Abstract

The bisphosphonate zoledronic acid (ZA) significantly reduces complications of bone metastasis by inhibiting resident macrophages, the osteoclasts. Recent clinical trials indicate additional anti-metastatic effects of ZA outside the bone. However, which step of metastasis is influenced and whether thisis due to directtoxicity on cancer cells or inhibition of the tumor promoting microenvironment, is unknown. In particular, tumor-associated and resident macrophages support each step of organ metastasis and could be a crucial target of ZA. Thus, we comparatively investigate the ZA effects on: i) different types of macrophages, ii) on breast cancer cells but also iii) on macrophage-induced invasion. We demonstrate that ZA concentrations reflecting the plasma level affected viability of human macrophages, murine bone marrow-derived macrophages as well as their resident brain equivalents, the microglia, while it did not influence the tested cancer cells. However, the effects on the macrophages subsequently reduced the macrophage/microglia-induced invasiveness of the cancer cells. In line with this, manipulation of microglia by ZA in organotypic brain slice cocultures reduced the tissue invasion by carcinoma cells. The characterization of human macrophages after ZA treatment revealed a phenotype/response shift, in particular after external stimulation. In conclusion, we show that therapeutic concentrations of ZA affect all types of macrophages but not the cancer cells. Thus, anti-metastatic effects of ZA are predominantly caused by modulating the microenvironment. Most importantly, our findings demonstrate that ZA reduced microglia-assisted invasion of cancer cells to the brain tissue, indicating a potential therapeutic role in the prevention of cerebral metastasis.

Highlights

  • Zoledronic acid (ZA) demonstrated in pre-clinical studies as well as clinical trials anti-metastatic activity during different steps of tumor progression

  • ZA is more cytotoxic for macrophages than for human breast cancer cells To be able to discriminate direct effects of ZA on breast cancer cells from impacts on different macrophage populations, we first analyzed the toxicity of this drug for two human breast cancer cell lines

  • This is due to the enrichment of ZA in the bone tissue where very high concentrations of ZA subsequently inhibit the resident macrophages, the osteoclasts

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Summary

Introduction

Zoledronic acid (ZA) demonstrated in pre-clinical studies as well as clinical trials anti-metastatic activity during different steps of tumor progression. Oncotarget 2013; 4: 1449-1460 receiving neo-adjuvant chemotherapy together with ZA demonstrated a significant decrease in the primary tumor mass compared to the neo-adjuvant chemotherapy alone [3]. Using different mouse models of mammary tumors, it has been shown that ZA reduces the burden of bone and lung and liver metastases, it diminishes the amount of macrophages in the primary tumor (tumor-associated macrophages) and the vascularization. In these studies ZA treatment increased tumor-free and overall survival [4, 5]. A modulation of γδ-T-cell functions with eventually tumor-inhibiting effects has been documented for bisphosphonates [11]

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