<?xml version="1.0" encoding="UTF-8"?><?xml-stylesheet type="text/xsl" href="static/style.xsl"?><OAI-PMH xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/ http://www.openarchives.org/OAI/2.0/OAI-PMH.xsd"><responseDate>2026-07-21T18:17:36Z</responseDate><request verb="GetRecord" identifier="oai:repisalud.isciii.es:20.500.12105/12870" metadataPrefix="mets">https://repisalud.isciii.es/rest/oai/request</request><GetRecord><record><header><identifier>oai:repisalud.isciii.es:20.500.12105/12870</identifier><datestamp>2024-09-27T08:35:31Z</datestamp><setSpec>com_20.500.12105_19604</setSpec><setSpec>com_20.500.12105_2051</setSpec><setSpec>col_20.500.12105_19605</setSpec></header><metadata><mets xmlns="http://www.loc.gov/METS/" xmlns:doc="http://www.lyncode.com/xoai" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" ID="&#xa;&#x9;&#x9;&#x9;&#x9;DSpace_ITEM_20.500.12105-12870" TYPE="DSpace ITEM" PROFILE="DSpace METS SIP Profile 1.0" xsi:schemaLocation="http://www.loc.gov/METS/ http://www.loc.gov/standards/mets/mets.xsd" OBJID="&#xa;&#x9;&#x9;&#x9;&#x9;hdl:20.500.12105/12870">
   <metsHdr CREATEDATE="2026-07-21T20:17:36Z">
      <agent ROLE="CUSTODIAN" TYPE="ORGANIZATION">
         <name>Repisalud</name>
      </agent>
   </metsHdr>
   <dmdSec ID="DMD_20.500.12105_12870">
      <mdWrap MDTYPE="MODS">
         <xmlData xmlns:mods="http://www.loc.gov/mods/v3" xsi:schemaLocation="http://www.loc.gov/mods/v3 http://www.loc.gov/standards/mods/v3/mods-3-1.xsd">
            <mods:mods xsi:schemaLocation="http://www.loc.gov/mods/v3 http://www.loc.gov/standards/mods/v3/mods-3-1.xsd">
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Aguirre, Luis A.</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Montalbán-Hernández, Karla</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Avendaño-Ortiz, José</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Marín, Elvira</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Lozano, Roberto</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Toledano, Víctor</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Sánchez-Maroto, Laura</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Terrón, Verónica</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Valentín, Jaime</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Pulido, Elisa</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Casalvilla, José Carlos</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Rubio, Carolina</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Diekhorst, Luke</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Laso-García, Fernando</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>del Fresno, Carlos</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Collazo-Lorduy, Ana</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Jiménez-Munarriz, Beatriz</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Gómez-Campelo, Paloma</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Llanos-González, Emilio</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Fernández-Velasco, María</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Rodríguez-Antolín, Carlos</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Pérez de Diego, Rebeca</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Cantero-Cid, Ramón</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Hernádez-Jimenez, Enrique</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Álvarez, Enrique</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Rosas, Rocío</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Dies López-Ayllón, Blanca</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>de Castro, Javier</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Wculek, Stefanie K</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Cubillos-Zapata, Carolina</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Ibanez de Caceres, Inmaculada</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Díaz-Agero, Prudencio</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Gutiérrez Fernández, María</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Paz de Miguel, María</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Sancho, David</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Schulte, Leon</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Perona, Rosario</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Belda-Iniesta, Cristobal</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Boscá, Lisardo</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>López-Collazo, Eduardo</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">funder</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Fundación para la Investigación Biomédica La Paz Hospital</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">funder</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Fundación Familia Alonso</mods:namePart>
               </mods:name>
               <mods:extension>
                  <mods:dateAccessioned encoding="iso8601">2021-05-05T07:30:24Z</mods:dateAccessioned>
               </mods:extension>
               <mods:extension>
                  <mods:dateAvailable encoding="iso8601">2021-05-05T07:30:24Z</mods:dateAvailable>
               </mods:extension>
               <mods:originInfo>
                  <mods:dateIssued encoding="iso8601">2020-09</mods:dateIssued>
               </mods:originInfo>
               <mods:identifier type="citation">Oncoimmunology. 2020; 9(1):1773204</mods:identifier>
               <mods:identifier type="doi">10.1080/2162402X.2020.1773204</mods:identifier>
               <mods:identifier type="issn">2162-4011</mods:identifier>
               <mods:identifier type="journal">Oncoimmunology</mods:identifier>
               <mods:identifier type="pubmedID">32923132</mods:identifier>
               <mods:identifier type="uri">http://hdl.handle.net/20.500.12105/12870</mods:identifier>
               <mods:abstract>The 'cancer cell fusion' theory is controversial due to the lack of methods available to identify hybrid cells and to follow the phenomenon in patients. However, it seems to be one of the best explanations for both the origin and metastasis of primary tumors. Herein, we co-cultured lung cancer stem cells with human monocytes and analyzed the dynamics and properties of tumor-hybrid cells (THC), as well as the molecular mechanisms beneath this fusion process by several techniques: electron-microscopy, karyotyping, CRISPR-Cas9, RNA-seq, immunostaining, signaling blockage, among others. Moreover, mice models were assessed for in vivo characterization of hybrids colonization and invasiveness. Then, the presence of THCs in bloodstream and samples from primary and metastatic lesions were detected by FACS and immunofluorescence protocols, and their correlations with TNM stages established. Our data indicate that the generation of THCs depends on the expression of CD36 on tumor stem cells and the oxidative state and polarization of monocytes, the latter being strongly influenced by microenvironmental fluctuations. Highly oxidized M2-like monocytes show the strongest affinity to fuse with tumor stem cells. THCs are able to proliferate, colonize and invade organs. THC-specific cell surface signature CD36+CD14+PANK+ allows identifying them in matched primary tumor tissues and metastases as well as in bloodstream from patients with lung cancer, thus functioning as a biomarker. THCs levels in circulation correlate with TNM classification. Our results suggest that THCs are involved in both origin and spread of metastatic cells. Furthermore, they might set the bases for future therapies to avoid or eradicate lung cancer metastasis.</mods:abstract>
               <mods:language>
                  <mods:languageTerm authority="rfc3066">eng</mods:languageTerm>
               </mods:language>
               <mods:accessCondition type="useAndReproduction"/>
               <mods:titleInfo>
                  <mods:title>Tumor stem cells fuse with monocytes to form highly invasive tumor-hybrid cells.</mods:title>
               </mods:titleInfo>
               <mods:genre>journal article</mods:genre>
            </mods:mods>
         </xmlData>
      </mdWrap>
   </dmdSec>
   <amdSec ID="TMD_20.500.12105_12870">
      <rightsMD ID="RIG_20.500.12105_12870">
         <mdWrap MIMETYPE="text/plain" MDTYPE="OTHER" OTHERMDTYPE="DSpaceDepositLicense">
            <binData>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</binData>
         </mdWrap>
      </rightsMD>
   </amdSec>
   <amdSec ID="FO_20.500.12105_12870_1">
      <techMD ID="TECH_O_20.500.12105_12870_1">
         <mdWrap MDTYPE="PREMIS">
            <xmlData xmlns:premis="http://www.loc.gov/standards/premis" xsi:schemaLocation="http://www.loc.gov/standards/premis http://www.loc.gov/standards/premis/PREMIS-v1-0.xsd">
               <premis:premis>
                  <premis:object>
                     <premis:objectIdentifier>
                        <premis:objectIdentifierType>URL</premis:objectIdentifierType>
                        <premis:objectIdentifierValue>https://repisalud.isciii.es/bitstreams/12b5b980-86de-4443-9a1e-754c931af181/download</premis:objectIdentifierValue>
                     </premis:objectIdentifier>
                     <premis:objectCategory>File</premis:objectCategory>
                     <premis:objectCharacteristics>
                        <premis:fixity>
                           <premis:messageDigestAlgorithm>MD5</premis:messageDigestAlgorithm>
                           <premis:messageDigest>cb43846d976b711471f7fcd5f89b70ff</premis:messageDigest>
                        </premis:fixity>
                        <premis:size>11331639</premis:size>
                        <premis:format>
                           <premis:formatDesignation>
                              <premis:formatName>application/pdf</premis:formatName>
                           </premis:formatDesignation>
                        </premis:format>
                     </premis:objectCharacteristics>
                     <premis:originalName>TumorStemCellsFuse_2020.pdf</premis:originalName>
                  </premis:object>
               </premis:premis>
            </xmlData>
         </mdWrap>
      </techMD>
   </amdSec>
   <amdSec ID="FO_20.500.12105_12870_2">
      <techMD ID="TECH_O_20.500.12105_12870_2">
         <mdWrap MDTYPE="PREMIS">
            <xmlData xmlns:premis="http://www.loc.gov/standards/premis" xsi:schemaLocation="http://www.loc.gov/standards/premis http://www.loc.gov/standards/premis/PREMIS-v1-0.xsd">
               <premis:premis>
                  <premis:object>
                     <premis:objectIdentifier>
                        <premis:objectIdentifierType>URL</premis:objectIdentifierType>
                        <premis:objectIdentifierValue>https://repisalud.isciii.es/bitstreams/bc146a1f-73ff-4dd5-bf37-bb9ea75add4c/download</premis:objectIdentifierValue>
                     </premis:objectIdentifier>
                     <premis:objectCategory>File</premis:objectCategory>
                     <premis:objectCharacteristics>
                        <premis:fixity>
                           <premis:messageDigestAlgorithm>MD5</premis:messageDigestAlgorithm>
                           <premis:messageDigest>6aa6135fb3c4895cfc9ffc940d0c5c39</premis:messageDigest>
                        </premis:fixity>
                        <premis:size>114518805</premis:size>
                        <premis:format>
                           <premis:formatDesignation>
                              <premis:formatName>application/octet-stream</premis:formatName>
                           </premis:formatDesignation>
                        </premis:format>
                     </premis:objectCharacteristics>
                     <premis:originalName>TumorStemCellsFuse_2020supp.zip</premis:originalName>
                  </premis:object>
               </premis:premis>
            </xmlData>
         </mdWrap>
      </techMD>
   </amdSec>
   <amdSec ID="FT_20.500.12105_12870_5">
      <techMD ID="TECH_T_20.500.12105_12870_5">
         <mdWrap MDTYPE="PREMIS">
            <xmlData xmlns:premis="http://www.loc.gov/standards/premis" xsi:schemaLocation="http://www.loc.gov/standards/premis http://www.loc.gov/standards/premis/PREMIS-v1-0.xsd">
               <premis:premis>
                  <premis:object>
                     <premis:objectIdentifier>
                        <premis:objectIdentifierType>URL</premis:objectIdentifierType>
                        <premis:objectIdentifierValue>https://repisalud.isciii.es/bitstreams/899c6b5c-beb3-4ca2-9702-6ebdd1f44d75/download</premis:objectIdentifierValue>
                     </premis:objectIdentifier>
                     <premis:objectCategory>File</premis:objectCategory>
                     <premis:objectCharacteristics>
                        <premis:fixity>
                           <premis:messageDigestAlgorithm>MD5</premis:messageDigestAlgorithm>
                           <premis:messageDigest>393f90b72762d4c7ecca1e89c5c2152d</premis:messageDigest>
                        </premis:fixity>
                        <premis:size>85291</premis:size>
                        <premis:format>
                           <premis:formatDesignation>
                              <premis:formatName>text/plain</premis:formatName>
                           </premis:formatDesignation>
                        </premis:format>
                     </premis:objectCharacteristics>
                     <premis:originalName>TumorStemCellsFuse_2020.pdf.txt</premis:originalName>
                  </premis:object>
               </premis:premis>
            </xmlData>
         </mdWrap>
      </techMD>
   </amdSec>
   <fileSec>
      <fileGrp USE="ORIGINAL">
         <file ID="BITSTREAM_ORIGINAL_20.500.12105_12870_1" MIMETYPE="application/pdf" SEQ="1" SIZE="11331639" CHECKSUM="cb43846d976b711471f7fcd5f89b70ff" CHECKSUMTYPE="MD5" ADMID="FO_20.500.12105_12870_1" GROUPID="GROUP_BITSTREAM_20.500.12105_12870_1">
            <FLocat LOCTYPE="URL" xlink:type="simple" xlink:href="https://repisalud.isciii.es/bitstreams/12b5b980-86de-4443-9a1e-754c931af181/download"/>
         </file>
         <file ID="BITSTREAM_ORIGINAL_20.500.12105_12870_2" MIMETYPE="application/octet-stream" SEQ="2" SIZE="114518805" CHECKSUM="6aa6135fb3c4895cfc9ffc940d0c5c39" CHECKSUMTYPE="MD5" ADMID="FO_20.500.12105_12870_2" GROUPID="GROUP_BITSTREAM_20.500.12105_12870_2">
            <FLocat LOCTYPE="URL" xlink:type="simple" xlink:href="https://repisalud.isciii.es/bitstreams/bc146a1f-73ff-4dd5-bf37-bb9ea75add4c/download"/>
         </file>
      </fileGrp>
      <fileGrp USE="TEXT">
         <file ID="BITSTREAM_TEXT_20.500.12105_12870_5" MIMETYPE="text/plain" SEQ="5" SIZE="85291" CHECKSUM="393f90b72762d4c7ecca1e89c5c2152d" CHECKSUMTYPE="MD5" ADMID="FT_20.500.12105_12870_5" GROUPID="GROUP_BITSTREAM_20.500.12105_12870_5">
            <FLocat LOCTYPE="URL" xlink:type="simple" xlink:href="https://repisalud.isciii.es/bitstreams/899c6b5c-beb3-4ca2-9702-6ebdd1f44d75/download"/>
         </file>
      </fileGrp>
   </fileSec>
   <structMap LABEL="DSpace Object" TYPE="LOGICAL">
      <div TYPE="DSpace Object Contents" ADMID="DMD_20.500.12105_12870">
         <div TYPE="DSpace BITSTREAM">
            <fptr FILEID="BITSTREAM_ORIGINAL_20.500.12105_12870_1"/>
         </div>
         <div TYPE="DSpace BITSTREAM">
            <fptr FILEID="BITSTREAM_ORIGINAL_20.500.12105_12870_2"/>
         </div>
      </div>
   </structMap>
</mets></metadata></record></GetRecord></OAI-PMH>