Nangia, V.; Ashraf, H.; Marikar, N.; Passanisi, V. J.; Ill, C. R.; Spencer, S. L.

Resistance to targeted therapy in BRAF-mutant melanomas can arise from drug-tolerant persister cells, which can non-genetically escape drug-induced quiescence to resume proliferation. To investigate how melanoma cells adapt to re-enter the cell cycle within 3-4 days of BRAF and MEK inhibition, we computationally reconstructed single-cell lineages from time-lapse imaging data, linking key signaling pathways to cell-cycle fate outcomes. We found that ERK reactivation, while necessary, is insufficient for cell-cycle re-entry in the presence of drug. Instead, mTORC1 emerged as an additional critical mediator, enhancing translation and cell growth in persisters destined for drug escape. We further found that ERK and mTORC1 signaling converge to produce Cyclin D1 protein levels, a key bottleneck for cell-cycle re-entry. Using CRISPR to tag endogenous Cyclin D1, we found that future escapees markedly upregulate Cyclin D1 at least 15 hours prior to drug escape, compared to non-escapees. Importantly, this early upregulation enables accurate prediction of future escapees from non-escapees, underscoring how differences in Cyclin D1 accumulation precede and govern the timing and likelihood of cell-cycle re-entry in persister cells. Our findings suggest that variability in ERK and mTORC1 activity underlies the heterogeneous Cyclin D1 levels observed, influencing the proliferative potential of persister cells and ultimately shaping the diverse cell-cycle behaviors observed under drug treatment. Cyclin D1 protein therefore emerges as both a critical biomarker and a therapeutic target for preventing cell-cycle re-entry in BRAF/MEK-treated melanoma.