Abstract
Cisplatin resistance causes ineffectiveness of cisplatin-based treatment for cervical carcinoma. The combination of cisplatin and other chemotherapeutic drugs is an available strategy to overcome this problem. However, chemotherapeutic drugs combined with cisplatin may show tissue toxicity and systemic side effects. Thus, there is a great need of seeking effective substitutes for these chemotherapeutic drugs to improve combination therapy. Here, we found that inactivating IL-6/JAK2/STAT3 signaling pathway sensitized carcinoma cells to cisplatin toxicity by increasing cisplatin accumulation, impairing DNA damage repair, and inhibiting the initiation and development of autophagy, which subsequently caused the increases in DNA damage levels and apoptosis rates in cisplatin-treated cells. We predicted that TFF3 negatively regulated transduction in the IL-6/JAK2/STAT3 pathway based on in silico analysis of the differentially expressed genes (DEGs) between highly trefoil factor 3(TFF3)-encoding mRNA-expressing carcinoma tissues and low-expressing counterparts, and experimentally determined that both ectopic expression of TFF3-encoding gene and TFF3 administration inhibited IL-6-induced STAT3 activation in carcinoma cells. Mechanistically, upon binding to IGF2R, TFF3 stabilized IGF2R by inhibiting the ubiquitin-proteasome degradation pathway to inactivate Akt and thereby STAT3. Moreover, we discovered that TFF3 administration antagonized protective effects of IL-6 stimulation against tumor-killing capacity of cisplatin. Based on these findings, we consider that TFF3 may be employed as a cisplatin sensitizer and have advantages over traditional chemotherapeutic drugs in cisplatin-based combination therapy, since it is a naturally occurring protein in cervical tissue.

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Data availability
All relevant data generated in this study are available within the article and supplementary files. The original data can be requested from the corresponding author for reasonable purposes. The bioinformatics analysis data were obtained from the TCGA (https://www.cancer.gov/) and GEO (https://www.ncbi.nlm.nih.gov/geo/).
Code availability
The “limma” package was employed to determine the differentially expressed genes. The “clusterProfiler” and “enrichplot” packages were used to perform gene enrichement analysis. The expression levels of TFF3 and XRCC4-encoding mRNAs were obtained from GSE7410, GSE39001 and GSE3514. And the “GEOquery” and “ggplot2” packages were separately exploited to group data and to conduct boxplot analysis that provides insightful visualization.
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Acknowledgements
We thank Professor Tie Wang (Institute of Intelligent Detection for Life and Health, Tianjin University of Technology) for providing the experimental platform and instruments for this research. This work was supported by the National Natural Science Foundation of China (grant number 81602403) and Tianjin Natural Science Foundation (No.23JCQNJC00790).
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YXZ and LY designed the study; YXZ performed the bioinformatics experiments; YXZ and LPY performed all the experiments; NA and BHF performed the preparation of the recombinant protein TFF3; WZ and LSJ cultured the human cervical cancer cell line; YXZ and LPY performed the data processing and visualization; YXZ and LY wrote and revised the manuscript; and JYG completed the construction of the plasmid.
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Zhang, Y., Yan, L., An, N. et al. TFF3 sensitizes cervical carcinoma cells to cisplatin toxicity by binding to IGF2R. Cancer Gene Ther 33, 155–168 (2026). https://doi.org/10.1038/s41417-025-00990-w
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DOI: https://doi.org/10.1038/s41417-025-00990-w


