Flash Talk + Poster Presentation 37th Lorne Cancer Conference 2025

NRF2 induces cell plasticity during liver tumour initiation (#223)

Athena Jessica S Ong 1 2 , Kristin K Brown 1 2 3 , Andrew G Cox 1 2 3
  1. Peter MacCallum Cancer Center, Carlton, VICTORIA, Australia
  2. Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
  3. Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Melbourne, VIC, Australia

Nuclear factor erythroid 2-related factor 2 (NRF2) is a transcription factor that plays a role in the regulation of redox homeostasis and cellular metabolism. Activating mutations in the NRF2 pathway have been identified in ~15% of liver cancer patients. However, the mechanisms by which NRF2 promotes liver tumourigenesis are poorly understood. To address this gap in knowledge, we developed a transgenic zebrafish model with hepatocyte-specific, inducible expression of a clinically relevant constitutively active NRF2 mutant (NRF2T80K). Using a combination of single-cell sequencing, confocal imaging, and functional assays, we have shown that constitutive activation of NRF2 drives hepatocyte to cholangiocyte transdifferentiation. Moreover, we find that NRF2-driven transdifferentiation, in the context of p53 deficiency, contributes to the initiation of cholangiocarcinoma. Importantly, we have demonstrated that NRF2 affects cell plasticity in a cell-autonomous, evolutionarily conserved, and reversible manner. Finally, we have shown that NRF2-driven transdifferentiation is inhibited by FHD-286, a selective inhibitor of BRG1/BRM within the SWI/SNF complex. Overall, our study reveals a novel role for NRF2 in the regulation of cell plasticity during liver tumourigenesis and identifies FHD-286 as a promising therapy for NRF2-driven liver cancers.