1. Epigenetic therapy inhibits metastases by disrupting premetastatic niches
- Author
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Ken Kang Hsin Wang, Zhihao Lu, John Wrangle, Charles M. Rudin, Michelle Vaz, Michael J. Topper, Yuping Mei, Stephen R. Broderick, Drew M. Pardoll, Ray Whay Chiu Yen, Hariharan Easwaran, Rosalyn A. Juergens, Stephen M. Cattaneo, Cynthia A. Zahnow, Joseph B. Margolick, Beverly Lee, Hao Zhang, Yi Cai, Richard J. Battafarano, Yujiao Wang, Kristen Rodgers, Barry D. Nelkin, Patrick M. Forde, Wenbing Xie, Ki Bem Kim, Malcolm V. Brock, Xi Jiao, Jianling Zou, Shuang Li, Yong Tao, Stephen B. Baylin, Stephen C. Yang, Chi-Ping Day, Joanne Riemer, Lin Shen, Errol L. Bush, Yanni Wang, Ying Cui, Huili Li, Young J. Kim, Alicia Hulbert, Peng Huang, Franck Housseau, Weiqiang Zhang, Limin Xia, Bin Zhang, Julie R. Brahmer, and Xiangqian Kong
- Subjects
0301 basic medicine ,Multidisciplinary ,Entinostat ,business.industry ,Cellular differentiation ,03 medical and health sciences ,chemistry.chemical_compound ,030104 developmental biology ,0302 clinical medicine ,medicine.anatomical_structure ,Downregulation and upregulation ,chemistry ,030220 oncology & carcinogenesis ,Cancer research ,medicine ,CXC chemokine receptors ,Histone deacetylase ,Epigenetics ,Bone marrow ,business ,Epigenetic therapy - Abstract
Cancer recurrence after surgery remains an unresolved clinical problem1–3. Myeloid cells derived from bone marrow contribute to the formation of the premetastatic microenvironment, which is required for disseminating tumour cells to engraft distant sites4–6. There are currently no effective interventions that prevent the formation of the premetastatic microenvironment6,7. Here we show that, after surgical removal of primary lung, breast and oesophageal cancers, low-dose adjuvant epigenetic therapy disrupts the premetastatic microenvironment and inhibits both the formation and growth of lung metastases through its selective effect on myeloid-derived suppressor cells (MDSCs). In mouse models of pulmonary metastases, MDSCs are key factors in the formation of the premetastatic microenvironment after resection of primary tumours. Adjuvant epigenetic therapy that uses low-dose DNA methyltransferase and histone deacetylase inhibitors, 5-azacytidine and entinostat, disrupts the premetastatic niche by inhibiting the trafficking of MDSCs through the downregulation of CCR2 and CXCR2, and by promoting MDSC differentiation into a more-interstitial macrophage-like phenotype. A decreased accumulation of MDSCs in the premetastatic lung produces longer periods of disease-free survival and increased overall survival, compared with chemotherapy. Our data demonstrate that, even after removal of the primary tumour, MDSCs contribute to the development of premetastatic niches and settlement of residual tumour cells. A combination of low-dose adjuvant epigenetic modifiers that disrupts this premetastatic microenvironment and inhibits metastases may permit an adjuvant approach to cancer therapy. In mouse models of pulmonary metastasis, adjuvant epigenetic therapy targeting myeloid-derived suppressor cells disrupts the premetastatic microenvironment after resection of primary tumours and inhibits the dissemination of residual tumour cells.
- Published
- 2020