mitochondrial YBX1 promotes cancer cell metastasis by inhibiting pyruvate uptake. Life Metabolism. 2023; 2(6):load038.
|
| [46] |
Marchesini M, Ogoti Y, Fiorini E, et al. ILF2 is a regulator of RNA splicing and DNA damage response in 1q21-amplified multiple myeloma. Cancer Cell. 2017; 32(1): 88-100.e6.
|
| [47] |
Bian JS, Chen J, Zhang J, et al. ErbB3 governs endothelial dysfunction in hypoxia-induced pulmonary hypertension. Circulation. 2024; 150(19): 1533-1553.
|
| [48] |
Chambers AF, Groom AC, MacDonald IC. Dissemination and growth of cancer cells in metastatic sites. Nat Rev Cancer. 2002; 2(8): 563-572.
|
| [49] |
Yamaguchi N, Wu YG, Ravetch E, et al. A targetable secreted neural protein drives pancreatic cancer metastatic colonization and HIF1α nuclear retention. Cancer Discov. 2024; 14(12): 2489-2508.
|
| [50] |
Lin JC, Wu YY, Wu JY, et al. TROP2 is epigenetically inactivated and modulates IGF-1R signalling in lung adenocarcinoma. EMBO Mol Med. 2012; 4(6): 472-485.
|
| [51] |
Cheloni G, Tanturli M, Tusa I, et al. Targeting chronic myeloid leukemia stem cells with the hypoxia-inducible factor inhibitor acriflavine. Blood. 2017; 130(5): 655-665.
|
| [52] |
Harlander S, Schönenberger D, Toussaint NC, et al. Combined mutation in Vhl, Trp53 and Rb1 causes clear cell renal cell carcinoma in mice. Nat Med. 2017; 23(7): 869-877.
|
| [53] |
Akgül Ö, Çetinkaya E, Ersöz Ş, et al. Role of surgery in colorectal cancer liver metastases. World J Gastroenterol. 2014; 20(20): 6113-6122.
|
| [54] |
Al Bandar MH, Kim NK. Current status and future perspectives on treatment of liver metastasis in colorectal cancer (Review). Oncol Rep. 2017; 37(5): 2553-2564.
|
| [55] |
Takahashi H, Berber E. Role of thermal ablation in the management of colorectal liver metastasis. Hepatobiliary Surg Nutr. 2020; 9(1): 49-58.
|
| [56] |
Riera KM, Jang B, Min J, et al. Trop2 is upregulated in the transition to dysplasia in the metaplastic gastric mucosa. J Pathol. 2020; 251(3): 336-347.
|
| [57] |
Zhao P, Zhang Z. TNF-α promotes colon cancer cell migration and invasion by upregulating TROP-2. Oncol Lett. 2018; 15(3): 3820-3827.
|
| [58] |
Eisenwort G, Jurkin J, Yasmin N, et al. Identification of TROP2 (TACSTD2), an EpCAM-like molecule, as a specific marker for TGF-β1-dependent human epidermal Langerhans cells. J Invest Dermatol. 2011; 131(10): 2049-2057.
|
| [59] |
Zhao M, DiPeri TP, Raso MG, et al. Epigenetically upregulating TROP2 and SLFN11 enhances therapeutic efficacy of TROP2 antibody drug conjugate sacitizumab govitecan. NPJ Breast Cancer. 2023; 9(1): 66.
|
| [60] |
Xu T, Stewart KM, Wang X, et al. Metabolic control of T(H)17 and induced T(reg) cell balance by an epigenetic mechanism. Nature. 2017; 548(7666): 228-233.
|
| [61] |
Baik SH, Kang S, Lee W, et al. A breakdown in metabolic reprogramming causes microglia dysfunction in Alzheimer's disease. Cell Metab. 2019; 30(3): 493-507.e6.
|
| [62] |
Sabari BR, Zhang D, Allis CD, et al. Metabolic regulation of gene expression through histone acylations. Nat Rev Mol Cell Biol. 2017; 18(2): 90-101.
|
| [63] |
Kaelin WG, McKnight SL. Influence of metabolism on epigenetics and disease. Cell. 2013; 153(1): 56-69.
|
| [64] |
Wang Z, Yip LY, Lee JHJ, et al. Methionine is a metabolic dependency of tumor-initiating cells. Nat Med. 2019; 25(5): 825-837.
|
| [65] |
Chen X, Li A, Sun BF, et al. 5-methylcytosine promotes pathogenesis of bladder cancer through stabilizing mRNAs. Nat Cell Biol. 2019; 21(8): 978-990.
|
| [66] |
Yang X, Yang Y, Sun BF, et al. 5-methylcytosine promotes mRNA export – NSUN2 as the methyltransferase and ALYREF as an m(5)C reader. Cell Res. 2017; 27(5): 606-625.
|
| [67] |
Liu T, Tian J, Chen Z, et al. Anti-TROP2 conjugated hollow gold nanospheres as a novel nanostructure for targeted photothermal destruction of cervical cancer cells. Nanotechnology. 2014; 25(34):345103.
|
| [68] |
Niu K, Chen Z, Li M, et al. NSUN2 lactylation drives cancer cell resistance to ferroptosis through enhancing GCLC-dependent glutathione synthesis. Redox Biol. 2025; 79:103479.
|
| [69] |
Xu M, Warner C, Duan X, et al. HIV coinfection exacerbates HBV-induced liver fibrogenesis through a HIF-1α- and TGF-β1-dependent pathway. J Hepatol. 2024; 80(6): 868-881.
|
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2026 The Author(s). Clinical and Translational Medicine published by John Wiley & Sons Australia, Ltd on behalf of Shanghai Institute of Clinical Bioinformatics.