Abstract Hepatocellular carcinoma (HCC) is the most frequent form of liver cancer and its associated mortality is increasing. Most HCC patients are diagnosed at an advanced stage of the disease, which is not eligible for curative surgery and for which efficient drugs remain elusive. Consequently, the prognosis of these patients is particularly poor, begging for a revolution in our therapeutic approach of the disease. Our in-depth understanding of HCC etiology suggests that patients at risk could be regularly screened for the early detection and treatment of nascent neoplastic lesions. This strategy requires a detailed knowledge of the early events that initiate HCC since their nature shapes the features of the developing lesions. However, the identity of cells that can serve as a cell of origin for HCC as well as the molecular events that transform them remain unknown, hampering the development of an early-intervention strategy. To address this important gap in our knowledge, we have taken advantage of a tractable model of HCC initiated upon Rb family loss of function, which is an almost universal event in cancer and particularly in HCC. The Cre/Lox-mediated inactivation of Rb family genes in distinct liver cell populations (cholangiocytes, hepatocytes, and various populations of bipotential and committed progenitors) reveals that most tested cell types, while displaying aberrant cell cycle activity, are resistant to transformation upon Rb pathway alteration. However, Rb family inactivation in Sox9-expressing bile duct progenitor cells initiates HCC that recapitulates the human disease. Interestingly, these committed cholangiocyte progenitors rapidly lose their canonical markers to adopt markers that are specific of the hepatocyte lineage, suggesting that Rb gene family inactivation potentiates their cellular plasticity. Importantly, analysis of human HCC array reveals that expansion of Sox9-expressing cells is a common feature of premalignant lesions and early-stage HCC. Despite its almost universal alteration in cancer, our mouse genetic approach demonstrates that only rare cell populations are susceptible to transformation upon Rb pathway inactivation. In addition, our data show that a cholangiocyte-restricted progenitor population can serve as the cell of origin for a hepatocyte-based type of cancer. This model will enable us to deconstruct the molecular mechanisms that initiate and drive early HCC development and ultimately allow us to shift the clinical management of the disease towards its early steps. Citation Format: Patrick Viatour. A SOX9+ bile duct progenitor as a cell of origin of hepatocellular carcinoma [abstract]. In: Proceedings of the AACR Special Conference: Advances in Modeling Cancer in Mice: Technology, Biology, and Beyond; 2017 Sep 24-27; Orlando, Florida. Philadelphia (PA): AACR; Cancer Res 2018;78(10 Suppl):Abstract nr B06.
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