Name: therapy testing in a spheroid-based 3d cell culture model for head and neck squamous cell carcinoma
Uploaded: 2018-04-20T12:30:00
Description: Watch this Scientific Journal Video about Therapy Testing in a Spheroid-based 3D Cell Culture Model for Head and Neck Squamous Cell Carcinoma at JoVE.com

This project was funded by a grant of the University of Munich (F&#246;FoLe project-no.: 789-781).

All studies shown in this manuscript, namely the use of human tumor specimens, are protected under and in consent with prior decisions from University Medicine of Mainz/University of Munich Medical Center Ethics committee. Patients have given informed consent according to national legal guidelines agreeing to scientific use of excess biological material that was obtained in the course of their treatment. Research has been performed in compliance with all institutional, national and international guidelines for human welf...

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G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+degree+of+intratumor+mutational+heterogeneity+varies+by+primary+tumor+sub-site.">The degree of intratumor mutational heterogeneity varies by primary tumor sub-site.</a> Oncotarget. 7 (19), 27185-27198 (2016).</li><li>Loyo, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lessons+learned+from+next-generation+sequencing+in+head+and+neck+cancer.">Lessons learned from next-generation sequencing in head and neck cancer.</a> Head Neck. 35 (3), 454-463 (2013).</li><li>Morris, L. G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Molecular+Landscape+of+Recurrent+and+Metastatic+Head+and+Neck+Cancers:+Insights+From+a+Precision+Oncology+Sequencing+Platform.">The Molecular Landscape of Recurrent and Metastatic Head and Neck Cancers: Insights From a Precision Oncology Sequencing Platform.</a> JAMA Oncol. , (2016).</li><li>Bauml, J. M., Cohen, R. B., Aggarwal, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Immunotherapy+for+head+and+neck+cancer:+latest+developments+and+clinical+potential.">Immunotherapy for head and neck cancer: latest developments and clinical potential.</a> Ther Adv Med Oncol. 8 (3), 168-175 (2016).</li><li>Mack, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rapid+and+non-enzymatic+in+vitro+retrieval+of+tumour+cells+from+surgical+specimens.">Rapid and non-enzymatic in vitro retrieval of tumour cells from surgical specimens.</a> PLoS One. 8 (1), e55540 (2013).</li><li>Ham, S. L., Joshi, R., Thakuri, P. 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P., Hofstaedter, F., Ebner, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+use+of+3-D+cultures+for+high-throughput+screening:+the+multicellular+spheroid+model.">The use of 3-D cultures for high-throughput screening: the multicellular spheroid model.</a> J Biomol Screen. 9 (4), 273-285 (2004).</li><li>Lin, R. Z., Chang, H. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recent+advances+in+three-dimensional+multicellular+spheroid+culture+for+biomedical+research.">Recent advances in three-dimensional multicellular spheroid culture for biomedical research.</a> Biotechnol J. 3 (9-10), 1172-1184 (2008).</li><li>Weiswald, L. B., Bellet, D., Dangles-Marie, V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Spherical+cancer+models+in+tumor+biology.">Spherical cancer models in tumor biology.</a> Neoplasia. 17 (1), 1-15 (2015).</li><li>Cancer Genome Atlas, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comprehensive+genomic+characterization+of+head+and+neck+squamous+cell+carcinomas.">Comprehensive genomic characterization of head and neck squamous cell carcinomas.</a> Nature. 517 (7536), 576-582 (2015).</li><li>Duarte, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Isolation+of+head+and+neck+squamous+carcinoma+cancer+stem-like+cells+in+a+syngeneic+mouse+model+and+analysis+of+hypoxia+effect.">Isolation of head and neck squamous carcinoma cancer stem-like cells in a syngeneic mouse model and analysis of hypoxia effect.</a> Oncol Rep. 28 (3), 1057-1062 (2012).</li><li>Reid, P. A., Wilson, P., Li, Y., Marcu, L. 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B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Can+animal+models+of+disease+reliably+inform+human+studies?.">Can animal models of disease reliably inform human studies?.</a> PLoS Med. 7 (3), e1000245 (2010).</li><li>Wilding, J. L., Bodmer, W. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cancer+cell+lines+for+drug+discovery+and+development.">Cancer cell lines for drug discovery and development.</a> Cancer Res. 74 (9), 2377-2384 (2014).</li><li>Chitcholtan, K., Asselin, E., Parent, S., Sykes, P. H., Evans, J. 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We were able to establish a protocol to generate reproducible spheroids from cell suspensions, for both cell lines and, in preliminary experiments, primary human tumor cells. We first assessed two previously described methods and identified the ULA-method, a method where culture plates with ultra-low adhesion surfaces are used, to be the safer and more reliable one for the generation of uniform three-dimensional spheroids. By combining two separate methods for assay read-out (size/area and cell viability), this multimoda...

Head and Neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide with a rising incidence of mucosal human papillomavirus (HPV) infection-associated pathogenesis, next to a majority of cases caused by excessive nicotine and alcohol consumption 1,2. While smaller tumors and pre-invasive stages are usually well treatable with surgical excision, usually combined with cervical lymph node dissection, treatment for advanced-stage and recurrent HNSCC remains challenging due to aggressive tumor invasion with metastatic spread and resistance to radiation and chemotherapy protocols3,4,5,6,7,8. Recent studies suggest a high variability of cellular phenotype, and sub-characterization of circulating and disseminated tumor cells has just begun9,10. The earlier belief of a solid, uniform tumor mass had to be revised in the light of recent studies in the past years11,12,13,14. Current approaches for tumor characterization and identification of key mutations could identify several genes that seem to be associated with therapy resistance but remain a cost-intensive approach. Moreover, knowledge of genotype does not necessarily allow a reliable prediction of phenotype and its treatment response.
There have been few advances in improving overall and disease-free survival for advanced-stage and recurrent disease. For nicotine- as well as virus-associated carcinoma, current treatment options besides surgery enclose aggressive radiation and platinum-based chemotherapy regimens. There have been implications for different response rates between HPV-negative and positive carcinoma; however, this has not yet lead to a change in general therapy guidelines. Resistance towards radiation and chemotherapy is a widespread phenomenon in all tumor stages and exists for platinum-based chemotherapy as well as for targeted therapy (Anti-EGFR; epidermal growth factor-receptor) and recently emerging checkpoint inhibition15. Ineffective radiation and chemotherapy come at a high cost of significant patient morbidity in terms of dysphagia, mucositis, dry mouth and risk of decrease of renal or cardiac function among others. Predicting therapy response prior the decision of a general therapy concept for each individual patient seems to be the crucial goal, preventing unnecessary treatment concepts, side effects and costs.
We sought to establish a model to test individual patient&#39;s treatment susceptibility towards current standard chemo-radiation that could be integrated into the regular and quality-controlled oncologic treatment algorithm from a technical standing point. The far goal was to use the model without using heavily altered and aged cell lines, as they poorly represent actual human tumor cells without their variability and heterogeneity as we know now, while establishment of the protocol was done in various cell lines. To be independent only from commercially available cell lines, we recently successfully generated an intermediate cell line called &#34;PiCa&#34; from primary HNSCC cells from human tumor specimens with conserved cellular markers on its surface and limited passages16. This PiCa cell line should serve as a preparation for the development of the model on the road to then later following trials with fresh human cancer cells from tumor biopsies. It has been shown that cells in three-dimensional cell cultures react differently and more in vivo-like to administration of cancer drugs than those growing in monolayers17,18,19,20,21, mainly due to conservation of migratory and sub-differentiation properties of certain cell subsets22,23,24. Here, we describe the protocol of a spheroid-based, three-dimensional model from intermediate cell lines and primary human squamous cell carcinoma cells and ways how integrate such a model into cancer treatment of the head and neck surgeon and oncologist (Figure 1).

<table>
	<tbody>
		<tr>
			<td>Dulbeccos modified Eagles medium (DMEM)</td>
			<td>Biochrom, Berlin, Germany</td>
			<td>F 0425</td>
			<td></td>
		</tr>
		<tr>
			<td>Fetal bovine serum</td>
			<td>Gibco Life Technologies, Paisley, UK</td>
			<td>10500-064</td>
			<td></td>
		</tr>
		<tr>
			<td>penicillin/streptomycin</td>
			<td>Biochrom, Berlin, Germany</td>
			<td>A2212</td>
			<td></td>
		</tr>
		<tr>
			<td>sodium pyruvate</td>
			<td>Biochrom, Berlin, Germany</td>
			<td>L0473</td>
			<td></td>
		</tr>
		<tr>
			<td>non-essential amino acids</td>
			<td>Biochrom, Berlin, Germany</td>
			<td>K0293</td>
			<td></td>
		</tr>
		<tr>
			<td>L-Glutamine</td>
			<td>Biochrom, Berlin, Germany</td>
			<td>K0293</td>
			<td></td>
		</tr>
		<tr>
			<td>Liberase</td>
			<td>Roche Life Sciences, Basel, Switzerland</td>
			<td>5401127001</td>
			<td></td>
		</tr>
		<tr>
			<td>GravityPLUS 3D Culture and Assay Platform</td>
			<td>InSphero, Schlieren, Switzerland</td>
			<td>PB-CS 06-001</td>
			<td></td>
		</tr>
		<tr>
			<td>GravityTRAP plate</td>
			<td>InSphero, Schlieren, Switzerland</td>
			<td>PB-CS-01-001</td>
			<td></td>
		</tr>
		<tr>
			<td>Ultra-low attachment (ULA) culture plates</td>
			<td>Corning, Corning, NY, USA</td>
			<td>4520</td>
			<td></td>
		</tr>
		<tr>
			<td>airway epithelial cell growth medium</td>
			<td>Promocell, Heidelberg, Germany</td>
			<td>C-21060</td>
			<td></td>
		</tr>
		<tr>
			<td>amphotericin B</td>
			<td>Biochrom, Berlin, Germany</td>
			<td>A 2612</td>
			<td></td>
		</tr>
		<tr>
			<td>airway epithelial cell growth medium supplement mix</td>
			<td>Promocell, Heidelberg, Germany</td>
			<td>C39165</td>
			<td></td>
		</tr>
		<tr>
			<td>WST-8 test</td>
			<td>Promocell, Heidelberg, Germany</td>
			<td>PC PK-CA705-CK04</td>
			<td></td>
		</tr>
		<tr>
			<td>Keratinocyte SFMedium + L-Glutamine 500mL</td>
			<td>Invitrogen</td>
			<td>#17005-034</td>
			<td></td>
		</tr>
		<tr>
			<td>Bovine Pituitary Extract (BPE), 25mg</td>
			<td>Invitrogen</td>
			<td>#37000015</td>
			<td></td>
		</tr>
		<tr>
			<td>Recombinant human Epithelial Growth Factor 2.5 &#181;g</td>
			<td>Invitrogen</td>
			<td>#37000015</td>
			<td></td>
		</tr>
		<tr>
			<td>DMEM High Glucose</td>
			<td>Invitrogen</td>
			<td>#21068-028</td>
			<td></td>
		</tr>
		<tr>
			<td>Penicillin Streptomycin 10000U/mL Penicillin/ 10000&#181;g/mL Streptomycin</td>
			<td>Invitrogen</td>
			<td>#15140-122</td>
			<td></td>
		</tr>
		<tr>
			<td>F12 Nutrient Mix</td>
			<td>Invitrogen</td>
			<td>#21765-029</td>
			<td></td>
		</tr>
		<tr>
			<td>Glutamax (200 mM L-Alanyl-L-Glutamin-Dipeptide in NaCl)</td>
			<td>Invitrogen</td>
			<td>#35050087</td>
			<td></td>
		</tr>
		<tr>
			<td>HBSS (Ca, Mg)</td>
			<td>Life Technologies</td>
			<td>#14025-092</td>
			<td>(no phenol red)</td>
		</tr>
		<tr>
			<td>1x TrypLE Expres Enzyme</td>
			<td>Invitrogen</td>
			<td>#12604-013</td>
			<td>(no phenol red)</td>
		</tr>
		<tr>
			<td>Accutase (enzymatic cell detachment solution)</td>
			<td>Innovative cell technologies</td>
			<td>Cat# AT104</td>
			<td></td>
		</tr>
		<tr>
			<td>70 &#181;m Falcon cell strainer</td>
			<td>BD Biosciences, USA</td>
			<td>#352350</td>
			<td></td>
		</tr>
	</tbody>
</table>

therapy testing in a spheroid-based 3d cell culture model for head and neck squamous cell carcinoma

Current treatment options for advanced and recurrent head and neck squamous cell carcinoma (HNSCC) enclose radiation and chemo-radiation approaches with or without surgery. While platinum-based chemotherapy regimens currently represent the gold standard in terms of efficacy and are given in the vast majority of cases, new chemotherapy regimens, namely immunotherapy are emerging. However, the response rates and therapy resistance mechanisms for either chemo regimen are hard to predict and remain insufficiently understood. Broad variations of chemo and radiation resistance mechanisms are known to date. This study describes the development of a standardized, high-throughput in vitro assay to assess HNSCC cell line&#39;s response to various therapy regimens, and hopefully on primary cells from individual patients as a future tool for personalized tumor therapy. The assay is designed to being integrated into the quality-controlled standard algorithm for HNSCC patients at our tertiary care center; however, this will be subject of future studies. Technical feasibility looks promising for primary cells from tumor biopsies from actual patients. Specimens are then transferred into the laboratory. Biopsies are mechanically separated followed by enzymatic digestion. Cells are then cultured in ultra-low adhesion cell culture vials that promote the reproducible, standardized and spontaneous formation of three-dimensional, spheroid-shaped cell conglomerates. Spheroids are then ready to be exposed to chemo-radiation protocols and immunotherapy protocols as needed. The final cell viability and spheroid size are indicators of therapy susceptibility and therefore could be drawn into consideration in future to assess the patients&#39; likely therapy response. This model could be a valuable, cost-efficient tool towards personalized therapy for head and neck cancer.

We were able to reproducibly generate spheroids from single cell suspensions, first from different cell lines including the proprietary PiCa cell line, later from primary human cancer cells derived from fresh tumor biopsies as described in Hagemann et al.26. We evaluated two established methods for spheroid generation; the two being the so-called hanging drop (HD) method and the ultra-low adhesion (ULA) method, the latter being the more effective and safe ...

Watch this Scientific Journal Video about Therapy Testing in a Spheroid-based 3D Cell Culture Model for Head and Neck Squamous Cell Carcinoma at JoVE.com

Therapy Testing in a Spheroid-based 3D Cell Culture Model for Head and Neck Squamous Cell Carcinoma

We describe the evolution of a spheroid-based, three-dimensional in vitro model that enables us to test the current standard of experimental therapy regimens for head and neck squamous cell carcinoma on cell lines, aiming at evaluating therapy susceptibility and resistance on primary cells from human specimens in the future.

Current treatment options for advanced and recurrent head and neck squamous cell carcinoma (HNSCC) enclose radiation and chemo-radiation approaches with ...

The overall goal of this in vitro method is to generate the three dimensional cell culture spheroids that enable the testing of current standard or experimental therapy regimens for head and neck squamous cell carcinoma. This method helps us to understand three dimensional tumor growth of head and neck cancer cells when exposed to radiation or chemo radiation treatment. It remains to be said that handling primary tumor cells is difficult and does not always lead to reliable three dimensional spheroid formation.Demonstrating the procedure will be Sabina Schwenk-Zieger, a technician from our laboratory. While using primary cells from a tumor specimen, place the specimen on a suitable and sterile surface and cut it thoroughly with a sterile, single-use scalpel into very small pieces. After sufficient mechanical separation of the primary tissue, transfer it into a vial containing collagenase 1 and 2 and incubate it for one hour at 37 degrees celsius.Next, sieve the mixture through a 70 micrometer Falcon cell strainer and wash the suspension with HBSS. After successful separation and subsequent washing, transfer the suspension containing one to two million cells into a T75 cell culture flask to grow to subconfluency at 37 degrees celsius for up to ten days. Under a microscope, confirm tumor cell growth.Count the cells in culture. Using an ultra-low adhesion 96-well plate with concave round bottoms, seed 5, 000 primary tumor cells, or 1, 000 to 2, 000 cells of intermediate cell line, in 200 to 300 microliters of media into the wells. Next, culture the cells at 37 degrees celsius.Perform media changes every other day. Pay attention not to aspirate the spheroid with the pipette during media changes. Culture the spheroids until the three dimensional spheroid-shaped cell conglomerates are observed.Keep in mind to exclude the wells with irregular or multiple spheroid formation from further investigation. Subsequently, change the media to media with chemo therapeutics and/or monoclonal antibodies at desired concentrations. Add Cisplatin at the concentrations of 2.5, five, or 10 micromolar or 5-Fluorouracil at 30 micromolar.In this procedure, measure the spheroid size after digital photo documentation on day six, day 10 and day 16 with a graphic software. After centrifugation of the plate at 520g for 2.5 minutes, remove the supernatant. Next, wash the cells with 1x PBS and centrifuge the plate again, followed by removing the supernatant.Next, add 100 microliters of enzymatic cell detachment solution to each vial to allow the spheroids to dissolve. Subsequently, incubate the plate for eight minutes at 37 degrees celsius. Check for successful dissolving of the spheroids under the microscope.Add 100 microliters of DMEM. Next, centrifuge the plate at 520g for 2.5 minutes. Then remove the supernatant and suspend the cells in 100 microliters of DMEM.Subsequently, if necessary, perform a commercially-available colorimetric proliferation assay and read the assay in an ELISA reader. All cell lines could generate reliable spheroids with differences in size and time of readout. Primary cells did form reproducible spheroids in ultra-low attachment plates.The Ki-67 staining reveals the periphery of the culture showing much higher proliferation rates than central cells, mimicking nutrient distribution in solid mucosal tumors that often show necrotic cores. Here, the effect of several chemo therapeutics and radiation on spheroid size. Radiation with two gray prior to treatment with Cisplatin, lead to a significant decrease in spheroid size compared to Cisplatin alone.With further establishment of generating spheroids from primary human cells, this is how the concept of therapy testing could be implemented. Spheroids would be generated after tumor biopsy, and then tested for molecular characteristics and therapy susceptibility. We were able to establish a protocol to generate reproducible spheroids from cell suspensions for both cell lines and primary human tumor cells.This multimodal assay is sufficiently sensitive to identify small differences between groups. In future, the assay could be used to first, assess individual response to standard and experimental therapy protocols. Second, further characterize the tumor cells from fresh specimens.And third, correlate therapy response to molecular patterns. The use of primary cells and the generation of spheroids would allow the preservation of as many characteristics of in vivo tumor growth as possible in combination with a cost-efficient assay for studying individual therapy response.

Research

JoVE Journal

Cancer Research

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