Abstract The tumor suppressor NF1 is classically considered a negative RAS regulator, but sparse evidence suggests additional RAS-independent roles. Early studies suggested an interaction with tubulin, which remains poorly characterized to date but may be of particular therapeutic interest as NF1 is somatically mutated across multiple tumor types. We showed that multiple CRISPR-Cas9-engineeerd NF1 KO HER2+ breast cancer cells (BT-474, SK-BR3, HCC1954) become exquisitely sensitive to the Antibody-Drug Conjugate (ADC) Trastuzumab emtansine (T-DM1); we here investigate the underlying mechanism.TDM1 hypersensitivy was specific to the maytansin microtubule-targeting payload, since it was i) replicated by the naked payload but not the naked antibody; ii) absent with other ADCs (T-DxD); iii) not accompanied by increased TDM1 uptake; iv) associated with increased tubulin-maytansin binding in KO cells, as per Cellular Thermal Shift Assay. The mechanism is likely RAS-independent, as KRAS G12V-overexpression did not alter TDM1 sensitivity. RNAseq revealed that KO cells deregulated genes associated with microtubular dynamics and G2-M transition more strongly upon TDM1-treatement. Multiple KO cells investigated by static and live imaging exhibited marked signs of altered mitosis, with longer G2/M, supernumerary centrosomes, chromosome misalignment and frequent aneuploidy, which could also be inferred in multiple public sequencing datasets (TCGA, MSK IMPACT, AACR GENIE). Based on this, we explored NF1 role on microtubule dynamics. We found several lines of evidence for a direct and mitosis-selective interaction between NF1 and tubulin: i) in Immunofluorescence (IF), NF1 was upregulated in mitosis and colocalized with the mitotic spindle; ii) NF1 co-Immunoprecipitated with tubulin in mitosis-enriched but not asynchronous cells; iii) purified NF1 co-eluted with tubulin in size-selection chromatography; iv) in silico modeling with AlphaFold2 predicted an interaction between NF1 central domains and the alpha-beta tubulin dimer. Crucially, KO cells exhibited severe microtubule hypodynamism in cold-induced depolymerization-repolymerization assays, replicated in multiple cell types and accompanied by imbalanced levels of plus/minus-end microtubule-associated proteins. By IF on cocultured WT/KO live cells, KO cells showed significantly higher GTP-tubulin, known to cause microtubular hyperstability, suggesting the intriguing possibility that NF1 may directly regulate tubulin intrinsic GTP-hydrolyzing activity, similar to its role on RAS. In conclusion, we provide extensive mechanistic evidence for a direct and previously underappreciated role of NF1 in microtubular dynamics, which reshapes our understanding of its tumor-suppressive activity and provides a rationale for pharmacological targeting of NF1-mutated tumors. Citation Format: Bruno A. Duso, Eleonora Messuti, Emanuele Bonetti, Giulia Tini, Alessia Castiglioni, Giuseppe Ciossani, Silvia Monzani, Chiara Soriani, Simona Rodighiero, Luigi Scietti, Costantino Jemos, Luca Mazzarella. NF1 (neurofibromatosis 1) controls microtubule dynamics and dictates sensitivity to maytansinoids. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4896.