Abstract

BackgroundCurrent treatment of ovarian cancer patients with chemotherapy leaves behind a residual tumor which results in recurrent ovarian cancer within a short time frame. We have previously demonstrated that a single short-term treatment of ovarian cancer cells with chemotherapy in vitro resulted in a cancer stem cell (CSC)-like enriched residual population which generated significantly greater tumor burden compared to the tumor burden generated by control untreated cells. In this report we looked at the mechanisms of the enrichment of CSC-like residual cells in response to paclitaxel treatment.MethodsThe mechanism of survival of paclitaxel-treated residual cells at a growth inhibitory concentration of 50% (GI50) was determined on isolated tumor cells from the ascites of recurrent ovarian cancer patients and HEY ovarian cancer cell line by in vitro assays and in a mouse xenograft model.ResultsTreatment of isolated tumor cells from the ascites of ovarian cancer patients and HEY ovarian cancer cell line with paclitaxel resulted in a CSC-like residual population which coincided with the activation of Janus activated kinase 2 (JAK2) and signal transducer and activation of transcription 3 (STAT3) pathway in paclitaxel surviving cells. Both paclitaxel-induced JAK2/STAT3 activation and CSC-like characteristics were inhibited by a low dose JAK2-specific small molecule inhibitor CYT387 (1 μM) in vitro. Subsequent, in vivo transplantation of paclitaxel and CYT387-treated HEY cells in mice resulted in a significantly reduced tumor burden compared to that seen with paclitaxel only-treated transplanted cells. In vitro analysis of tumor xenografts at protein and mRNA levels demonstrated a loss of CSC-like markers and CA125 expression in paclitaxel and CYT387-treated cell-derived xenografts, compared to paclitaxel only-treated cell-derived xenografts. These results were consistent with significantly reduced activation of JAK2 and STAT3 in paclitaxel and CYT387-treated cell-derived xenografts compared to paclitaxel only-treated cell derived xenografts.ConclusionsThis proof of principle study demonstrates that inhibition of the JAK2/STAT3 pathway by the addition of CYT387 suppresses the ‘stemness’ profile in chemotherapy-treated residual cells in vitro, which is replicated in vivo, leading to a reduced tumor burden. These findings have important implications for ovarian cancer patients who are treated with taxane and/or platinum-based therapies.

Highlights

  • Current treatment of ovarian cancer patients with chemotherapy leaves behind a residual tumor which results in recurrent ovarian cancer within a short time frame

  • We demonstrate that a short-term single exposure of CYT387 in addition to paclitaxel reduces the cancer stem cell (CSC)-like characteristics and activation of Janus activated kinase 2 (JAK2)/signal transducer and activation of transcription 3 (STAT3) pathway promoted by paclitaxel in residual cells in vitro

  • CYT387 treatment significantly reduced the CSC-like trait associated with paclitaxel treatment in HEY cells and ascites-derived tumor cells We have previously shown the existence of CSC-like phenotypes in ovarian cancer cell lines, including the HEY cell line, primary and ascites-derived ovarian tumor cells isolated from ovarian cancer patients in response to cisplatin and paclitaxel treatments [14,32,45]

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Summary

Introduction

Current treatment of ovarian cancer patients with chemotherapy leaves behind a residual tumor which results in recurrent ovarian cancer within a short time frame. The majority of these patients relapse within two years, resulting in a 5-year survival rate of only 27% [3] This low survival rate is largely due to the presence of chemotherapy-resistant residual tumor cells which have the capacity to withstand the cytotoxic effects of therapies and repopulate, leading to recurrence [4]. Aggregates of tumor cells commonly known as ‘spheroids’ float freely in an anchorage independent condition in ascites [16,17,18,19]. This transceolomic route of ovarian cancer metastasis has been suggested due to the development of ovarian cells from the coelomic mesothelium during embryogenesis [20]. Along with transcoelomic metastatic tumors, extensive seeding of cancer cells on various abdominal organs such as the colon, uterus and omentum is commonly observed in the late-stage disease [2]

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