Abstract Oncogenic mutations arise frequently in young tissues, yet most remain clinically silent, suggesting that non-genetic variables may act as major drivers of cancer initiation. With age, this landscape of tolerance gradually diminishes, allowing mutated cells to bypass restraint and initiate tumorigenesis. Although cancer has long been considered as a hallmark disease of aging, recent evidence shows its incidence is now rising sharply in younger individuals, particularly of squamous cell carcinomas (SCCs). Understanding how mutated cells tolerate oncogenic stress in youth, and why this tolerance collapses over time, may provide opportunities for preventive intervention. These considerations are particularly important in the context of stem cells (SCs) which serve as the cells of origin for many cancers and whose fate and fitness are tightly orchestrated by their microenvironment, or “niches.” Yet, the niche-derived signals that precede and direct tumor formation remain poorly understood. The lymphatic vasculature, recently identified as a SC niche, is consistently remodeled in tumors and associated with heightened risk of metastasis and death among cancer patients. To investigate the impact of the lymphatic niches on early-stage tumorigenesis, we used skin SCC as a model, and examined SC tolerance to oncogenic stress under lymphatic loss-of-function conditions. Deep volumetric imaging revealed that lymphatic dysfunction predisposes stem cells to genomic instability, marked by accumulation of DNA damage indicators such as γH2AX in non-dividing cells, even in the absence of carcinogen exposure. These findings suggest that intact lymphatic niches protect SCs from genomic instability and preserve tissue homeostasis. Using a novel stem cell-lymphatic organotypic model, we found that SCs co-cultured with lymphatic vessels exhibited reduced DNA damage compared to those cultured with stromal cells following exposure to suboptimal carcinogenic insults. To directly test whether lymphatic dysfunction accelerates tumorigenesis, we induced Kras activation and p53 loss in Sox9+ hair follicle SCs. Pharmacological perturbation of lymphatics in this model led expansion of mutant clones in the epidermis within three weeks post-induction and significantly earlier tumor onset. Together, these findings uncover a previously unrecognized role for the lymphatic vasculature in reprogramming stem cell vulnerability to oncogenic stress. By linking lymphatic integrity to genomic stability, this work highlights lymphatic-driven regulation as a potential target for early detection and prevention of SC-derived cancers, including age related metastatic disease. Citation Format: Ananya Goyal, Madison Conte, Shiri Gur-Cohen. Lymphatic niches shield stem cells from malignant fate abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 4686.
Goyal et al. (Fri,) studied this question.