Elisabeth Schneider, Steffi Treitschke, Sandra Grunewald, Severin Guetter, Isabell Blochberger, Stefan Rose-John, Melanie Werner-Klein, Miodrag Gužvić, Ana Grujovic, Norbert Heine, Jens Warfsmann, Catherine Botteron, Christian Werno, Nadia Harbeck, Cäcilia Köstler, Huiqin Koerkel-Qu, Milan Obradovic, Brigitte Rack, Bernhard Polzer, Kathrin Weidele, Martin Hoffmann, Petra Rümmele, Xin Lu, Giancarlo Feliciello, Sandra Huber, Nina Patwary, Stefan Buchholz, Stefan Kirsch, Gundula Haunschild, Kamran Honarnejad, Zbigniew T. Czyz, Christoph Klein, Christoph Irlbeck, and Publica
Although thousands of breast cancer cells disseminate and home to bone marrow until primary surgery, usually less than a handful will succeed in establishing manifest metastases months to years later. To identify signals that support survival or outgrowth in patients, we profile rare bone marrow-derived disseminated cancer cells (DCCs) long before manifestation of metastasis and identify IL6/PI3K-signaling as candidate pathway for DCC activation. Surprisingly, and similar to mammary epithelial cells, DCCs lack membranous IL6 receptor expression and mechanistic dissection reveals IL6 trans-signaling to regulate a stem-like state of mammary epithelial cells via gp130. Responsiveness to IL6 trans-signals is found to be niche-dependent as bone marrow stromal and endosteal cells down-regulate gp130 in premalignant mammary epithelial cells as opposed to vascular niche cells. PIK3CA activation renders cells independent from IL6 trans-signaling. Consistent with a bottleneck function of microenvironmental DCC control, we find PIK3CA mutations highly associated with late-stage metastatic cells while being extremely rare in early DCCs. Our data suggest that the initial steps of metastasis formation are often not cancer cell-autonomous, but also depend on microenvironmental signals., Metastatic dissemination in breast cancer patients occurs early in malignant transformation, raising questions about how disseminated cancer cells (DCC) progress at distant sites. Here, the authors show that DCCs in bone marrow are activated via IL6-trans-signaling and thereby acquire stemness traits relevant for metastasis formation.