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Supplementary Figure S2 from A PERK-Specific Inhibitor Blocks Metastatic Progression by Limiting Integrated Stress Response–Dependent Survival of Quiescent Cancer Cells

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posted on 2023-12-15, 08:40 authored by Veronica Calvo, Wei Zheng, Anna Adam-Artigues, Kirk A. Staschke, Xin Huang, Julie F. Cheung, Ana Rita Nobre, Sho Fujisawa, David Liu, Maria Fumagalli, David Surguladze, Michael E. Stokes, Ari Nowacek, Mark Mulvihill, Eduardo F. Farias, Julio A. Aguirre-Ghiso

Supplementary Figure S2. (a) Normalized area of single macro-metastases in lung in vehicle (N=22) and HC4-treated animals (N=15). P by MannWhitney test. (b) 2.5x105 HNSCC T-Hep3 cells as single cell suspensions were injected via tail vein in Balb/c nu/nu mice and 24 h after injectionanimals were treated with vehicle or HC4 (50 mg/kg) for 10 days. Frequency of T-HEp3 DCCs in the lung detected via a human specific anti-vimentinantibody was scored. 5 lung sections/animal ± s.d (N=5 per group). Scale bar, 10 µm. P by Mann-Whitney test. (c) Balb/c syngeneic EMT6 micewere treated with HC4 at 10 mg/kg for 17 days. Metastatic lesions were detected by H&E staining and quantified in 5 lung section/animal. P byMann-Whitney test. (d) Quantification of circulating tumor cells/ml blood by HER2 staining of cytospins (N=4 per group) P by Mann-Whitney test. (e)Percentage P-Rb+ micro-metastasis per lung section/animal in vehicle (N=4) and HC4-treated animals (N=6). Scale bar, 25 µm. P by Student’s ttest. (f) Number of D-Hep3 cells per nodule in vehicle and HC4-treated (20 µM, 6 days) CAM tumors (N=6 per group) (left); quantification andrepresentative images of D-HEp3 CAM tumors stained for cleaved caspase-3 (green), vimentin (red), and DAPI (blue) (right). Approximately 1000cells per group were assessed, p by Mann-Whitney test. Scale bars, 25 μm. (g) Mice were injected with MMTV-HER2 cells from primary tumorlesions via the tail vein, allowed them to expand into established metastatic lesions for 3 weeks and treated with vehicle or HC4 (50 mg/kg) for 2weeks. Micro-metastasis were detected by H&E or IF (HER2 detection) staining and quantified in 5 lung section/animal ±s.d (N=8 per group). P byMann-Whitney test

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Ramon Areces Foundation

National Cancer Institute (NCI)

United States Department of Health and Human Services

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Congressionally Directed Medical Research Programs (CDMRP)

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ARTICLE ABSTRACT

The integrated stress response (ISR) kinase PERK serves as a survival factor for both proliferative and dormant cancer cells. We aim to validate PERK inhibition as a new strategy to specifically eliminate solitary disseminated cancer cells (DCC) in secondary sites that eventually reawake and originate metastasis. A novel clinical-grade PERK inhibitor (HC4) was tested in mouse syngeneic and PDX models that present quiescent/dormant DCCs or growth-arrested cancer cells in micro-metastatic lesions that upregulate ISR. HC4 significantly blocks metastasis, by killing quiescent/slow-cycling ISRhigh, but not proliferative ISRlow DCCs. HC4 blocked expansion of established micro-metastasis that contained ISRhigh slow-cycling cells. Single-cell gene expression profiling and imaging revealed that a significant proportion of solitary DCCs in lungs were indeed dormant and displayed an unresolved ER stress as revealed by high expression of a PERK-regulated signature. In human breast cancer metastasis biopsies, GADD34 expression (PERK-regulated gene) and quiescence were positively correlated. HC4 effectively eradicated dormant bone marrow DCCs, which usually persist after rounds of therapies. Importantly, treatment with CDK4/6 inhibitors (to force a quiescent state) followed by HC4 further reduced metastatic burden. In HNSCC and HER2+ cancers HC4 caused cell death in dormant DCCs. In HER2+ tumors, PERK inhibition caused killing by reducing HER2 activity because of sub-optimal HER2 trafficking and phosphorylation in response to EGF. Our data identify PERK as a unique vulnerability in quiescent or slow-cycling ISRhigh DCCs. The use of PERK inhibitors may allow targeting of pre-existing or therapy-induced growth arrested “persister” cells that escape anti-proliferative therapies.

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