Evidence map›Paper›PMID 39900637›Full record

ArticleNature communications2025

Early tolerance and late persistence as alternative drug responses in cancer.

Simona Punzi, Davide Cittaro, Guido Gatti, Gemma Crupi, Oronza A Botrugno, Antonino Alex Cartalemi, Alon Gutfreund, Caterina Oneto, Valentina Giansanti, Chiara Battistini and 16 more

Abstract read
In one paragraph

Article in Nature communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Article
  6. Targeting tumor transition windows.Exploration of targeted anti-tumor therapy · 2026
    Review
  7. Organoids glimpse: the nexus for diverse tumor heterogeneity.Frontiers in cell and developmental biology · 2026
    Review
  8. Review
  9. Review
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Simona PunziFunctional Genomics of Cancer Unit, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy. punzi.simona@hsr.it.ORCID http://orcid.org/0000-0002-8734-6404
Davide CittaroCenter for Omics Sciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.ORCID http://orcid.org/0000-0003-0384-3700
Guido GattiFunctional Genomics of Cancer Unit, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.ORCID http://orcid.org/0000-0001-6225-2383
Gemma CrupiFunctional Genomics of Cancer Unit, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.ORCID http://orcid.org/0000-0003-4822-7645
Oronza A BotrugnoFunctional Genomics of Cancer Unit, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.ORCID http://orcid.org/0000-0002-2568-9815
Antonino Alex CartalemiFunctional Genomics of Cancer Unit, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.ORCID http://orcid.org/0000-0003-1523-4443
Alon GutfreundThe Racah Institute of Physics, The Hebrew University of Jerusalem, Jerusalem, Israel.ORCID http://orcid.org/0000-0002-3891-2908
Caterina OnetoCenter for Omics Sciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.ORCID http://orcid.org/0009-0006-4553-2221
Valentina GiansantiCenter for Omics Sciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.ORCID http://orcid.org/0000-0003-0617-6245
Chiara BattistiniUnit of Gynaecological Oncology Research, European Institute of Oncology IRCSS, Milan, Italy.ORCID http://orcid.org/0000-0003-3583-290X
Giovanni SantacatterinaCancer Data Science Laboratory, Department of Mathematics and Geosciences, University of Trieste, Trieste, Italy.
Lucrezia PatrunoDepartment of Informatics, Systems and Communication of the University of Milan-Bicocca, Milan, Italy.
Ilaria VillantiUniversità Vita-Salute San Raffaele, Milan, Italy.
Martina PalumboFunctional Genomics of Cancer Unit, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Daniel J LavertyHarvard Chan School of Public Health, Boston, MA, USA.
Francesca GianneseCenter for Omics Sciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.ORCID http://orcid.org/0000-0001-8695-649X
Alex GraudenziDepartment of Informatics, Systems and Communication of the University of Milan-Bicocca, Milan, Italy.ORCID http://orcid.org/0000-0001-5452-1918
Giulio CaravagnaCancer Data Science Laboratory, Department of Mathematics and Geosciences, University of Trieste, Trieste, Italy.ORCID http://orcid.org/0000-0003-4240-3265
Marco AntoniottiDepartment of Informatics, Systems and Communication of the University of Milan-Bicocca, Milan, Italy.ORCID http://orcid.org/0000-0002-2823-6838
Zachary NagelHarvard Chan School of Public Health, Boston, MA, USA.ORCID http://orcid.org/0000-0003-2104-2093
Ugo CavallaroUnit of Gynaecological Oncology Research, European Institute of Oncology IRCSS, Milan, Italy.ORCID http://orcid.org/0000-0002-0884-6460
Luisa LanfranconeDepartment of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy.ORCID http://orcid.org/0000-0002-4523-3815
Timothy A YapTherapeutics Discovery Division, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.ORCID http://orcid.org/0000-0002-2154-3309
Giulio DraettaDepartment of Genomic Medicine, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center Houston, Houston, TX, USA.ORCID http://orcid.org/0000-0001-5225-9610
Nathalie BalabanThe Racah Institute of Physics, The Hebrew University of Jerusalem, Jerusalem, Israel.
Giovanni TononFunctional Genomics of Cancer Unit, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy. tonon.giovanni@hsr.it.ORCID http://orcid.org/0000-0003-2973-5038

Funding

Training Program in Molecular and Integrative Physiological SciencesT32HL007118 · NHLBI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI LU, QUAN · 1985 to 2025
$14.3M
Fondazione Italiana per la Ricerca sul Cancro (Italian Foundation for Cancer Research) 2279Fondazione Italiana per la Ricerca sul Cancro (Italian Foundation for Cancer Research) 24913Fondazione Italiana per la Ricerca sul Cancro (Italian Foundation for Cancer Research) 26728-2021Fondazione Italiana per la Ricerca sul Cancro (Italian Foundation for Cancer Research) 28987Ministry of Health, Italy | Agenzia Italiana del Farmaco, Ministero della Salute (Italian Medicines Agency) RF-2021-12374586NHLBI NIH HHS T32 HL007118
6 · The paper itself

Abstract

Bacteria withstand antibiotic treatment through three alternative mechanisms: resistance, persistence or tolerance. While resistance and persistence have been described, whether drug-induced tolerance exists in cancer cells remains largely unknown. Here, we show that human cancer cells elicit a tolerant response when exposed to commonly used chemotherapy regimens, propelled by the pervasive activation of autophagy, leading to the comprehensive activation of DNA damage repair pathways. After prolonged drug exposure, such tolerant responses morph into persistence, whereby the increased DNA damage repair is entirely reversed. The central regulator of mitophagy PINK1 drives this reduction in DNA repair via the cytoplasmic relocalization of the cell identity master HNF4A, thus hampering HNF4A transcriptional activation of DNA repair genes. We conclude that exposing cancer cells to relevant standard-of-care antitumour therapies induces a pervasive drug-induced tolerant response that might be broadly exploited to increase the impact of first-line, adjuvant treatments and debulking in advanced cancers.

Indexed as

Antineoplastic AgentsDrug Resistance, NeoplasmDrug ToleranceNeoplasmsAutophagyCell Line, TumorDNA DamageDNA RepairHepatocyte Nuclear Factor 4HumansMitophagyProtein KinasesPTEN-Induced Putative KinaseAntineoplastic AgentsHepatocyte Nuclear Factor 4Protein KinasesPTEN-Induced Putative Kinase

Identifiers

PMID39900637
PMCPMC11790948

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.