Therapy-Resistant Residual Cancer Cell Dependencies Mapped

Cancer drugs can shrink fast-growing tumors. But sometimes a few tumor cells survive. These “persister” cells seed new tumors, forcing cancer patients into arduous cycles of testing and treatment. The problem is that persister cells are rare—as few as one in a thousand tumor cells—and they’re genetically identical to the tumor, which makes them hard to find. Plus, their tenacity can be temporary, and by the time a scientist can get them in a petri dish, the qualities that helped them survive may have faded.

To figure out how to beat them, researchers at the University of California, San Francisco (UCSF), built a robotic system that treats thousands of mini tumors at once in the laboratory. Their resulting ResMap platform lets scientists systematically identify, track, and treat surviving cells. The platform revealed shared features among persister cells that could help explain why cancer comes back—features that could be exploited by future drug therapies to beat them. “A few years ago, people were still asking whether persister cells were real,” said Xiaoxiao “Vany” Sun, PhD, an assistant researcher in the UCSF Department of Pharmaceutical Chemistry. “Now we can find them and test ideas for how to eliminate them.”

Sun is first author of the team’s published paper in Science Advances, titled “ResMap: A community resource for systematic mapping of therapy-persistent residual cancer cell dependencies across contexts,” stating, “ResMap establishes a foundation for coordinated community efforts to accelerate rational persister-directed combination strategies toward the clinic.”

Residual disease following targeted therapy remains a key challenge to achieving lasting responses in oncogene-driven cancers, the authors stated. Drug-tolerant persister cells, which the team describes as “subpopulations that survive initial therapy without stable genetic resistance,” can contribute to residual disease and seed tumor relapse. “Targeting drug-tolerant persister cells has emerged as an essential complement to oncogene-directed therapy, yet the field has lacked a unified framework to evaluate and prioritize candidate targets,” they wrote. “Understanding and targeting these cells have emerged as a promising strategy for achieving lasting therapeutic outcomes.”

Cancer cell persistence was first described in 2010, the authors explained, and studies have linked persister survival to different biological processes and resulted in “an expanding list” of candidate therapeutic targets. However, they noted, “… despite over a decade of research, no persister-directed therapy has reached clinical approval.”

For their reported study, the team gathered 94 drug candidates that other laboratories had flagged as potential persister therapies. They wanted to test each drug at different doses, on persisters from two types of lung cancer that had been treated with standard therapies. “As a testbed, we selected four lung cancer models: two with EGFR inhibitor osimertinib (EGFRi)–treated EGFRmut cell lines (PC9 and MGH134) and two with KRAS inhibitor sotorasib (KRASi)–treated KRASG12C cell lines (LU65 and MGH1138-1),” they wrote in summary. Each model was screened under normal oxygen and hypoxic conditions.

It would require 10,000 painstaking, week-long experiments—so they built a robotic platform to eliminate the labor and inconsistency of doing it by hand.

Thousands of miniature tumors sat in stacks of 384-well plates inside controlled incubators. A robotic arm, like those used in pharmaceutical drug screening, moved the plates between experimental stations. One station used sound waves to deposit tiny, precise doses of drug onto each tumor (first, a lung cancer therapy; then, an experimental persister therapy). Other stations stained the tumors with antibodies and took microscopic images of each tumor or group of persisters.

The overall ResMap platform incorporated multiple components, the team explained. “… we developed the ResMap platform incorporating four integrated components: an automated high-throughput workflow, machine learning-based normalization, a persistence-specific metric, and a validated framework.”

Their results showed that of the tested drugs, nine consistently weakened persister cells. The findings suggest that persister cells may share common vulnerabilities, even if they had emerged under different treatment conditions. “Initial screening identified 12 targets with conserved anti-persister activity across genotypes and oxygen environments; follow-up validation reproduced nine of these targets and revealed variable degrees of persister specificity relative to general cytotoxicity.” The investigators suggested that, “Collectively, these findings suggest that although persister biology involves multiple adaptive programs, targeting individual, well-chosen survival pathways may be sufficient to meaningfully reduce residual disease burden.”

Steve Altschuler, PhD, professor of pharmaceutical chemistry at UCSF and co-senior author of the paper, said, “We expected each tumor to behave as its own special case. Instead, we found patterns that held up across many different samples, suggesting there may be underlying rules that can help predict which therapies are most likely to work.”

The team plans to expand the platform to include more tumor types and treatment conditions. They hope the resulting dataset will be a resource to help researchers eliminate persister cells before they can give rise to drug-resistant disease. “ResMap provides a community resource for coordinated validation efforts and rational combination design aimed at minimizing residual disease following anticancer therapy,” they stated.

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Silica Nanoparticles Induce Ferroptosis, Reprogram Immunity in Prostate Cancer Models

Ultrasmall fluorescent core‑shell silica nanoparticles—best known for their roles in medical imaging applications—are now showing surprising therapeutic muscle. Originally engineered as inert carriers for imaging agents, these particles, called Cornell Prime dots (C’ dots), have steadily expanded their résumé. In a new preclinical study, researchers at Weill Cornell Medicine report that these engineered silica nanoparticles can directly kill prostate tumor cells while reawakening antitumor immunity, offering a potential new edge in a disease where immunotherapy has historically struggled.

Prostate cancer remains one of the most immunologically “cold” solid tumors, with myeloid‑driven immune suppression, metabolic bottlenecks, and stromal remodeling that blunt the effects of checkpoint blockade. The new work suggests that C’ dots—when targeted to prostate‑specific membrane antigen (PSMA)—can break through these layers of resistance by triggering ferroptosis, remodeling the tumor microenvironment, and priming tumors for combination immunotherapy.

“We’re very encouraged by these results; a treatment that directly induces tumor‑cell death while transforming the immune microenvironment, as this does, would represent a new clinical paradigm,” said senior author Michelle Bradbury, MD, PhD, the endowed professor of imaging research in radiology and director of the Molecular Imaging Innovations Institute at Weill Cornell Medicine and a neuroradiologist at NewYork-Presbyterian/Weill Cornell Medical Center.

The study, published in Cancer Research and titled “Reprogramming of TLR–Ferroptosis Signaling and Immunometabolic Pathways Overcomes Myeloid Suppression to Improve Checkpoint Blockade in Prostate Cancer,” shows that the silica particles accumulate in prostate tumors and push cancer cells toward ferroptosis, a form of iron‑dependent cell death driven by runaway lipid peroxidation. Although the particles were originally designed for imaging, the team found that they often pick up positively charged iron ions in the bloodstream and shuttle them into tumor cells—effectively turning the particles into catalytic seeds for oxidative collapse.

At the same time, the nanoparticles reshape the immune landscape. T cells, macrophages, and other immune populations shift from inert or suppressive states into robust antitumor activity, converting cold tumors into hot ones. “One of the most intriguing aspects of this work is the convergence of direct tumor cell killing with broad immune remodeling,” said co‑author Jedd Wolchok, MD, PhD, the Meyer director of the Sandra and Edward Meyer Cancer Center, professor of medicine at Weill Cornell Medicine, director of the Parker Institute for Cancer Immunotherapy at Weill Cornell Medicine Meyer Cancer Center, and an oncologist at NewYork-Presbyterian/Weill Cornell Medical Center.

prostate cancer
Multiplex immunofluorescence image of a prostate tumor 10 days after treatment with prostate-targeted C’ dots and immunotherapy, showing extensive infiltration of immune cells throughout the tumor. Different colors represent distinct immune cell populations, including anti-tumor T cells, helper T cells, regulatory T cells, and macrophages. The image illustrates the coordinated immune response triggered within the tumor following treatment. [Bradbury Lab]

The therapeutic impact was most striking in survival experiments. C’ dots alone modestly extended survival in aggressive mouse models, as did checkpoint blockade alone. But the combination produced complete or near‑complete remissions in 40% of mice. Adding CSF‑1R blockade increased complete remissions to 50%.

The researchers’ next steps include continuing to explore these ultrasmall core-shell silica particles, setting the stage for the platform’s translational potential.

“By creating conditions that support a more effective antitumor immune response, these particles may help unlock the full potential of immunotherapy in prostate cancer, where durable responses have historically been difficult to achieve,” added Wolchok.

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Characterizing Social Determinants of Health in Patients With Type 2 Diabetes and Liver Disease: Cross-Sectional Survey Study

Background: The mortality rate from liver disease among people with type 2 diabetes mellitus (T2DM) increased by 20% between 2001 and 2018. There are marked racial and ethnic differences among people with T2DM at risk of metabolic dysfunction–associated steatotic liver disease (MASLD) and related complications. Objective: We aimed to investigate the distribution of individual-level social determinants of health (SDOH) in people living with both T2DM and MASLD. Methods: In this small cross-sectional study, patients (N=50) were recruited from a tertiary care general hepatology clinic to complete a survey that assessed potential determinants of health. We sought to oversample Black and Hispanic patients to better understand the prevalence of SDOH. Electronic health records were reviewed to determine stage of liver disease, and these data were linked to survey results to identify the distribution of individual-level determinants of health in patients with cirrhosis. Results: Black and Hispanic respondents were more likely to report more experiences of racial discrimination, worries about being discriminated against, and group-based medical mistrust, especially regarding unsupportive health care providers. Cirrhosis groups tended to have lower incomes and less coverage from private health insurance. However, no substantial trends were observed in the distribution of health literacy, discrimination, and diabetes stigma among patients with and without cirrhosis. Conclusions: These findings will inform a future study aimed at assessing and developing interventions to address the combined impact of individual- and neighborhood-level SDOH on health-related outcomes in patients with T2DM and MASLD.
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Standardized Patient vs Video Demonstration for Teaching Psychomotor Skills in Spinal Injury Management to Undergraduate Medical Students: Prospective Interventional Comparative Study

<strong>Background:</strong> Emergency trauma care in the “golden hour” can reduce the fatality rates by 20%-50%. Imparting trauma care training in the undergraduate Indian medical graduate curriculum can prepare graduates as first responders for both prehospital and hospital setup management. However, teaching these skills for managing acute traumas in a competency-based medical education curriculum is challenging. These skills can be taught on a standardized patient (SP), allowing the learner to achieve higher clinical competency and better communication skills. However, since SP availability is limited, a video demonstration (VD) of such skills is an easy and reliable teaching-learning method. <strong>Objective:</strong> This study aims to evaluate the effectiveness of using an SP vs VD for teaching psychomotor skills to undergraduate students in the management of spinal injury. <strong>Methods:</strong> A prospective interventional comparative study was performed in the orthopedics department of a teaching hospital from September 2024 to February 2025, with institutional ethics committee approval. Thirty undergraduate students posted in the orthopedics department were divided into 2 groups (15 each) based on their even and odd roll numbers (systematic sampling). One group was shown a VD of the skills like application of an improvised cervical collar and log rolling maneuver for the management of a patient with spinal injury in a primary setting, while the other group was taught on an SP. The students were assessed by an objective structured clinical examination (OSCE), and maneuvers were performed on mannequins. Pretest and posttest evaluations with peer-validated questionnaires along with students’ feedbacks were obtained. The data were analyzed using unpaired 2-sided <i>t</i> test for OSCE scores and paired 2-sided <i>t</i> test for pretest and posttest scores with statistical significance set at <i>P</i>&lt;.05 (95% CI). Student feedback questionnaires based on a 5-point Likert scale were evaluated. <strong>Results:</strong> The mean OSCE scores obtained by the VD group (15.47) were significantly different from those obtained by the SP group (18.27) (<i>P</i>=.004). However, the mean OSCE scores obtained in individual skill demonstration stations for log rolling maneuver and cervical spine immobilization of the VD group were 2.27 and 3.20 and those of the SP group were 2.33 and 3.27, respectively. This difference was not significant (<i>P</i>=.74 and .79, respectively). The student feedback showed that teaching with an SP was marginally more interesting and effective, giving them more confidence to apply these skills in a primary setting. <strong>Conclusions:</strong> Both VD and SP methods are equally effective for teaching lifesaving psychomotor skills for the management of spinal injury. However, SP group students had better student engagement. Hence, a blended approach, where VD is used to teach large groups or can be given to students prior to the sessions, followed by teaching or assessing on SPs for application of these skills will lead to optimum results and save time.

When Process Design Fails: 5 Common Planning Gaps That Create Downstream Purification Bottlenecks


Panelists

Image of Victoria Hepworth

Victoria Hepworth

Product Manager
Greenfield Global

Panelist

Image of Victoria Hepworth

Victoria Hepworth

With over a decade of hands-on experience in the biopharmaceutical industry, Victoria specializes in the design and implementation of ready-to-use solutions and single-use consumables supporting downstream purification processes. She brings a strategic, highly collaborative approach to problem-solving, partnering closely with cross-functional teams to deliver scalable improvements that enhance operational efficiency and drive successful results.

Victoria is passionate about building strong team environments, supporting diverse learning styles, and applying data-driven decision-making to optimize performance across the process lifecycle.



Image of Cole Cordes

Cole Cordes

Head of Manufacturing,
Supply Chain and MSAT
Bionova Scientific

Panelist

Image of Cole Cordes

Cole Cordes

With more than 30 years of leadership experience in the biopharmaceutical and life sciences industries, Cole specializes in manufacturing operations, supply chain strategy, and MSAT across the product lifecycle. He brings a strategic, results-driven approach to operational excellence, partnering with cross-functional teams to optimize manufacturing performance, strengthen supply reliability, and support successful commercialization.

Cole is passionate about building high-performing organizations, developing talent, and leveraging data-driven decision-making to drive continuous improvement, scalability, and business growth.



Broadcast Date: 

  • Time: 

Downstream bottlenecks often stem from early process design decisions that fail to fully account for scale, variability, and the manufacturing realities of therapeutic modalities such as monoclonal antibodies.

As upstream titers rise and novel modalities introduce added complexity, these early oversights can force reactive workarounds that impact throughput, cost, and product quality. By taking a more deliberate and forward-looking approach, teams can reduce downstream risk and build processes that are better equipped for manufacturing scale.

In this GEN webinar, our speakers will examine five common planning gaps that can contribute to bottlenecks, including single-source material dependency, raw material pack size selection, sensitive buffer designs, and single-use systems designed without realistic failure modes. Using real-world MSAT and tech transfer examples, they will illustrate how, when overlooked, these drivers can lead to deviations, safety risks, and longer cycle times—and how to proactively address them. The webinar explores practical strategies that can help evaluate materials, buffer systems, and consumables through a scale‑ready lens—helping teams build more robust purification processes and avoid these common bottlenecks.

A live Q&A session will follow the presentation offering you a chance to pose questions to our expert panelists.

Produced with support from:

Greenfield Global logo

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ZoBio Introduces DNA-Encoded Library Service for Exploratory Drug Discovery Programs

Officials at Leiden, Netherlands-based CRO ZoBio say the company has launched a DNA-Encoded Library (DEL) discovery service, which is designed to help biotech and pharmaceutical companies generate validated, progressible hits against novel and challenging drug targets.

The new offering combines structure-grade protein production, quantitative biophysics, DEL screening, off-DNA hit validation and X-ray crystallography into a single workflow, according to a company spokesperson, who explains that it enables clients to move beyond hit identification toward high-confidence starting points for drug discovery programs.

ZoBio maintains that unlike transactional DEL screening approaches that focus solely on hit generation, its platform is designed to deliver biologically relevant, structurally characterized hit matter with clear potential for progression. The service is particularly suited to exploratory and difficult-to-drug targets, including protein–protein interactions (PPIs) and targets with poorly defined binding pockets, where conventional screening approaches often fail, notes Gregg Siegal, CEO of ZoBio.

“Drug discovery teams today are increasingly focused on highly validated but technically challenging targets, where traditional screening approaches can struggle to deliver meaningful starting points,” he continues. “Our approach combines DEL technology with the structural biology, biophysics, and assay expertise needed to generate hits that clients can confidently progress.”

Siegal also points out that the DEL service is library-agnostic, enabling clients to access commercially available DEL collections or apply ZoBio’s workflow to proprietary client-owned libraries. The integrated platform reportedly includes:

  • Structure-grade protein production and characterization
  • Quantitative biophysical assay development using techniques such as SPR
  • Biophysically informed DEL selection design
  • Interactive DEL data analysis and hit prioritization
  • Off-DNA hit resynthesis and orthogonal validation
  • Structural characterization through X-ray crystallography
  • Mechanistic insight to support downstream optimization

The workflow is designed to support collaborative decision-making throughout the discovery process, helping clients rapidly establish whether difficult or exploratory targets are viable for further development, according to Siegal, who says that members of the ZoBio team will be available for meetings during the BIO International Convention in San Diego to discuss the new service.

 

 

 

 

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Health Care Providers’ Perspectives on a Hybrid Outpatient Stroke Telerehabilitation Program: Qualitative Implementation Study

Background: Although patient outcomes are improved by stroke rehabilitation, the suggested amount of therapy is rarely maintained. The COVID-19 pandemic aggravated this situation further due to disruptions in health care. One solution was the rapid and extensive transition to virtual care. A hybrid outpatient stroke telerehabilitation program (HOSTP) was introduced by St John’s Rehab—a tertiary rehabilitation hospital in Toronto, Ontario. The HOSTP integrated in-person and virtual care in an effort to alleviate long-standing obstacles that challenge stroke rehabilitation. Objective: This study explored health care providers’ (HCPs) experiences with the HOSTP and their perspectives on its implementation, quality, and impact to determine the modifications needed to optimize its delivery and sustainability. Methods: A qualitative implementation study was conducted, with semistructured interviews conducted among HCPs involved in the HOSTP. The interview guide was informed by the CFIR (Consolidated Framework for Implementation Research). In total, 14 HCPs were recruited and interviewed from St John’s Rehab outpatient program. Interview transcripts were analyzed using a 2-stage analytic approach involving inductive thematic analysis, followed by deductive categorization using CFIR. Results: Four main themes were identified across CFIR domains: (1) adaptability and flexibility of the hybrid care model (intervention characteristics), (2) alignment with patient needs and resources (outer setting), (3) the impact of organizational resources and infrastructure (inner setting), and (4) variability in provider confidence and perceptions of virtual care (characteristics of individuals). Key determinants were identified as adaptability, patient-related factors, resource availability, and provider beliefs about virtual care. Conclusions: Our findings suggest that, from HCPs’ viewpoints, optimizing virtual care processes and resources may support access and care quality within hybrid outpatient stroke rehabilitation. HCPs viewed maintaining virtual care as important for supporting ongoing access and patient-centered care. Lastly, optimizing the benefits and mitigating the drawbacks of hybrid care can ensure future integration of virtual care into standard outpatient stroke rehabilitation.
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Examining the Efficacy of a Telehealth-Based Virtual Reality Clinic in Treating Adults With Specific Phobia: Feasibility Randomized Controlled Trial

Background: Virtual reality (VR) has the potential to enhance telemental health care (TMH) by enabling accessible, engaging, and personalized treatment from home. Although VR is well-supported for in-person treatment, evidence for telehealth-based VR is limited. Moreover, no prior research has demonstrated the feasibility of therapists and clients conducting therapy sessions remotely within a shared (ie, multiuser) VR experience. Objective: The primary objective of this study was to evaluate the feasibility of conducting a randomized controlled efficacy trial (RCT) comparing exposure therapy delivered via Doxy.me VR (Doxy.me Inc)—a multiuser, telehealth-based VR app—to standard TMH in adults with clinically elevated fear of dogs, snakes, or spiders. A secondary objective was to preliminarily examine clinical (ie, specific phobia symptom severity) and treatment-related outcomes (ie, therapeutic alliance, client satisfaction, system usability, presence, cybersickness, and treatment fidelity). Methods: This study used a single-site, fully remote, parallel, feasibility RCT design. Participants were randomly assigned using a 1:1 ratio to receive 12 weekly exposure therapy sessions over 3 months, delivered via either standard TMH or Doxy.me VR. Assessments were conducted at baseline, each session, midtreatment, and posttreatment. All therapy sessions were audio recorded, 20% of which were randomly selected and rated for treatment fidelity. Feasibility benchmarks during the 12-month trial included: (1) enrolling 30 participants during Months 1‐9 of the trial; (2) collecting 70% of midtreatment self-report data; (3) collecting 70% of posttreatment self-report data; (4) collecting 70% of weekly self-report data; and (5) achieving treatment fidelity ≥80%. Between-group differences in clinical treatment-related outcomes also were examined preliminarily. Results: A total of 54 participants were enrolled between October 25, 2023 and July 26, 2024, and randomly assigned to the Doxy.me VR (n=29) and TMH (n=25) conditions, exceeding our recruitment target by 180%. Among the 30 participants targeted for completion, data were obtained from 29 (96.7%) at midtreatment and 28 (93.3%) at posttreatment. Participants completed 86.5% (180/208) of weekly self-report assessments. Treatment fidelity was 90% based on ratings of 41 session recordings. There were no significant between-group differences in clinical outcomes (all >.05) or most treatment-related outcomes. However, client satisfaction improved significantly more for the Doxy.me VR condition compared to TMH (=.04). Power analyses indicated that a sample of 160 participants would ensure adequate power for a fully powered trial. Conclusions: Telehealth-based, multiuser, synchronous VRET is feasible and shows preliminary evidence of efficacy. These findings are promising, and opportunities to improve procedures identified in this feasibility trial will directly inform the protocol for a fully powered RCT evaluating telehealth-based VR and its potential to improve treatment of mental health disorders. Trial Registration: ClinicalTrials.gov NCT06302868; https://clinicaltrials.gov/study/NCT06302868 International Registered Report Identifier (IRRID): RR2-10.2196/65770