Polyclonal breast cancer metastases arise from collective dissemination of keratin 14-expressing tumor cell clusters
PNAS Dec 2015, doi: 10.1073/pnas.1508541113Kevin J. Cheung et al
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Significance
Conventional models of cancer progression propose that single cells
leave the primary tumor, enter the circulation, and seed
clonal metastases. However, metastases can
contain multiple clones, raising the question: How do polyclonal
metastases form?
We demonstrate that cancer cells seed
distant organs as cohesive clusters, composed of two molecularly
distinct subpopulations,
whose proportions vary systematically
during metastasis. We establish that collective dissemination is a
frequent mechanism
for metastasis and identify a molecular
program in the most invasive, keratin 14+ (K14+)
cancer cells, regulating cell–cell adhesion, cell–matrix adhesion, and
immune evasion. We demonstrate that this metastatic
phenotype is dependent upon K14
expression. Understanding the molecular basis of collective
dissemination may therefore enable
novel prognostics and therapies to improve
patient outcomes.
Abstract
Recent genomic studies challenge the conventional model that each
metastasis must arise from a single tumor cell and instead
reveal that metastases can be composed of
multiple genetically distinct clones. These intriguing observations
raise the question:
How do polyclonal metastases emerge from
the primary tumor? In this study, we used multicolor lineage tracing to
demonstrate
that polyclonal seeding by cell clusters
is a frequent mechanism in a common mouse model of breast cancer,
accounting for
>90% of metastases. We directly
observed multicolored tumor cell clusters across major stages of
metastasis, including collective
invasion, local dissemination,
intravascular emboli, circulating tumor cell clusters, and
micrometastases. Experimentally
aggregating tumor cells into clusters
induced a >15-fold increase in colony formation ex vivo and a
>100-fold increase in
metastasis formation in vivo.
Intriguingly, locally disseminated clusters, circulating tumor cell
clusters, and lung micrometastases
frequently expressed the epithelial
cytoskeletal protein, keratin 14 (K14). RNA-seq analysis revealed that
K14+ cells were enriched for desmosome and hemidesmosome
adhesion complex genes, and were depleted for MHC class II genes.
Depletion
of K14 expression abrogated distant
metastases and disrupted expression of multiple metastasis effectors,
including Tenascin
C (Tnc), Jagged1 (Jag1), and Epiregulin (Ereg). Taken together, our findings reveal K14 as a key regulator of metastasis and establish the concept that K14+ epithelial tumor cell clusters disseminate collectively to colonize distant organs.
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