Lymphatic Invasion of Plakoglobin-Dependent Tumor Cell Clusters Drives Formation of Polyclonal Lung Metastases in Colon Cancer.
Journal
Gastroenterology
Series/Report No.
Gastroenterology
Journal Volume
165
Journal Issue
2
Start Page
429-444.e15
ISSN
1528-0012
Date Issued
2023-08
Author(s)
Küçükköse, Emre
Laoukili, Jamila
Gorelick, Alexander N
Degner, Sebastian
Laclé, Miangela M
van den Bent, Lotte
Peters, Niek A
Verheem, André
Frenkel, Nicola C
Wassenaar, Emma C E
Lansu, Nico
Lenos, Kristiaan J
Vermeulen, Louis
Koopman, Miriam
Roodhart, Jeanine M L
Kops, Geert J P L
Borel Rinkes, Inne H M
Hagendoorn, Jeroen
Naxerova, Kamila
Kranenburg, Onno
Abstract
Patients with colon cancer with liver metastases may be cured with surgery, but the presence of additional lung metastases often precludes curative treatment. Little is known about the processes driving lung metastasis. This study aimed to elucidate the mechanisms governing lung vs liver metastasis formation.
Patient-derived organoid (PDO) cultures were established from colon tumors with distinct patterns of metastasis. Mouse models recapitulating metastatic organotropism were created by implanting PDOs into the cecum wall. Optical barcoding was applied to trace the origin and clonal composition of liver and lung metastases. RNA sequencing and immunohistochemistry were used to identify candidate determinants of metastatic organotropism. Genetic, pharmacologic, in vitro, and in vivo modeling strategies identified essential steps in lung metastasis formation. Validation was performed by analyzing patient-derived tissues.
Cecum transplantation of 3 distinct PDOs yielded models with distinct metastatic organotropism: liver only, lung only, and liver and lung. Liver metastases were seeded by single cells derived from select clones. Lung metastases were seeded by polyclonal clusters of tumor cells entering the lymphatic vasculature with very limited clonal selection. Lung-specific metastasis was associated with high expression of desmosome markers, including plakoglobin. Plakoglobin deletion abrogated tumor cell cluster formation, lymphatic invasion, and lung metastasis formation. Pharmacologic inhibition of lymphangiogenesis attenuated lung metastasis formation. Primary human colon, rectum, esophagus, and stomach tumors with lung metastases had a higher N-stage and more plakoglobin-expressing intra-lymphatic tumor cell clusters than those without lung metastases.
Lung and liver metastasis formation are fundamentally distinct processes with different evolutionary bottlenecks, seeding entities, and anatomic routing. Polyclonal lung metastases originate from plakoglobin-dependent tumor cell clusters entering the lymphatic vasculature at the primary tumor site.
Subjects
Lymphatics
Metastasis Mechanism
Organ Tropism
Patient-Derived Organoids
SDGs
Publisher
Elsevier BV
Type
journal article