1. Autophagy is required for mammary tumor recurrence by promoting dormant tumor cell survival following therapy.
- Author
-
Dwyer S, Ruth J, Seidel HE, Raz AA, and Chodosh LA
- Subjects
- Animals, Female, Mice, Humans, Neoplasm, Residual pathology, Apoptosis Regulatory Proteins metabolism, Apoptosis Regulatory Proteins genetics, Microtubule-Associated Proteins metabolism, Microtubule-Associated Proteins genetics, Breast Neoplasms pathology, Breast Neoplasms drug therapy, Breast Neoplasms genetics, Breast Neoplasms metabolism, Breast Neoplasms mortality, Membrane Proteins metabolism, Membrane Proteins genetics, Ubiquitin-Activating Enzymes genetics, Ubiquitin-Activating Enzymes metabolism, Ubiquitin-Activating Enzymes antagonists & inhibitors, Mammary Neoplasms, Experimental pathology, Mammary Neoplasms, Experimental drug therapy, Mammary Neoplasms, Experimental genetics, Cell Line, Tumor, Autophagy drug effects, Neoplasm Recurrence, Local pathology, Autophagy-Related Protein 7 genetics, Autophagy-Related Protein 7 metabolism, Autophagy-Related Protein 5 metabolism, Autophagy-Related Protein 5 genetics, Cell Survival drug effects, Beclin-1 metabolism, Beclin-1 genetics, Chloroquine pharmacology, Chloroquine therapeutic use
- Abstract
Background: Mortality from breast cancer is principally due to tumor recurrence. Recurrent breast cancers arise from the pool of residual tumor cells, termed minimal residual disease, that survive treatment and may exist in a dormant state for 20 years or more following treatment of the primary tumor. As recurrent breast cancer is typically incurable, understanding the mechanisms underlying dormant tumor cell survival is a critical priority in breast cancer research. The importance of this goal is further underscored by emerging evidence suggesting that targeting dormant residual tumor cells in early-stage breast cancer patients may be a means to prevent tumor recurrence and its associated mortality. In this regard, the role of autophagy in dormant tumor cell survival and recurrence remains unresolved, with conflicting reports of both pro-survival/recurrence-promoting and pro-death/recurrence-suppressing effects of autophagy inhibition in dormant tumor cells. Resolving this question has important clinical implications., Methods: We used genetically engineered mouse models that faithfully recapitulate key features of human breast cancer progression, including minimal residual disease, tumor dormancy, and recurrence. We used genetic and pharmacological approaches to inhibit autophagy, including treatment with chloroquine, genetic knockdown of ATG5 or ATG7, or deletion of BECN and determined their effects on dormant tumor cell survival and recurrence., Results: We demonstrate that the survival and recurrence of dormant mammary tumor cells following therapy is dependent upon autophagy. We find that autophagy is induced in vivo following HER2 downregulation and remains activated in dormant residual tumor cells. Using genetic and pharmacological approaches we show that inhibiting autophagy by chloroquine administration, ATG5 or ATG7 knockdown, or deletion of a single allele of the tumor suppressor Beclin 1 is sufficient to inhibit mammary tumor recurrence, and that autophagy inhibition results in the death of dormant mammary tumor cells in vivo., Conclusions: Our findings demonstrate a pro-tumorigenic role for autophagy in tumor dormancy and recurrence following therapy, reveal that dormant tumor cells are uniquely reliant upon autophagy for their survival, and indicate that targeting dormant residual tumor cells by inhibiting autophagy impairs tumor recurrence. These studies identify a pharmacological target for a cellular state that is resistant to commonly used anti-neoplastic agents and suggest autophagy inhibition as an approach to reduce dormant minimal residual disease in order to prevent lethal tumor recurrence., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF