tracking-tumor-cell-dissemination-from-lung-metastases-using

Tracking Tumor Cell Dissemination from Lung Metastases Using Photoconversion

Metastasis - the systemic spread of cancer - is the leading cause of cancer-related deaths. Although metastasis is commonly thought of as a unidirectional ...

Albert Einstein College of Medicine/Montefiore Medical Center

Metastases are initiated by disseminated tumor cells (DTCs) that colonize distant organs. Growing evidence suggests that the microenvironment of the primary tumor primes DTCs for dormant or proliferative fates. However, the manner in which this occurs remains poorly understood. Here, using the Window for High-Resolution Intravital Imaging of the Lung (WHRIL), we study the live lung longitudinally and follow the fate of individual DTCs that spontaneously disseminate from orthotopic breast tumors. We find that spontaneously DTCs have increased levels of retention, increased speed of extravasation, and greater survival after extravasation, compared to experimentally metastasized tumor cells. Detailed analysis reveals that a subset of macrophages within the primary tumor induces a pro-dissemination and pro-dormancy DTC phenotype. Our work provides insight into how specific primary tumor microenvironments prime a subpopulation of cells for expression of proteins associated with dissemination and dormancy.

Primary tumor associated macrophages activate programs of invasion and dormancy in disseminating tumor cells.

to develop several digital pathology-based machine vision algorithms for combining TMEM and Mena scores and determine if a combination of these biomarkers improves the ability to predict development of distant metastasis over and above that of either biomarker alone.

Combining TMEM Doorway Score and Mena Score Improves the Prediction of Distant Recurrence Risk in HR+/HER2- Breast Cancer Patients.

Black, compared to white, women with residual estrogen receptor-positive (ER+) breast cancer after neoadjuvant chemotherapy (NAC) have worse distant recurrence-free survival (DRFS). Such racial disparity may be due to difference in density of portals for systemic cancer cell dissemination, called TMEM doorways, and pro-metastatic tumor microenvironment (TME). Here, we evaluate residual cancer specimens after NAC from 96 Black and 87 white women. TMEM doorways are visualized by triple immunohistochemistry, and cancer stem cells by immunofluorescence for SOX9. The correlation between TMEM doorway score and pro-metastatic TME parameters with DRFS is examined using log-rank and multivariate Cox regression. Black, compared to white, patients are more likely to develop distant recurrence (49% vs 34.5%, p = 0.07), receive mastectomy (69.8% vs 54%, p = 0.04), and have higher grade tumors (p = 0.002). Tumors from Black patients have higher TMEM doorway and macrophages density overall (p = 0.002; p = 0.002, respectively) and in the ER+/HER2- (p = 0.02; p = 0.02, respectively), but not in the triple negative disease. Furthermore, high TMEM doorway score is associated with worse DRFS. TMEM doorway score is an independent prognostic factor in the entire study population (HR, 2.02; 95%CI, 1.18-3.46; p = 0.01), with a strong trend in ER+/HER2- disease (HR, 2.38; 95%CI, 0.96-5.95; p = 0.06). SOX9 expression is not associated with racial disparity in TME or outcome. In conclusion, higher TMEM doorway density in residual breast cancer after NAC is associated with higher distant recurrence risk, and Black patients are associated with higher TMEM doorway density, suggesting that TMEM doorway density may contribute to racial disparities in breast cancer.

Xianjun Ye

Department of Pathology,
Cancer Dormancy and Tumor Microenvironment Institute,
Gruss-Lipper Biophotonics Center

Albert Einstein College of Medicine/Montefiore Medical Center

Tracking Tumor Cell Dissemination from Lung Metastases Using Photoconversion

Xianjun Ye

Department of Pathology,Cancer Dormancy and Tumor Microenvironment Institute,Gruss-Lipper Biophotonics Center

Albert Einstein College of Medicine/Montefiore Medical Center

Tracking Tumor Cell Dissemination from Lung Metastases Using Photoconversion

Department of Pathology,
Cancer Dormancy and Tumor Microenvironment Institute,
Gruss-Lipper Biophotonics Center