Multivalent state transitions shape the intratumoral composition of small cell lung carcinoma
Small cell lung carcinoma (SCLC) is an aggressive, tobacco-associated tumor characterized by rapid growth, early metastases, and initial response followed by almost invariable resistance to chemotherapy. Studies to date have not resolved the extent that diverse transcriptional programs drive SCLC and contribute to its lethality. We combined patient-derived xenograft (PDX) (n = 64) resources with multi-omic profiling, single-cell fluorescence tracking of ex vivo tumor cells, and mathematical and statistical models to study the topology of the SCLC transcriptional state space and its plasticity.