Distinct tumor architectures for metastatic colonization of the brain

Brain metastasis is a dismal cancer complication, hinging on the initial survival and outgrowth of disseminated cancer cells. To understand these crucial early stages of colonization, we investigated two prevalent sources of cerebral relapse, triple-negative (TNBC) and HER2+ breast cancer (HER2BC). We show that these tumor types colonize the brain aggressively, yet with distinct tumor architectures, stromal interfaces, and autocrine growth programs. TNBC forms perivascular sheaths with diffusive contact with astrocytes and microglia. In contrast, HER2BC forms compact spheroids prompted by autonomous extracellular matrix components and segregating stromal cells to their periphery. Single-cell transcriptomic dissection reveals canonical Alzheimer's disease-associated microglia (DAM) responses. Differential engagement of tumor-DAM signaling through the receptor AXL suggests specific pro-metastatic functions of the tumor architecture in both TNBC perivascular and HER2BC spheroidal colonies. The distinct spatial features of these two highly efficient modes of brain colonization have relevance for leveraging the stroma to treat brain metastasis.

Abstract PR004: Mechanistic basis for TGF-β-induced fibrogenic EMTs in metastasis

The cytokine TGF-β is a central regulator of tissue homeostasis and regeneration through multiple coordinated effects on epithelial, immune, and mesenchymal stromal systems. Malfunctions of TGF-β signaling cause fibrosis, immune dysfunction, and cancer. As part of its multifunctional program, TGF-β induces epithelial-mesenchymal transitions (EMTs). Carcinoma cells use TGF-β to undergo EMT and adopt a highly plastic phenotype that facilitates tumor growth and metastasis. Notably, TGF-β-induced EMTs in epithelial progenitor cells are accompanied by the expression of fibrogenic factors that activate fibroblasts to produce and remodel the extracellular matrix. This not only occurs during wound healing but also in lung adenocarcinoma (LUAD) and pancreatic adenocarcinoma (PDAC) cells, suggesting that EMT and fibrogenesis are parts of an orchestrated program. We recently showed that the transcription factor RAS-Responsive Element-Binding Protein 1 (RREB1) activated by RAS-MAPK signaling synergizes with SMADs to coordinately activate the expression of EMT transcription factor Snai1 and fibrogenic genes in carcinoma progenitors (Su et al Nature 2020). Using metastasis transplantation models, we have now found that both arms of the RREB1-dependent TGF-β responses are important for metastasis. Knockout of individual fibrogenic genes in cancer cells inhibited metastasis without altering the induction of EMT by TGF-β. To address why these TGF-β target genes specifically require KRAS-activated RREB1 for transcriptional induction, we employed proteomics approaches coupled with a CRISPR-based genetic screen. With this approach we identified DXH9 and INO80 as RREB1-interacting factors essential for TGF-β activation of fibrogenic EMT programs in PDAC and LUAD cells. DXH9 and INO80 are helicases that interact and SMAD3 and RREB1 in response to TGF-β. Knockout of Dhx9 or Ino80 abolished the induction of Snai1 and fibrogenic genes by TGF-β, inhibited the LUAD metastasis, and decreased intratumoral fibrosis, thus phenocopying the knockout of Rreb1. The helicase domain of DHX9 is required for TGF-β gene responses and metastasis. Our evidence indicates that RREB1, DXH9, and INO80 function to remodel the chromatin at specific loci that constitute a TGF-β-dependent fibrogenic EMT program. This work illuminates a previously unknown cooperation between TGF-β and RAS-MAPK pathways during epithelial tissue regeneration and its cooption in carcinoma metastasis.

Citation Format: Jun Ho Lee, Harihar Basnet, Francisco Sánchez-Rivera, Zhenghan Wang, Liangji Li, Joan Massagué. Mechanistic basis for TGF-β-induced fibrogenic EMTs in metastasis [abstract]. In: Proceedings of the AACR Special Conference: Cancer Metastasis; 2022 Nov 14-17; Portland, OR. Philadelphia (PA): AACR; Cancer Res 2022;83(2 Suppl_2):Abstract nr PR004.

Abstract A12: L1CAM defines the regenerative origin of metastasis initiating cells in colorectal cancer

Metastatic cancers relapse due to the emergence of stemlike clones capable of reversible quiescence, tumour reinitiation, and therapy resistance termed metastasis-initiating cells (MICs). The origins of MICs and their relationship to primary tumor-initiating cells are not known, largely due to a lack of representative models of MICS. To directly scrutinize MICs in patient metastases, we established organoid cultures from therapy-resistant, residual colorectal cancer (CRC) liver metastases of patients undergoing cancer surgery. We identify the neuronal cell adhesion molecule L1 (L1CAM) as a critical mediator and marker of colorectal cancer (CRC) MICs. L1CAM+ cells are quiescent in well-structured neoplastic glands in vivo, but when dissociated from their epithelial niche, drive organoid regeneration and xenograft tumor reinitiation. FACS-sorted L1CAM+ cells preferentially regenerate heterogeneous organoids containing both L1CAM+ and L1CAM- progeny. Single-cell mRNA sequencing of 10,000 cells from four patient-derived organoids reveals that L1CAMhigh MICs in human CRC organoids partially overlap with a subset of LGR5high cancer stem cells (CSCs). The number of LGR5-expressing cells decreases, while the number of L1CAM-expressing cells increases in metastases in comparison with primary tumors in patients. We show that L1CAM is required for organoid formation, intestinal epithelial repair following colitis in vivo, regeneration of orthotopic rectal tumors, and metastatic colonization of the liver, but is dispensable for intestinal epithelial homeostasis or tumor initiation. Mechanistically, disruption of intercellular epithelial contacts inhibits an E-cadherin-REST signaling axis and enables transcriptional derepression of L1CAM. Our work underscores the distinct requirements of the CSCs that initiate tumor growth and MICs that drive lethal metastatic relapse. We identify the loss of epithelial integrity, an obligatory step of metastasis, as a crucial molecular driver of the transcriptional plasticity required for the emergence of prometastatic traits. Further, we define L1CAM as a crucial vulnerability of MICs that could be exploited therapeutically to treat patients with metastatic cancer.

Citation Format: Karuna Ganesh, Harihar Basnet, Yasemin Kaygusuz, Ashley Laughney, Lan He, Roshan Sharma, Kevin O'Rourke, Vincent Reuter, Yun-Han Huang, Ignas Masilionis, Mesruh Turkekul, Ekrem Er, Katja Manova-Todorova, Leonard Saltz, Martin Weiser, Julio Garcia-Aguilar, Richard Koche, Scott Lowe, Dana Peer, Jinru Shia, Joan Massague. L1CAM defines the regenerative origin of metastasis initiating cells in colorectal cancer [abstract]. In: Proceedings of the AACR Special Conference on the Evolving Landscape of Cancer Modeling; 2020 Mar 2-5; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2020;80(11 Suppl):Abstract nr A12.

Publisher Correction: TGF-β orchestrates fibrogenic and developmental EMTs via the RAS effector RREB1

An Amendment to this paper has been published and can be accessed via a link at the top of the paper.

L1CAM defines the regenerative origin of metastasis-initiating cells in colorectal cancer

Metastasis-initiating cells with stem-like properties drive cancer lethality, yet their origins and relationship to primary-tumor-initiating stem cells are not known. We show that L1CAM⁺ cells in human colorectal cancer (CRC) have metastasis-initiating capacity, and we define their relationship to tissue regeneration. L1CAM is not expressed in the homeostatic intestinal epithelium, but is induced and required for epithelial regeneration following colitis and in CRC organoid growth. By using human tissues and mouse models, we show that L1CAM is dispensable for adenoma initiation but required for orthotopic carcinoma propagation, liver metastatic colonization and chemoresistance. L1CAM^high cells partially overlap with LGR5^high stem-like cells in human CRC organoids. Disruption of intercellular epithelial contacts causes E-cadherin-REST transcriptional derepression of L1CAM, switching chemoresistant CRC progenitors from an L1CAM^low to an L1CAM^high state. Thus, L1CAM dependency emerges in regenerative intestinal cells when epithelial integrity is lost, a phenotype of wound healing deployed in metastasis-initiating cells.

ID1 Mediates Escape from TGFβ Tumor Suppression in Pancreatic Cancer

TGFβ is an important tumor suppressor in pancreatic ductal adenocarcinoma (PDA), yet inactivation of TGFβ pathway components occurs in only half of PDA cases. TGFβ cooperates with oncogenic RAS signaling to trigger epithelial-to-mesenchymal transition (EMT) in premalignant pancreatic epithelial progenitors, which is coupled to apoptosis owing to an imbalance of SOX4 and KLF5 transcription factors. We report that PDAs that develop with the TGFβ pathway intact avert this apoptotic effect via ID1. ID1 family members are expressed in PDA progenitor cells and encode components of a set of core transcriptional regulators shared by PDAs. PDA progression selects against TGFβ-mediated repression of ID1. The sustained expression of ID1 uncouples EMT from apoptosis in PDA progenitors. AKT signaling and mechanisms linked to low-frequency genetic events converge on ID1 to preserve its expression in PDA. Our results identify ID1 as a crucial node and potential therapeutic target in PDA. SIGNIFICANCE: Half of PDAs escape TGFβ-induced tumor suppression without inactivating the TGFβ pathway. We report that ID1 expression is selected for in PDAs and that ID1 uncouples TGFβ-induced EMT from apoptosis. ID1 thus emerges as a crucial regulatory node and a target of interest in PDA.This article is highlighted in the In This Issue feature, p. 1.

Labeling and Isolation of Fluorouracil Tagged RNA by Cytosine Deaminase Expression

Tissues are comprised of different cell types whose interactions elicit distinct gene expression patterns that regulate tissue formation, regeneration, homeostasis and repair. Analysis of these gene expression patterns require methods that can capture as closely as possible the transcriptomes of cells of interest in their tissue microenvironment. Current technologies designed to study in situ transcriptomics are limited by their low sensitivity that require cell types to represent more than 1% of the total tissue, making it challenging to transcriptionally profile rare cell populations rapidly isolated from their native microenvironment. To address this problem, we developed fluorouracil-tagged RNA sequencing (Flura-seq) that utilizes cytosine deaminase (CD) to convert the non-natural pyrimidine fluorocytosine to fluorouracil. Expression of S. cerevisiae CD and exposure to fluorocytosine generates fluorouracil and metabolically labels newly synthesized RNAs specifically in cells of interest. Fluorouracil-tagged RNAs can then be immunopurified and used for downstream analysis. Here, we describe the detailed protocol to perform Flura-seq both in vitro and in vivo. The robustness, simplicity and lack of toxicity of Flura-seq make this tool broadly applicable to many studies in developmental, regenerative, and cancer biology.

Flura-seq identifies organ-specific metabolic adaptations during early metastatic colonization

Metastasis-initiating cells dynamically adapt to the distinct microenvironments of different organs, but these early adaptations are poorly understood due to the limited sensitivity of in situ transcriptomics. We developed fluorouracil-labeled RNA sequencing (Flura-seq) for in situ analysis with high sensitivity. Flura-seq utilizes cytosine deaminase (CD) to convert fluorocytosine to fluorouracil, metabolically labeling nascent RNA in rare cell populations in situ for purification and sequencing. Flura-seq revealed hundreds of unique, dynamic organ-specific gene signatures depending on the microenvironment in mouse xenograft breast cancer micrometastases. Specifically, the mitochondrial electron transport Complex I, oxidative stress and counteracting antioxidant programs were induced in pulmonary micrometastases, compared to mammary tumors or brain micrometastases. We confirmed lung metastasis-specific increase in oxidative stress and upregulation of antioxidants in clinical samples, thus validating Flura-seq's utility in identifying clinically actionable microenvironmental adaptations in early metastasis. The sensitivity, robustness and economy of Flura-seq are broadly applicable beyond cancer research.

Abstract 4990: Regenerative origin of colorectal metastasis stem cells

Metastatic cancers invariably relapse due to the emergence of resistant tumor clones capable of self-renewal, entry into and exit from quiescence, tumor re-initiation and therapy resistance. The origins of such metastasis propagating cells (MPCs), which ultimately cause cancer death, are not well-understood.

To directly scrutinize MPCs in patient metastases, we established ex vivo organoid cultures from surgically resected, chemoresistant residual colorectal cancer (CRC) liver metastases. We show that the neuronal cell-adhesion molecule L1CAM, which is ectopically expressed in many cancer types and strongly associated with poor prognosis, is a marker of MPCs. L1CAM+ cells are largely quiescent in structured neoplastic glands in tumors, but when dissociated from their epithelial niche, proliferate to regenerate heterogeneous organoids or xenografts containing both L1CAM+ and L1CAM- progeny.

To define the relationship between L1CAM+ MPCs and Lgr5+ intestinal stem cells, we performed single cell mRNA sequencing on ~15,000 CRC organoid-derived cells from four patients. We identified only partial overlap between Lgr5+ and L1CAM+ cells. Lgr5high cells consistent with homeostatic stem cells, have low L1CAM levels, while Lgr5low transit amplifying progenitor-like cells have high L1CAM levels. In addition, we identify a separate population of L1CAMhighLgr5- cells. The data suggest that human CRC metastases are derived from an L1CAM+ population of transit-amplifying, partially differentiated cells.

L1CAM is not expressed in intact human or mouse intestinal crypts during homeostasis. However, when the intestinal epithelium is disrupted by dextran sodium sulfate-mediated colitis, L1CAM is strongly induced in cells in the middle of regenerating crypts. Intestinal epithelium specific deletion of L1CAM causes profound weight loss, poor tissue healing and reduces survival in DSS-treated mice. In turn, L1CAM knockdown/knockout in mouse or human CRC cells inhibits regeneration of organoids in vitro, subcutaneous tumors and orthotopic liver metastases in vivo. Mechanistically, L1CAM RNA expression is normally silenced in non-neuronal cells by the transcriptional repressor REST. We show that disruption of epithelial integrity by organoid dissociation or E-cadherin knockdown reduces REST binding to an L1CAM intronic enhancer, thus inducing L1CAM expression.

Our results suggest that L1CAM is dispensable for epithelial homeostasis, but is required for normal and neoplastic epithelial regeneration when tissue integrity is disrupted. During cancer progression, disseminated tumor cells at the invasion front of primary tumors, in the circulation, or in isolated residual disease following therapy, induce and depend on L1CAM for survival and eventual regrowth. Thus, L1CAM represents a crucial vulnerability of disseminated and residual MPCs that could be exploited therapeutically to treat patients with metastatic cancer.

Citation Format: Karuna Ganesh, Harihar Basnet, Kevin P. O'Rourke, Ashley M. Laughney, Lan He, Eduard Batlle, Scott W. Lowe, Dana Pe'er, Jinru Shia, Joan Massague. Regenerative origin of colorectal metastasis stem cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4990.

Metastatic Latency and Immune Evasion through Autocrine Inhibition of WNT

Metastasis frequently develops years after the removal of a primary tumor, from a minority of disseminated cancer cells that survived as latent entities through unknown mechanisms. We isolated latency competent cancer (LCC) cells from early stage human lung and breast carcinoma cell lines and defined the mechanisms that suppress outgrowth, support long-term survival, and maintain tumor-initiating potential in these cells during the latent metastasis stage. LCC cells show stem-cell-like characteristics and express SOX2 and SOX9 transcription factors, which are essential for their survival in host organs under immune surveillance and for metastatic outgrowth under permissive conditions. Through expression of the WNT inhibitor DKK1, LCC cells self-impose a slow-cycling state with broad downregulation of ULBP ligands for NK cells and evasion of NK-cell-mediated clearance. By expressing a Sox-dependent stem-like state and actively silencing WNT signaling, LCC cells can enter quiescence and evade innate immunity to remain latent for extended periods.

YAP mediates crosstalk between the Hippo and PI(3)K–TOR pathways by suppressing PTEN via miR-29

Organ development is a complex process governed by the interplay of several signalling pathways that have critical functions in the regulation of cell growth and proliferation. Over the past years, the Hippo pathway has emerged as a key regulator of organ size. Perturbation of this pathway has been shown to play important roles in tumorigenesis. YAP, the main downstream target of the mammalian Hippo pathway, promotes organ growth, yet the underlying molecular mechanism of this regulation remains unclear. Here we provide evidence that YAP activates the mammalian target of rapamycin (mTOR), a major regulator of cell growth. We have identified the tumour suppressor PTEN, an upstream negative regulator of mTOR, as a critical mediator of YAP in mTOR regulation. We demonstrate that YAP downregulates PTEN by inducing miR-29 to inhibit PTEN translation. Last, we show that PI(3)K–mTOR is a pathway modulated by YAP to regulate cell size, tissue growth and hyperplasia. Our studies reveal a functional link between Hippo and PI(3)K–mTOR, providing a molecular basis for the coordination of these two pathways in organ size regulation.

Monomeric structure of the cardioprotective chemokine SDF-1/CXCL12

The chemokine stromal cell-derived factor-1 (SDF-1/CXCL12) directs leukocyte migration, stem cell homing, and cancer metastasis through activation of CXCR4, which is also a coreceptor for T-tropic HIV-1. Recently, SDF-1 was shown to play a protective role after myocardial infarction, and the protein is a candidate for development of new anti-ischemic compounds. SDF-1 is monomeric at nanomolar concentrations but binding partners promote self-association at higher concentrations to form a typical CXC chemokine homodimer. Two NMR structures have been reported for the SDF-1 monomer, but only one matches the conformation observed in a series of dimeric crystal structures. In the other model, the C-terminal helix is tilted at an angle incompatible with SDF-1 dimerization. Using a rat heart explant model for ischemia/reperfusion injury, we found that dimeric SDF-1 exerts no cardioprotective effect, suggesting that the active species is monomeric. To resolve the discrepancy between existing models, we solved the NMR structure of the SDF-1 monomer in different solution conditions. Irrespective of pH and buffer composition, the C-terminal helix remains tilted at an angle with no evidence for the perpendicular arrangement. Furthermore, we find that phospholipid bicelles promote dimerization that necessarily shifts the helix to the perpendicular orientation, yielding dipolar couplings that are incompatible with the NOE distance constraints. We conclude that interactions with the alignment medium biased the previous structure, masking flexibility in the helix position that may be essential for the distinct functional properties of the SDF-1 monomer.

Structural basis of CXCR4 sulfotyrosine recognition by the chemokine SDF-1/CXCL12

Stem cell homing and breast cancer metastasis are orchestrated by the chemokine stromal cell-derived factor 1 (SDF-1) and its receptor CXCR4. Here, we report the nuclear magnetic resonance structure of a constitutively dimeric SDF-1 in complex with a CXCR4 fragment that contains three sulfotyrosine residues important for a high-affinity ligand-receptor interaction. CXCR4 bridged the SDF-1 dimer interface so that sulfotyrosines sTyr7 and sTyr12 of CXCR4 occupied positively charged clefts on opposing chemokine subunits. Dimeric SDF-1 induced intracellular Ca2+ mobilization but had no chemotactic activity; instead, it prevented native SDF-1-induced chemotaxis, suggesting that it acted as a potent partial agonist. Our work elucidates the structural basis for sulfotyrosine recognition in the chemokine-receptor interaction and suggests a strategy for CXCR4-targeted drug development.