PCNA-Pol κ-Polδ /USP18 axes stabilize replication fork and restart to reduce cisplatin cytotoxicity
This study reveals that in cisplatin-resistant head and neck squamous carcinoma cells, DNA polymerase kappa (Polκ) mitigates drug toxicity not primarily through lesion bypass, but by forming two critical axes with PCNA—Polδ to drive proliferation and USP18 to stabilize DNA repair proteins and replication forks—thereby maintaining genomic stability and offering a novel therapeutic target.