Lymphatic metastasis is the main metastatic route for colorectal cancer, which increases the risk of cancer recurrence and distant metastasis. The properties of the lymph node metastatic colorectal cancer (LNM-CRC) cells are poorly understood, and effective therapies are still lacking. Here, we found that hypoxia-induced fibroblast activation protein alpha (FAP α ) expression in LNM-CRC cells. Gain- or loss-function experiments demonstrated that FAP α enhanced tumor cell migration, invasion, epithelial-mesenchymal transition, stemness, and lymphangiogenesis via activation of the STAT3 pathway. In addition, FAP α in tumor cells induced extracellular matrix remodeling and established an immunosuppressive environment via recruiting regulatory T cells, to promote colorectal cancer lymph node metastasis (CRCLNM). Z-GP-DAVLBH, a FAP α -activated prodrug, inhibited CRCLNM by targeting FAP α -positive LNM-CRC cells. Our study highlights the role of FAP α in tumor cells in CRCLNM and provides a potential therapeutic target and promising strategy for CRCLNM.
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