The myogenesis program drives clonal selection and resistance in

Rhabdomyosarcoma (RMS) is a pediatric cancer with features of skeletal muscle; patients with unresectable or metastatic RMS fare poorly due to high rates of disease recurrence. Here, we use single-cell and single nucleus RNA sequencing to show that RMS tumors recapitulate the spectrum of embryonal myogenesis. Using matched patient samples from a clinical trial and orthotopic patient-derived xenografts (O-PDXs), we show that chemotherapy eliminates the most proliferative component with features of myoblasts within embryonal RMS; after treatment, the immature population with features of paraxial mesoderm expands to reconstitute the developmental hierarchy of the original tumor. We discovered that this paraxial mesoderm population is dependent on EGFR signaling and is sensitive to EGFR inhibitors. Taken together, these data serve as a proof of concept that targeting each developmental state in embryonal RMS is an effective strategy for improving outcomes by preventing disease recurrence.

Automated summary

Through single-cell and single nucleus RNA sequencing, the study found that rhabdomyosarcoma recapitulates the developmental hierarchy of embryonal myogenesis. Chemotherapy can eliminate the most proliferative component with features of myoblasts, and the immature paraxial mesoderm population expands after treatment. This paraxial mesoderm population is dependent on EGFR signaling and is sensitive to EGFR inhibitors.