Cancer metastasis as a result of interactions between epithelial and mesenchymal gene programs / Metàstasis del càncer com a resultat d’interaccions entre programes gènics epitelials i mesenquimals

Resumen

This Doctoral Thesis project is part of a broader research program whose global aim is to better understand key molecular and cellular events in tumor metastasis, in particular those associated with prostate cancer, in order to identify regulatory molecules, gene networks and biochemical pathways, to propose relevant biomarkers and, finally, to provide proof-of-concept validations for potential therapeutic targets. As a starting point, this particular project has relied on comparative analyses between isogenic tumor cells with high vs. low metastatic potentials. The results of this Thesis project are reflected in two different but closely related studies. Article 1, the main publication of this project, focuses on how phenotypic switches and interactions between distinct tumor cell subpopulations engage or suppress metastasis, and which are the genetic programs that may govern such transformations. Article 2 is more focused on specific molecular post-transcriptional regulatory mechanisms that influence the latter steps of metastatic colonization. 1) Malignant progression in cancer requires populations of tumor-initiating cells (TICs) endowed with unlimited self-renewal, survival under stress and establishment of distant metastases. Additionally, the acquisition of invasive properties driven by epithelial-mesenchymal transition (EMT) is critical for the evolution of neoplastic cells into fully metastatic populations. Here we characterize cellular models derived from prostate and bladder cancer cell lines in which tumor subpopulations expressing a strong epithelial gene program are enriched in highly metastatic TICs, while a second subpopulation with stable mesenchymal traits is impoverished in TICs. Constitutive overexpression of the transcription factor Snai1 in the epithelial/TIC-enriched populations engaged a mesenchymal gene program and suppressed their self-renewal and metastatic phenotypes. Conversely, knockdown of EMT factors in the mesenchymal-like prostate cancer cell subpopulation caused a gain in epithelial features and properties of TICs. Both tumor cell subpopulations cooperated among them, such that the non-metastatic mesenchymal-like prostate cancer subpopulation enhanced the in vitro invasiveness of the metastatic epithelial subpopulation and, in vivo, promoted the escape of the latter from primary implantation sites and accelerated their metastatic colonization. Our models provide new insights into how dynamic interactions between epithelial, self-renewal and mesenchymal gene programs determine the plasticity of epithelial tumor-initiating cells. 2) Although the role of miR-200s in regulating E-cadherin expression and epithelial-to-mesenchymal transition is well established, their influence on metastatic colonization remains controversial. Here we have used clinical and experimental models of breast cancer metastasis to discover a pro-metastatic role of miR-200s that goes beyond their regulation of E-cadherin and epithelial phenotype. Overexpression of miR-200s is associated with increased risk of metastasis in breast cancer and promotes metastatic colonization in mouse models, phenotypes that cannot be recapitulated by E-cadherin expression alone. Genomic and proteomic analyses revealed global shifts in gene expression upon miR-200 overexpression toward that of highly metastatic cells. miR-200s promote metastatic colonization partly through direct targeting of Sec23a, which mediates secretion of metastasis-suppressive proteins, including Igfbp4 and Tinagl1, as validated by functional and clinical correlation studies. Overall, these findings suggest a pleiotropic role of miR-200s in promoting metastatic colonization by influencing E-cadherin–dependent epithelial traits and Sec23a-mediated tumor cell secretome. Both studies, when considered together, share important and novel views of metastasis, mainly in relationship with the last steps of the metastatic cascade, strongly suggesting that prostate, bladder and breast tumor cells with an epithelial non-secretory phenotype are more prone to metastatize. We propose that mesenchymal-like tumor cells with a relatively stable EMT derive from epithelial-CSC cells at the primary tumor site, largely in response to microenvironmental influences. As we have shown in the first study, both tumor cell populations, epithelial-CSC or TIC and mesenchymal-like, interact with each other, one consequence being a transient EMT of the epithelial-CSC population that had retained their epithelial state. Thus, in a given tumor microenvironment, there is a strong pressure for epithelial-CSC to drift from epithelial to mesenchymal-like phenotypes. Together, these heterogeneous populations of tumor cells are effective at overcoming the initial barriers to metastasis where invasion is required. After completing these initial steps, mesenchymal-like tumor cell populations are less critically required, while epithelial-CSC are more important and critical to finally grow metastastatic secondary tumors. There are many reasons to support that epithelial-CSC-unsecretory cells are more capable of metastatic colonization, including the facts that they can form clusters in the bloodstream for better survival, are resistant to anoikis, they show anchorage-independent growth and strong self-renewal capacity that permit them to adapt to different environments and initiate and grow secondary tumors. Very interestingly, such cells have a reduced secretion of metastatic suppressor factors which may interact in autocrine and paracrine fashion with tumoral and stromal cells at metastatic sites.