Oncogenic KRAS Drives Lipofibrogenesis to Promote Angiogenesis and Colon Cancer Progression
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Abstract
Oncogenic KRAS (KRAS*) contributes to many cancer hallmarks. In colorectal cancer, KRAS* suppresses antitumor immunity to promote tumor invasion and metastasis. Here, we uncovered that KRAS* transforms the phenotype of carcinoma-associated fibroblasts (CAF) into lipid-laden CAFs, promoting angiogenesis and tumor progression. Mechanistically, KRAS* activates the transcription factor CP2 (TFCP2) that upregulates the expression of the proadipogenic factors BMP4 and WNT5B, triggering the transformation of CAFs into lipid-rich CAFs. These lipid-rich CAFs, in turn, produce VEGFA to spur angiogenesis. In KRAS*-driven colorectal cancer mouse models, genetic or pharmacologic neutralization of TFCP2 reduced lipid-rich CAFs, lessened tumor angiogenesis, and improved overall survival. Correspondingly, in human colorectal cancer, lipid-rich CAF and TFCP2 signatures correlate with worse prognosis. This work unveils a new role for KRAS* in transforming CAFs, driving tumor angiogenesis and disease progression, providing an actionable therapeutic intervention for KRAS*-driven colorectal cancer. Significance: This study identified a molecular mechanism contributing to KRAS*-driven colorectal cancer progression via fibroblast transformation in the tumor microenvironment to produce VEGFA driving tumor angiogenesis. In preclinical models, targeting the KRAS*–TFCP2–VEGFA axis impaired tumor progression, revealing a potential novel therapeutic option for patients with KRAS*-driven colorectal cancer. This article is featured in Selected Articles from This Issue, p. 2489
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KRAS can alter the phenotype of CAFs, enriching them with lipids, which promotes angiogenesis and tumor progression.
“KRAS can alter the phenotype of CAFs, enriching them with lipids, which promotes angiogenesis and tumor progression.”
From The Role of KRAS Mutations in Colorectal Cancer: Biological Insights, Clinical Implications, and Future Therapeutic Perspectives (2025) · cites this paper as [26]
Lipid-enriched CAFs produce VEGFA, fostering angiogenesis and supporting tumor growth.
“These lipid-enriched CAFs produce VEGFA, fostering angiogenesis and supporting tumor growth [26].”
From The Role of KRAS Mutations in Colorectal Cancer: Biological Insights, Clinical Implications, and Future Therapeutic Perspectives (2025) · cites this paper as [26]
KRAS activates the transcription factor CP2 (TFCP2), which then stimulates adipocyte differentiation factors, converting CAFs into lipid-rich cells.
“KRAS activates the transcription factor CP2 (TFCP2), which then stimulates adipocyte differentiation factors, converting CAFs into lipid-rich cells.”
From The Role of KRAS Mutations in Colorectal Cancer: Biological Insights, Clinical Implications, and Future Therapeutic Perspectives (2025) · cites this paper as [26]
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- Authors
- Hsu, W.-H., LaBella, K. A., Lin, Y., Xu, P., Lee, R., Hsieh, C.-E., Yang, L., Zhou, A., Blecher, J. M., Wu, C.-J., Lin, K., Shang, X., Jiang, S., Spring, D. J., Xia, Y., Chen, P., Shen, J. P., Kopetz, S., & DePinho, R. A.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- 3Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
- ORCID
- Venue
- Cancer Discovery
- Published
- 2023-09-27
- Volume
- 13
- Issue
- 12
- Pages
- 2652-2673
- ISSN
- 2159-8274 (ISSN-L)
- 2159-8290
- PMC
- PMC10807546
- OpenAlex
- W4387115132
- Cited by
- 125
- References
- 81
- Citations by year
- 2026: 42 · 2025: 53 · 2024: 28 · 2023: 2
- FWCI
- 15.18
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cancer Discovery (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Commons-TMC (Texas Medical Center) (submittedVersion)
- Funders
- Cancer Prevention and Research Institute of Texas (RP210028)
- National Institutes of Health (F99 CA274661, R01 CA231360)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Cells and Metastasis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Angiogenesis and VEGF in Cancer
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Keywords
- oncogenic KRAS, colorectal cancer, cancer-associated fibroblasts, angiogenesis, VEGF-A, TFCP2, BMP4, Wnt5b, tumor microenvironment, tumor progression, antitumor immunity, prognostic signature, KRAS-targeted therapy
- MeSH terms
- Cancer-Associated Fibroblasts, Angiogenesis, Animals, Colonic Neoplasms, DNA-Binding Proteins, Fibroblasts, Humans, Lipids, Transcription Factors, Colorectal Neoplasms, Proto-Oncogene Proteins p21(ras), Mice, Tumor Microenvironment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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