Clinical Pharmacodynamic Biomarkers Program, Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland.
In Vivo Evaluation Program, Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland.
Cancer Res. 2020 Jan 15;80(2):304-318. doi: 10.1158/0008-5472.CAN-18-3539. Epub 2019 Nov 15.
The significance of the phenotypic plasticity afforded by epithelial-mesenchymal transition (EMT) for cancer progression and drug resistance remains to be fully elucidated in the clinic. We evaluated epithelial-mesenchymal phenotypic characteristics across a range of tumor histologies using a validated, high-resolution digital microscopic immunofluorescence assay (IFA) that incorporates β-catenin detection and cellular morphology to delineate carcinoma cells from stromal fibroblasts and that quantitates the individual and colocalized expression of the epithelial marker E-cadherin (E) and the mesenchymal marker vimentin (V) at subcellular resolution ("EMT-IFA"). We report the discovery of β-catenin cancer cells that coexpress E-cadherin and vimentin in core-needle biopsies from patients with various advanced metastatic carcinomas, wherein these cells are transitioning between strongly epithelial and strongly mesenchymal-like phenotypes. Treatment of carcinoma models with anticancer drugs that differ in their mechanism of action (the tyrosine kinase inhibitor pazopanib in MKN45 gastric carcinoma xenografts and the combination of tubulin-targeting agent paclitaxel with the BCR-ABL inhibitor nilotinib in MDA-MB-468 breast cancer xenografts) caused changes in the tumor epithelial-mesenchymal character. Moreover, the appearance of partial EMT or mesenchymal-like carcinoma cells in MDA-MB-468 tumors treated with the paclitaxel-nilotinib combination resulted in upregulation of cancer stem cell (CSC) markers and susceptibility to FAK inhibitor. A metastatic prostate cancer patient treated with the PARP inhibitor talazoparib exhibited similar CSC marker upregulation. Therefore, the phenotypic plasticity conferred on carcinoma cells by EMT allows for rapid adaptation to cytotoxic or molecularly targeted therapy and could create a form of acquired drug resistance that is transient in nature. SIGNIFICANCE: Despite the role of EMT in metastasis and drug resistance, no standardized assessment of EMT phenotypic heterogeneity in human carcinomas exists; the EMT-IFA allows for clinical monitoring of tumor adaptation to therapy.
上皮-间质转化 (EMT) 赋予的表型可塑性对癌症进展和耐药性的意义在临床上仍有待充分阐明。我们使用经过验证的高分辨率数字显微镜免疫荧光分析 (IFA) 评估了一系列肿瘤组织学中的上皮-间质表型特征,该分析结合了 β-连环蛋白检测和细胞形态学,以从基质成纤维细胞中区分癌细胞,并定量分析上皮标志物 E-钙粘蛋白 (E) 和间充质标志物波形蛋白 (V) 的个体和共定位表达,达到亚细胞分辨率(“EMT-IFA”)。我们报告了在来自各种晚期转移性癌患者的核心针活检中发现的β-连环蛋白癌细胞,这些细胞共表达上皮标志物 E-钙粘蛋白和间充质标志物波形蛋白,它们在强烈的上皮样和强烈的间充质样表型之间发生转变。用作用机制不同的抗癌药物(MKN45 胃癌异种移植中的酪氨酸激酶抑制剂帕唑帕尼和微管靶向药物紫杉醇与 BCR-ABL 抑制剂尼罗替尼的联合)治疗癌模型导致肿瘤上皮-间质特征发生变化。此外,在紫杉醇-尼罗替尼联合治疗的 MDA-MB-468 肿瘤中出现部分 EMT 或间充质样癌细胞导致癌症干细胞 (CSC) 标志物上调,并对 FAK 抑制剂敏感。接受 PARP 抑制剂他拉唑帕尼治疗的转移性前列腺癌患者也表现出类似的 CSC 标志物上调。因此,EMT 赋予癌细胞的表型可塑性允许其快速适应细胞毒性或分子靶向治疗,并可能产生一种短暂的获得性耐药形式。意义:尽管 EMT 在外泌体和耐药性中起作用,但目前尚不存在人类癌中 EMT 表型异质性的标准化评估;EMT-IFA 允许对肿瘤对治疗的适应性进行临床监测。