Contact-based thymidylate transfer promotes collective tumor growth

Sustained cell proliferation is a fundamental hallmark of cancer, yet its mechanism remains elusive, particularly in context of heterogenous tumor organization, intercellular interactions, and metabolite exchanges. In this study, we uncover a mechanism of tumor growth via collective proliferation, where cells connected by gap junctions enable equilibration of thymidylate (dTMP) to allow the proliferation of cells lacking canonical de novo dTMP biosynthesis and salvage driven by thymidylate synthase (TYMS) and thymidine kinase 1 (TK1) enzymes, respectively. Collective proliferation is driven by dTMP-proficient cancer cells alongside cells of varied origins, such as macrophages and endothelial cells. The mechanism is also observed in clinical samples and is validated in a genetic mouse model of lung cancer harboring dual Tyms/Tk1 tumor-specific knockout, in which tumors grow despite lacking enzymatic dTMP synthesis and tumor progression is opposed by gap junction inhibition. Data further hint that this mechanism is critical driver of tumor pathophysiology, influencing key processes such as senescence, genomic instability and drug resistance. These findings revise the current dogma of ubiquitous nucleotide biosynthesis in each proliferating cancer cell in a tumor and suggest that a programmed dTMP distribution maintains collective tumor growth. This mechanism could be exploited in cancer therapy.