In a groundbreaking development that could revolutionize the therapeutic landscape of gastric cancer, researchers have unveiled the pivotal role of the molecular interplay between USP29, SMURF1, and FSP1 in suppressing ferroptosis—a newly recognized form of programmed cell death linked to iron-dependent lipid peroxidation. The study, led by Wu, Z., Tu, X., Zhu, S., and colleagues, published in Nature Communications in 2025, sheds light on the intricate biochemical orchestra that enables cancer cells to resist chemotherapy, potentially opening avenues for overcoming one of the most formidable obstacles in oncology: chemoresistance.
Gastric cancer remains a leading cause of cancer-related mortality worldwide, primarily due to late diagnosis and the robust resistance of tumor cells to conventional chemotherapy regimens. The discovery that the suppression of ferroptosis is instrumental in fostering this chemoresistance introduces a paradigm shift in our understanding of tumor survival strategies. Ferroptosis, distinct from apoptosis and necrosis, involves the accumulation of lethal lipid peroxides in the presence of iron, instigating selective cancer cell death. Therefore, the manipulation of the ferroptotic pathway represents a promising strategy to sensitize cancer cells to treatment.
Central to this newly elucidated mechanism is the interplay between two proteins, USP29 and SMURF1, which modulate the activity of FSP1 (ferroptosis suppressor protein 1). FSP1 functions as a guardian against ferroptosis by reducing ubiquinone to ubiquinol, preventing the buildup of lipid peroxides in cell membranes. The study reveals that USP29, a ubiquitin-specific protease, and SMURF1, an E3 ubiquitin ligase, orchestrate precise post-translational modifications that stabilize and regulate FSP1 activity, thereby suppressing ferroptosis in gastric cancer cells.
Delving deeper into the molecular intricacies, USP29 acts by deubiquitinating FSP1, counteracting the ubiquitination tag that marks proteins for proteasomal degradation. Meanwhile, SMURF1 paradoxically contributes to the fine-tuned ubiquitination dynamics that control FSP1 turnover but ensures its optimal function in ferroptosis suppression. This nuanced regulatory crosstalk preserves FSP1 levels at a threshold that is sufficient to inhibit ferroptosis without triggering proteotoxic stress, allowing cancer cells to survive cytotoxic insults from chemotherapy.
The researchers utilized a combination of advanced molecular biology techniques including co-immunoprecipitation, site-directed mutagenesis, and ubiquitination assays to decode this regulatory network. Their data demonstrated that disrupting the USP29-SMURF1-FSP1 axis sensitized gastric cancer cells to ferroptosis inducers and conventional chemoagents, dramatically decreasing cell viability. Furthermore, in vivo models reinforced these findings, where targeted inhibition of USP29 or SMURF1 resulted in tumor regression and enhanced chemotherapy efficacy.
This surge in ferroptosis upon inhibition was accompanied by an increase in iron-dependent reactive oxygen species (ROS) and pronounced lipid peroxidation, hallmark features of ferroptotic cell death. By contrast, overexpression of USP29 or SMURF1 impeded these processes, reinforcing the concept that this axis is a master regulator of ferroptosis resistance in gastric cancer. Importantly, patient-derived tumor samples exhibited elevated levels of USP29 and SMURF1, correlating with poorer prognosis and reduced response to chemotherapy, suggesting direct clinical relevance.
The implications of these findings extend beyond simple mechanistic insights. Targeting the USP29-SMURF1-FSP1 axis heralds the emergence of a novel class of therapeutic interventions aiming to-reactivate ferroptosis in resistant cancers. Current treatment modalities rarely consider ferroptosis as a therapeutic target, but this research underscores the necessity to integrate ferroptosis modulation into future precision oncology protocols, particularly for refractory gastric cancers.
Moreover, the study sparks a broader inquiry into the ubiquitin-proteasome system’s role in cancer biology, specifically how the delicate balance of ubiquitination and deubiquitination shapes tumor cell fate. Expanding this knowledge could facilitate the development of small-molecule inhibitors or RNA-based therapeutics to selectively disrupt USP29 or SMURF1 functionality, enhancing ferroptosis induction without compromising normal cellular processes.
While ferroptosis has attracted significant attention in recent years, the comprehensive understanding of its regulatory pathways in diverse cancer types remains incomplete. This research is exemplary in illuminating a critical control node within gastric cancer cells and providing a blueprint for similar investigations in other malignancies where ferroptosis resistance is a barrier to effective treatment.
Critically, the study also underscores the evolutionary conservation of this molecular machinery, as analogous pathways have been observed in other cancer models, implying that the USP29-SMURF1-FSP1 regulatory axis might represent a universal mechanism of chemoresistance beyond gastric cancer. This universality enhances the potential impact of therapeutic agents targeting this axis.
The exploration of ferroptosis modulators is no longer an abstract research objective but a tangible pathway to improved clinical outcomes. The ability to sensitize resistant tumors to existing chemotherapies by reinstating ferroptotic cell death holds promise for patients who have exhausted standard treatments. The study by Wu and colleagues thereby catalyzes the translation of ferroptosis research from bench to bedside.
Future research will need to prioritize the identification of drug candidates that can specifically impede USP29 or SMURF1 without invoking off-target effects. Additionally, combinatorial strategies employing ferroptosis inducers alongside immunotherapies or targeted agents could surmount tumor heterogeneity and adaptive resistance mechanisms.
This landmark article not only enriches our molecular understanding of gastric cancer chemoresistance but also challenges the oncology community to rethink lethal pathways as allies in cancer eradication. Ferroptosis, once an obscure form of cell death, emerges at the forefront of cancer biology as a powerful lever capable of tipping the balance toward therapeutic success.
In conclusion, the mechanistic dissection of how USP29 and SMURF1 collaboratively sustain FSP1-mediated ferroptosis suppression equips researchers and clinicians with key molecular targets to overcome chemoresistance. As new therapies emerge from these insights, the grim prognosis historically associated with gastric cancer may be decisively altered, heralding a new era in cancer treatment grounded in molecular precision and innovative cell death pathways.
Subject of Research: Gastric cancer chemoresistance; ferroptosis suppression mechanisms involving USP29, SMURF1, and FSP1.
Article Title: USP29 and SMURF1 orchestrate FSP1-mediated ferroptosis suppression to facilitate chemoresistance in gastric cancer.
Article References:
Wu, Z., Tu, X., Zhu, S. et al. USP29 and SMURF1 orchestrate FSP1-mediated ferroptosis suppression to facilitate chemoresistance in gastric cancer. Nat Commun (2025). https://doi.org/10.1038/s41467-025-66319-1
Image Credits: AI Generated
