Cancer Liver Metastases Research Articles

CYP2E1-dependent upregulation of SIRT7 is response to alcohol mediated metastasis in hepatocellular carcinoma.

Long-term alcohol use is a confirmed risk factor of liver cancer tumorigenesis and metastasis. Multiple mechanisms responsible for alcohol related tumorigenesis have been proposed, including toxic reactive metabolite production, oxidative stress and fat accumulation. However, mechanisms underlying alcohol-mediated liver cancer metastasis remain largely unknown. We have previously demonstrated that SIRT7 regulates chemosensitivity by altering a p53-dependent pathway in human HCC. In the current study, we further revealed that SIRT7 is a critical factor in promoting liver cancer metastasis. SIRT7 expression is associated with disease stage and high SIRT7 predicts worse overall and disease-free survival. Overexpression of SIRT7 promotes HCC cell migration and EMT while knockdown of SIRT7 showed opposite effects. Mechanistically, we found that SIRT7 suppresses E-Cadherin expression through FOXO3-dependent promoter binding and H3K18 deacetylation. Knockdown of FOXO3 abolished the suppressive effect of SIRT7 on E-cadherin transcription. More importantly, we identified that alcohol treatment upregulates SIRT7 and suppresses E-cadherin expression via a CYP2E/ROS axis in hepatocytes both in vitro and in vivo. Antioxidant treatment in primary hepatocyte or CYP2E1-/- mice fed with alcohol impaired those effects. Reducing SIRT7 activity completely abolished alcohol-mediated promotion of liver cancer metastasis in vivo. Taken together, our data reveal that SIRT7 is a pivotal regulator of alcohol-mediated HCC metastasis.

Connexin32 regulates expansion of liver cancer stem cells via the PI3K/Akt signaling pathway.

Liver cancer stem cells (LCSCs) are responsible for liver cancer recurrence, metastasis, and drug resistance. Previous studies by the authors demonstrated that upregulated expression of connexin 32 (Cx32) reversed doxorubicin resistance and reduced invasion and metastasis of liver cancer cells. However, the role of Cx32 in expansion of LCSCs remains unclear. A total of 85 patients were enrolled in the present study and followed-up for 5 years. The expression of Cx32 in hepatocellular carcinoma (HCC) tissues and corresponding paracancerous tissues were detected by immunohistochemistry (IHC). Cx32 was silenced in HepG2 cells and overexpressed in HCCLM3 cells and the stemness of liver cells was examined by detecting the expression of LCSC markers (EpCAM, CD133, Nanog, Oct4, Sox9, c-Myc), sphere formation, and xenograft tumorigenesis. Finally, the effect of the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) pathway on Cx32-regulated LCSC expansion was investigated. Cx32 was downregulated in LCSCs and HCC tissues, and predicted poor prognosis in patients with HCC. Overexpression of Cx32 in HCCLM3 cells significantly inhibited LCSC expansion, tumorigenesis, and phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) pathway activity. By contrast, silencing of Cx32 in HepG2 cells upregulated expansion of LCSCs and PI3K/Akt pathway activity. Modulating the activity of the PI3K/Akt pathway by SC-79 and LY294002 in HepG2 and HCCLM3 cells, respectively, confirmed that Cx32 could affect the expansion of LCSCs through PI3K/Akt signaling. In conclusion, the present study demonstrated that Cx32 regulated the expansion of LCSCs, and increased expression of Cx32 significantly inhibited the expansion of LCSCs, suggesting that Cx32 may be an optimal target for intervention of HCC.

Effect and mechanism of immune surveillance activated by autotransfusion on reducing liver cancer metastasis based on HLA-DQB1/PDCD1

IntroductionLiver cancer is a common tumor of digestive system. Hepatectomy sometimes results in massive hemorrhage, and intraoperative autotransfusion is often required.Material and methodsMethods: In this basic research, the liver cancer rat model was established, and the visible liver cancer tissue was surgically removed, and the blood of the mice was recovered.ResultsThe results showed that the model group had the highest recurrence and metastasis of liver cancer, and the lowest was autotransfusion group. Flow cytometry showed that the number of HLA-DQB1 positive cells, the content of CD4+CD25+T cells, and the proliferation of CD4+T cells were the most in the autotransfusion group, followed by the model group, and the least in the auto+HLA-DQB1 group, which showed no difference from the control group. Immunohistochemistry and western blot analysis showed that the lowest expression of PDCD1 protein was in the autotransfusion group, which showed no significant difference from the control group, and the highest expression was in auto-HLA-DQB1, followed by the model group.ConclusionsIt elucidates the molecular mechanism that autotransfusion will activate the up-regulated expression of signal molecule HLA-DQB1, enhance the immune surveillance of CD4+T cells, reduce the expression of PDCD1 on the surface molecule of liver cancer cells, and inhibit liver cancer metastasis.Autotransfusion activated the expression of signaling molecule HLA-DQB1, enhanced the immune surveillance of CD4+T cells, reduced the expression of PDCD1 on the surface of liver cancer cells, and reduced the metastasis and recurrence of liver cancer.

Expression of Concern: Long noncoding RNA HOXA-AS2 promotes non-small cell lung cancer progression by regulating miR-520a-3p

The Editorial Office has been made aware of potential issues surrounding the scientific validity of this paper, hence has issued an Expression of Concern to notify readers whilst the Editorial Office investigates. Duplications have been identified across multiple papers with no common authors. Figure panel 3b appears to be the same as Figure 3B of the article ‘Long noncoding RNA 00460 (LINC00460) promotes glioma progression by negatively regulating miR-320a’ (DOI: 10.1002/jcb.28232) and as Figure 3D (vertically flipped) of the article ‘STAT3-mediated upregulation of lncRNA HOXD-AS1 as a ceRNA facilitates liver cancer metastasis by regulating SOX4’ (DOI: 10.1186/s12943-017-0680-1). The authors have been contacted with regards to these concerns.

Female Colon Cancer Metastasis Pattern and Prognosis: A SEER-Based Study.

The purpose of this study was to compare the metastatic pattern and prognosis of female colon cancer (FCC) to that of male colon cancer (MCC) to ascertain the independent factors impacting the prognosis of patients with FCC. The data of the present study population were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Descriptive analysis, the Kaplan-Meier method, and the Cox regression were used to evaluated FCC characteristics and factors associated with prognosis. There were 56,442 patients diagnosed with FCC, of whom 8,817 had distant metastases. Compared to patients with nonmetastatic FCC, a greater proportion of metastatic FCC patients was less than 60 years of age, black race, and grade III-IV. The primary sites were mainly located on the left side and have more possibility to receive chemotherapy and radiotherapy. Compared to metastatic MCC, a higher proportion of metastatic FCC patients ranged over 60 years of age, black race, treated without chemotherapy, and insurance, while the primary site was located on the right side. Liver and lung were the two most common sites of solitary metastases in CC, and among patients with solitary metastases in CC, patients who had lung metastases had a better prognosis than those who developed other types of metastasizes. Patients with FCC with metastases of the liver had a worse prognosis than their MCC counterparts. Cox multivariate regression analysis showed that the risk ratio was higher in metastatic FCC patients compared to those without metastases. We report the survival comparison of metastatic FCC with nonmetastatic FCC through the SEER database. Our results suggest that it has unique clinicopathological features and differs from metastatic MCC. Furthermore, patients with liver metastatic FCC have a worse prognosis than those with MCC. Emphasis on screening for colon cancer in women and additional clinical care should be paid for, especially for patients with FCC with metastatic liver cancer.

MPZL1 upregulation promotes tumor metastasis and correlates with unfavorable prognosis in non-small cell lung cancer.

Non-small cell lung cancer (NSCLC), accounting for 85% of all lung cancer, is one of the leading causes of cancer-related death worldwide. Previously, we demonstrated that MPZL1 gene amplification promotes liver cancer metastasis through activating Src/Cortactin pathway. However, the clinical relevance and biological roles of the MPZL1 gene in lung cancer are still unknown. Here, we found that MPZL1 expression upregulates in human NSCLC, which is partly due to the copy number amplification of this gene. Next, we observed that high MPZL1 expression correlates with unfavorable prognosis of NSCLC patients. We further demonstrated that ectopic MPZL1 overexpression promotes in vitro migratory but not proliferation and colony formation abilities of both H1299 and H460 cells. Consistently, we found that MPZL1 knockdown impairs the migratory abilities of A549 and H1775 cells. Moreover, we found that MPZL1 knockdown inhibits in vivo metastatic but not tumor growth abilities of the A549 cells. Additionally, a total of 297 differentially expressed genes (DEGs) were identified by RNA sequencing in A549 cells upon MPZL1 knockdown. By integrative analysis of DEGs regulated by MPZL1 in A549 cells and human NSCLC tissues, we revealed that COL11A1 is the potential effector gene that positively regulated by MPZL1 and correlates with poor prognosis of NSCLC patients. In conclusion, our work indicates that one of the mechanisms by which MPZL1 promotes NSCLC metastasis is through upregulating the COL11A1, and MPZL1 can be used as a biomarker to predict the prognosis of NSCLC patients.

The Increasing Role of CT-Guided Cryoablation for the Treatment of Liver Cancer: A Single-Center Report.

Simple SummaryImage-guided percutaneous ablation of primary and metastatic liver tumors has been gaining importance in patients who are not suitable for hepatic resection or liver transplantation. The aim of our retrospective study was to assess the effectiveness of CT-guided cryoablation in 49 patients with hepatocellular carcinoma or liver metastases. Our results highlighted that cryoablation is an effective and safe method for the treatment of liver cancers that are not amenable to surgical resection. Furthermore, cryoablation has important advantages when compared to other ablation techniques such as radiofrequency or microwave ablation; therefore, this method should be included in the armamentarium of treatment options in centers dedicated to the multidisciplinary treatment of liver cancer.Purpose: Cryoablation (CrA) is a minimally invasive treatment that can be used in primary and metastatic liver cancer. The purpose of this study was to assess the effectiveness of CrA in patients with hepatocellular carcinoma (HCC) and liver metastases. Methods: We retrospectively evaluated the patients who had CrA for HCC or liver metastases between 2015 and 2020. Technical success, complete ablation, CrA-related complications, local tumor progression, local recurrences, and distant metastases were evaluated in the study population. In patients with HCC, the median survival was also estimated. Results: Sixty-four liver tumors in 49 patients were treated with CrA (50 metastases and 14 HCC). The mean tumor diameter was 2.15 cm. The mean follow-up was 19.8 months. Technical success was achieved in the whole study population. Complete tumor ablation was observed after one month in 92% of lesions treated with CrA (79% and 96% in the HCC Group and metastases Group, respectively, p < 0.001). Local tumor progression occurred in 12.5 of lesions, with no difference between the study groups (p = 0.105). Sixteen patients (33%) developed local recurrence (45% and 29% in the HCC Group and metastases Group, respectively, p = 0.477). Seven patients (14%) developed distant metastases in the follow-up period. Ten patients (20.8%) underwent redo CrA for local recurrence or incomplete tumor ablation. Minor complications were observed in 14% of patients. In patients with HCC, the median survival was 22 months. Conclusions: CrA can be safely used for treatment of HCC and liver metastases not amenable of surgical resection. Further studies are necessary to better define the role of CrA in the multidisciplinary treatment of liver malignancies.

Effect of pharmaceutical care on the treatment of neuropathic pain induced by bone metastasis of liver cancer: case report

Effect of pharmaceutical care on the treatment of neuropathic pain induced by bone metastasis of liver cancer: case report

Circulating tumour cell gene expression and chemosensitivity analyses: predictive accuracy for response to multidisciplinary treatment of patients with unresectable refractory recurrent rectal cancer or unresectable refractory colorectal cancer liver metastases

BackgroundPatients with unresectable recurrent rectal cancer (RRC) or colorectal cancer (CRC) with liver metastases, refractory to at least two lines of traditional systemic therapy, may receive third line intraarterial chemotherapy (IC) and targeted therapy (TT) using drugs selected by chemosensitivity and tumor gene expression analyses of liquid biopsy-derived circulating tumor cells (CTCs).MethodsIn this retrospective study, 36 patients with refractory unresectable RRC or refractory unresectable CRC liver metastases were submitted for IC and TT with agents selected by precision oncotherapy chemosensitivity assays performed on liquid biopsy-derived CTCs, transiently cultured in vitro, and by tumor gene expression in the same CTC population, as a ratio to tumor gene expression in peripheral mononuclear blood cells (PMBCs) from the same individual. The endpoint was to evaluate the predictive accuracy of a specific liquid biopsy precision oncotherapy CTC purification and in vitro culture methodology for a positive RECIST 1.1 response to the therapy selected.ResultsOur analyses resulted in evaluations of 94.12% (95% CI 0.71–0.99) for sensitivity, 5.26% (95% CI 0.01–0.26) for specificity, a predictive value of 47.06% (95% CI 0.29–0.65) for a positive response, a predictive value of 50% (95% CI 0.01–0.98) for a negative response, with an overall calculated predictive accuracy of 47.22% (95% CI 0.30–0.64).ConclusionsThis is the first reported estimation of predictive accuracy derived from combining chemosensitivity and tumor gene expression analyses on liquid biopsy-derived CTCs, transiently cultured in vitro which, despite limitations, represents a baseline and benchmark which we envisage will be improve upon by methodological and technological advances and future clinical trials.

Abstract 1007: Spatial, temporal and heterogeneous changes in transport phenotype in liver metastasis of breast cancer

Abstract Various heterogeneities in response of metastatic tumors to systemic anti-cancer therapy are major source of therapeutic resistance. Cancer cells from bulk tumors and cancer cell lines are not clonal. A highly heterogeneous tumor microenvironment is known to develop by subclones. Furthermore, metastasis can evolve during the disease progression as well as in response to systemic therapies. These spatial and temporal variations of heterogeneity in tumors can affect blood perfusion and vascular permeability which can determine the level of mass/anti-cancer drugs transport to tumors (we refer to as “transport phenotype”). Insufficient drug transport to tumor in vivo can generate transport-based therapeutic resistance even for agents with proven efficacy against the target cancer cell lines in vitro. Our goal is to understand spatial and temporal heterogeneity in transport of mass/anti-cancer drugs to metastatic tumors to overcome the therapeutic resistance. The study of bulk tumors will provide a mixture of different functions from heterogeneous sets of various clones. We sought to establish single cell-derived clones from a 4T1 parental murine breast cancer cell line in order to dissect and simplify the heterogeneity in polyclonal cell populations in tumors. First, we found heterogeneous accumulation of systemically injected PEGylated liposomal doxorubicin (PLD) among multiple, experimental liver metastases of 4T1 parental (polyclonal) breast cancer in mouse. Intravital Microscopy imaging of liver metastases through a window chamber over time revealed different transport phenotypes, in terms of circulation and diffusion of systemically injected fluorescent tracers around/inside parental (polyclonal) tumors. Furthermore, transport phenotype can be modulated from one to another after PLD therapy, creating possible mechanisms of transport based on drug resistance. When single cell clone-derived metastases were established, a clone dependent difference in transport phenotype was found. Interestingly transport phenotype even in clonal tumors was temporally evolved and increased its heterogeneity. These data suggest that transport phenotype cannot be determined solely by genotype of tumor and can be evolved and more heterogeneous as a function of tumor growth and systemic chemotherapy. Clinical implication of our findings is that transport of therapeutics to tumor and its efficacy may not be predicted by DNA-based assay for clinical decision-making and transport-based therapeutics resistance will eventually occur in every tumor types. Citation Format: Aygul Sadigova, Megumi Kai, Yan Ting Liu, Thao Nguyen, Chihiro Hashimoto, Kenji Yokoi. Spatial, temporal and heterogeneous changes in transport phenotype in liver metastasis of breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1007.

Abstract 6116: Tumor immune environment in liver metastasis of colorectal cancer and its correlation with recurrence free survival

Abstract Introduction: The liver is a common site of metastases of colorectal cancer. Tumor infiltrating lymphocytes (TILs) play an important role in the process of colorectal cancer liver metastasis (CRCLM). A comprehensive investigation into TILs will provide more prognostic information for patients with colorectal liver metastases after liver resection. Methods: 15 CRC patients with liver metastases from our hospital were enrolled in the study. The density and percentage of the TILs [CD8+, CD3+, CD4+, CD20+, tumor associated macrophages (TAMs), dim CD56+NK, bright CD56+NK, PD-1+etc.] in the liver metastasis samples from operation were analyzed by multiplex immunofluorescence technique (3DMedcines Inc.). The level of the density and percentage of immune cells were determined by dichotomy method. The correlation between recurrence free survival (RFS) and immune cells were analyzed using the Kaplan-Meier curve and Log-rank test. Results: The existence of dim CD56+ NK cells in the stroma was associated with significant improvement in RFS (p=0.0461). The median RFS was 26.1 months (95% CI, 14.9 to 33.5) with the existence of dim CD56+ NK cells in the stroma versus 1.7 months (95% CI, -18.0 to 32.4) without dim CD56+ NK cells in the stroma. Nevertheless, dim CD56+ NK cells in the tumor-enriched segments was not significantly associated with improved outcome. The existence of bright CD56+ NK cells in the stroma was associated with significant improvement in RFS (p=0.0307) but not in the tumor-enriched segments. The median RFS was 34.6 months (95% CI, 15.0 to 35.2) with the existence of bright CD56+ NK cells in the stroma versus 7.9 months (95% CI, -5.3 to 23.1) without bright CD56+ NK cells in the stroma. However, low FoxP3+ cells in the tumor-enriched segments (p=0.0037) was significantly associated with improved outcome but not in the stroma. The median RFS was 36.5 months (95% CI, 23.1 to 40.1) with low FoxP3+ cells versus 8.2 months (95% CI, 0.5 to 21.8) with high FoxP3+ cells in the tumor-enriched segments. Low CD3+CD4+FoxP3+ cells (p=0.074) and the existence of PD-L1+CD68+ cells (p=0.0524) in the tumor-enriched segments showed a trend towards better RFS. No significant correlation was achieved for CD8+, CD3+, CD3+CD4+, CD20+, CD68+CD163+, CD68+CD163-, PD-1, PD-1+CD8+ cells either in the tumor-enriched segments nor in the stroma. Conclusion: We identified that CD56+ NK cells in stroma are associated with improved outcome in CRCLM. Nevertheless, FoxP3+ cells are associated with poor prognosis in CRCLM. Citation Format: Jiamin Zhou, Weiqi Xu, Miao Wang, Siqi Zhang, Ding Zhang. Tumor immune environment in liver metastasis of colorectal cancer and its correlation with recurrence free survival [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 6116.

Liver biopsy technique in the era of genomic cancer therapies: a single-center retrospective analysis.

With the evolution of personalized medicine in the field of oncology, which includes optimal treatment selection using next-generation sequencing-based companion diagnostic systems and tumor-agnostic treatments according to common biomarkers, a liver tumor biopsy technique that can obtain a sufficient specimen volume must be established. The current study aimed to evaluate the safety and availability of a liver tumor biopsy technique with multiple puncture sites made using a coaxial introducer needle and embolization with gelatin sponge particles. Patients with primary or metastatic liver cancer who underwent liver tumor biopsies with puncture tract embolization using gelatin sponge (Spongel®) from October 2019 to September 2020 were included in the study. The complication and diagnostic rates were evaluated, and whether the specimen volume was sufficient for Foundation® CDx was investigated. In total, 96 patients were enrolled in this analysis. The median total number of puncture times per patient was 3 (range 1-8). The pathological diagnostic rate was 79.2%. Using the FoundationOne® CDx, specimens with a sufficient volume required for genomic medicine were collected in 84.9% of patients. The incidence rate of bleeding was 4.2% (n = 4), and only one patient presented with major bleeding requiring transfusion. Liver biopsy with puncture tract embolization using a gelatin sponge may be safe and effective for collecting specimens with a volume sufficient for modern cancer treatments.

Abstract 5633: Beta-Glucan treatment restricts liver metastasis in pancreatic cancer

Abstract Introduction: For most patients with pancreatic ductal adenocarcinoma (PDAC), metastatic disease is the main cause of mortality with the liver being the most common site of metastasis. In the liver, macrophages are the most abundant immune cell subset, yet their role in regulating liver metastasis remains poorly understood. Two distinct macrophage populations exist in the liver: liver-resident Clec4f+F4/80+ Kupffer cells (KCs) and Clec4fnegF4/80+ bone marrow derived macrophages (BMDMs). Here, we sought to understand the impact of these macrophage subsets on liver metastasis and the ability of a myeloid agonist, a β-glucan (BG), to skew macrophages towards an anti-metastatic phenotype. Methods: C57BL/6 mice were given an intraportal (iPo) injection of an LSL-KrasG12D/+;LSL-Trp53R172H/+;Pdx-1-Cre;LSL-Rosa26-Yfp (KPCY) cell line to model liver metastasis. Mice were necropsied 2 days later to measure metastatic seeding of cancer cells or 12-14 days later to assess metastatic lesion outgrowth. Liver metastatic burden and immune cell populations were analyzed by flow cytometry and immunohistochemistry. In macrophage depletion experiments, liver macrophages were depleted using clodronate encapsulated liposomes (CEL) delivered intraperitoneally. In studies involving BG treatment, weekly intravenous administration of BG began 2 days prior to iPo injection of cancer cells. Results: Liver macrophage depletion did not influence metastatic seeding in the liver; but, did inhibit the outgrowth of established metastatic colonies. Histological analysis showed that Clec4f+ KCs were excluded from metastatic lesions, whereas BMDMs actively infiltrated. BMDM infiltration into lesions was also largely unaffected by CEL treatment. To stimulate macrophages with anti-metastatic activity, BG was administered systemically and found to bind to &amp;gt;95% of KCs but only 30% of BMDMs and 20-35% of other immune cell populations. BG treatment attenuated liver metastasis when given during both the seeding and outgrowth phases of metastasis (mean metastatic burden as % live cells in liver: 1%, BG vs 6.5%, control, p&amp;lt;0.0001). Analysis of metastatic lesions in BG treated mice by histology showed smaller lesions (mean size: 0.9mm2, BG vs 1.5mm2, control, p=0.09), decreased proliferating cancer cells (mean # of proliferating cancer cells per unit metastatic area: 480, BG vs 810, control, p&amp;lt;0.0001), and increased numbers of CD3+ T cells at the periphery of lesions compared to lesions from control mice (mean # of T cells per mm2 metastatic area: 300, BG vs 135, control, p&amp;lt;0.0001). The efficacy of BG to restrict liver metastasis was dependent on liver macrophages. Conclusions: Taken together, these findings suggest that, while liver macrophages can be coopted to support metastatic outgrowth, treatment with a β-glucan, as a myeloid agonist is a novel strategy to engender liver macrophages with anti-metastatic activity. Citation Format: Stacy K. Thomas, Shaanti Choi-Bose, Heather Coho, Christopher Casella, Meredith L. Stone, Max M. Wattenberg, Gregory L. Beatty. Beta-Glucan treatment restricts liver metastasis in pancreatic cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5633.

Abstract 5983: Gene profile analysis of breast cancer lung metastasis, liver metastasis, brain metastasis and primary tumor

Abstract Background: The incidence of male breast cancer (MBC) is lower than female breast cancer (FBC), representing 1% of all breast cancer worldwide. The difference with FBC may affect the treatment strategy of MBC, but the necessary precondition is that we should know more about the difference between FBC and MBC. However, Because of its low incidence that the relevant data about MBC is relatively scarce. Here we report some data about gene mutation of MBC, and compared it with FBC. Methods: Blood or tumor Tissue samples of breast cancer were collected and subjected to NGS in a College of American Pathologists (CAP)-certified and Clinical Laboratory Improvement Amendments (CLIA)-accredited lab for gene mutation analysis (3D Medicines Inc.,Shanghai, China). Statistical analysis was performed using GraphPad Prism (version 7.01) and SPSS version 21.0 (SPSS,Inc.). Results: Approximately 182 samples were analyzed, among which, exist 82 samples were from primary tissue, 66 samples were breast cancer liver metastases, 20 were lung metastases and 14 were brain metastases. High genomic heterogeneity was found among primary breast cancer tissue, breast cancer liver metastases, lung metastases, brain metastases, that is at least 20 gene mutations were found in these BC samples, while different gene mutations were showed among primary and different metastases tissues. The top five mutated gene in primary tumor tissue were TP53(80.49%), PIK3CA(53.66%), FGF19(30.49%), ERBB2(26.83%), MYC(23.17%); in liver metastases tissues were TP53(54.55%), FGF19(39.39%), PIK3CA(37.88%), ERBB2(21.21%), CCND1(19.70%); in lung metastases tissues were TP53(70.00%), PIK3CA(55.00%), ERBB2,MCL1(25.00%), CDKN2A/2B(20.00%), CCND1, NF1, CDK12(15.00%), CCND2, MYC, PTEN, GNAS, FGF19, PTK2, FGFR1(10.00%); in brain metastases tissues were TP53(42.86%), PIK3CA(28.57%), ZNF703, PREX2, JAK3, MYC, FGFR1(14.29%). Besides, levels of TMB were also different among primary tissue, liver, lung and brain metastases tissues. Higher TMB level were showed in liver and brain metastases tissue than primary and lung metastases tissues (p&amp;lt;0.001). Conclusions: Different metastases of breast cancer were different in gene mutation landscape, this imply these patients should be managed differently. Citation Format: Yanman Fang, Hushan Zhang, Jiali Zou, Fulin Zhou, Xuejie Tang, Yi Yang, Li Luo, Yu Ding. Gene profile analysis of breast cancer lung metastasis, liver metastasis, brain metastasis and primary tumor [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5983.

Abstract 2544: Preoperative exercise inhibits hepatic metastasis by suppressing PMN-MDSC formation of NETs

Abstract Introduction: Under surgical trauma, the pathological amplification and activation of neutrophils with potent immunosuppressive functions, also known as polymorphonuclear myeloid-derived suppressive cells (PMN-MDSCs), can promote metastasis by forming neutrophil extracellular traps (NETs) that are web-like structures consisting of nuclear DNA, histones, and granule proteins. Preoperative exercise (PEx) reduces postoperative complications with improved clinical outcomes in cancer patients undergoing surgeries. are. Our preliminary data show that PEx suppresses liver ischemia/reperfusion (I/R)-induced colorectal cancer (CRC) liver metastasis. Our recent studies have shown I/R-induced NETs promote liver CRC metastasis by capturing tumor cells and preventing infiltration and cytotoxicity of CD8+ T cells in tumor microenvironment (TME). We hypothesize that PEx remodels the TME by suppressing PMN-MDSCs formation of NETs. Methods: Male mice were subjected to exercise for 4 weeks, before MC38 colorectal cancer cells were injected through portal vein, and then subjected to 70% partial liver warm I/R as surgical stress. The single-cell RNA sequencing (scRNA-seq) was performed on CD45+leukocytes from TME 3 weeks after surgery. Immunofluorescence staining and Western Blot were used to determine NETs formation in the TME. Flow cytometry was used to determine the infiltration of PMN-MDSCs and CD8+ T lymphocytes in the tumors. Results: Our scRNA-seq data reveal that PEx leads to a remarkable transcriptomic shift in most immune cells types, such as PMN-MDSCs, M-MDSCs, T cells, Kupffer cells, B cells, NK and NKT cells, in the TME. PEx decreases the percentages of PMN-MDSCs in the TME and inhibits theNETs formation by PMN-MDSCs. scRNA-seq shows a significant increase of the chemokines CXCL10 in PEx-trained PMN-MDSCs obtained 3 weeks after I/R-induced hepatic metastasis, compared with sedentary controls. In addition, PEx increases the number of CD8+ T lymphocytes infiltrating the TME. Summary: Our study shows that PEx downregulates NETs formation and increases the CXCL10 expression in PMN-MDSCs, thus promoting the recruitment more cytotoxic CD8 T lymphocytes to suppress tumor metastasis. Citation Format: Xiang Cheng, Hongji Zhang, Allan Tsung, Hai Huang. Preoperative exercise inhibits hepatic metastasis by suppressing PMN-MDSC formation of NETs [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2544.

Abstract 2515: Estrogen regulates the immune microenvironment of colorectal cancer liver metastases

Abstract Liver metastases (LM) remain a major cause of cancer-related death and many cancers preferably metastasize to the liver due to its unique anatomical location, rich blood supply and immune-tolerant microenvironment. Up to 50% of colorectal carcinoma patients develop LM during their disease and this is associated with a poor prognosis. Our laboratory previously identified a sexual dimorphism in the regulation of the immune microenvironment (IME) of LM and showed that estrogen could promote the accumulation of myeloid-derived suppressor cells (MDSCs) and Tregs in the liver in response to invading cancer cells. The objective of this study was to elucidate the role of estrogen in the recruitment and polarization of monocytes/macrophages and in the accumulation and phenotype of natural killer (NK) cells in the IME of colorectal carcinoma LM (CRCLM). Moreover, we sought to determine the therapeutic potential of Selective Estrogen Receptor Degrader (SERD) therapy in tumor bearing female mice. In estrogen-competent female mice bearing CRCLM, we found increased gene and protein expression of the immunosuppressive cytokine TGF-β, and inversely a decrease in the pro-inflammatory cytokine TNF-alpha. Furthermore, we identified a significant increase of newly recruited, immunosuppressive CD68+F4/80+CD163+ M2 macrophages, as compared to estrogen-depleted (ovariectomized) mice. The recruitment of pro-inflammatory CD68+F4/80+TNF-alpha+ M1 macrophages, and the accumulation of the highly cytotoxic NK1.1+ CD49a+ liver NK cells were increased in estrogen-depleted female mice and could be restored upon estrogen supplementation. Moreover, treatment of female mice with the SERD Fulvestrant, markedly reduced the number of CRCLM compared to vehicle-treated mice, and significantly reduced the cell frequencies and counts of recruited myeloid cells and M2 macrophages in the liver. Taken together, our results identify estrogen as a critical regulator of an immunosuppressive tumor ME in the liver and a potential therapeutic target. Funding by the Canadian Institute of Health Research is gratefully acknowledged. Citation Format: Yasmine Benslimane, Sarah Lapin, Julien Chambon, Matthew Leibovitch, Stéphanie Perrino, Pnina Brodt. Estrogen regulates the immune microenvironment of colorectal cancer liver metastases [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2515.

Abstract 6154: Distinct immunosuppressive environments elicited in vessel co-opting and angiogenic colorectal cancer liver metastases and changes following treatment

Abstract Colorectal cancer (CRC) is the third most common cancer worldwide and 50% of CRC patients develop liver metastases. Colorectal cancer liver metastases (CRCLM) present as two major histological growth patterns (HGP) that predict response to treatment/survival: 1. angiogenic tumors characterized by a desmoplastic stroma separating CRC cells from the liver parenchyma and are highly angiogenic and 2. co-opting tumors where tumor cells infiltrate the parenchymal cells in the liver and grow by co-opting the sinusoidal blood vessels between the liver cell plates without sprouting angiogenesis. Angiogenic tumors receiving neoadjuvant anti-angiogenics (anti-VEGF) and chemotherapy have more than double the 5-year overall survival compared to patients with co-opting tumors who have received the same neoadjuvant regimen. In addition, our clinical data revealed that anti-angiogenics could negatively affect outcomes in patients with co-opting lesions. The goal of our study is to understand how the immune system affects the development of the two distinct CRCLM tumors. We used both Nanostring GeoMX spatial protein profiling platform, immunohistochemistry and immunofluorescence, to identify the immune landscapes in chemonaïve and treated human CRCLM tumors. We observed that angiogenic tumors were rich in both CD4 and CD8 T cells with a near absence of neutrophils and macrophages. These adaptive immune cells were also FOXP3 positive indicating an immunosuppressive phenotype. Interestingly, we observed that vessel co-opting tumors have far fewer infiltrating lymphocytes than angiogenic tumors, but interestingly have greater numbers of innate cells - mostly neutrophils and macrophages. The macrophages were further characterized as being M2, tumor promoting, leading to an immunosuppressive environment. We then went on to analyze treated tumors. For those patients treated with chemotherapy alone we observed a larger infiltration of T cells in the angiogenic tumors and the appearance of T cells infiltrating the co-opting tumors. Surprisingly, in patients treated with chemotherapy and anti-angiogenic drugs (ie. anti-VEGF), which is part of the standard of care, the co-opting tumors no longer demonstrated the presence of T cell infiltration and had a similar profile to the chemonaïve tumors. This could explain why chemotherapy in co-opting tumors had a higher overall survival compared to those treated with chemotherapy and anti-VEGF. These results suggest developing treatments aimed at reshaping the different immune landscape in angiogenic and co-opting CRCLM to yield beneficial results for patient overall survival. Furthermore, the identification of immune cells or immune mediators facilitating the development of these two tumor would identify immune cell targets for immunotherapies. Citation Format: Diane H. Kim, Thomas Z. Mayer, Stephanie K. Petrillo, Anthoula Lazaris, Peter Metrakos. Distinct immunosuppressive environments elicited in vessel co-opting and angiogenic colorectal cancer liver metastases and changes following treatment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 6154.

Abstract 1580: Cancer cells promote phenotypic alterations in adjacent hepatocytes to facilitate vessel co-option in colorectal cancer liver metastasis

Abstract Vessel co-option is associated with resistance against anti-angiogenic therapy in colorectal cancer liver metastases (CRCLM). Vessel co-opted lesions are characterized by highly motile cancer cells that move toward and along the pre-existing vessels in the surrounding non-malignant tissue and hijack them to gain access to nutrient. In order to access the sinusoidal vessels, the cancer cells must displace the hepatocytes and occupy their space. However, the mechanisms underlying this displacement are unknown. Herein, we examined the involvement of apoptosis, motility, epithelial-mesenchymal transition (EMT) and autophagy pathways in hepatocyte’s displacement by cancer cells. We demonstrated that cancer cells induce the expression of the proteins that associated with upregulation of apoptosis, motility and EMT in adjacent hepatocytes in vitro and in vivo. Accordingly, we observed upregulation of cleaved caspase-3, cleaved poly (ADP-ribose) polymerase-1 (PARP-1) and Actin Related Protein 2/3 (ARP2/3) in adjacent hepatocytes to cancer cells, while we noticed lower expression levels of E-cadherin. Importantly, Runt-related transcription factor 1 (RUNX1) knockdown in the cancer cells has impaired their function towards adjacent hepatocytes in vitro and in vivo. Altogether, our data indicating that cancer cells may exploit various mechanisms to displace the hepatocytes and access to the sinusoidal vessels to establish vessel co-option. Citation Format: Miran Rada, Anthoula Lazaris, Peter Metrakos. Cancer cells promote phenotypic alterations in adjacent hepatocytes to facilitate vessel co-option in colorectal cancer liver metastasis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1580.

Liver Metastatic Breast Cancer: Epidemiology, Dietary Interventions, and Related Metabolism.

The median overall survival of patients with metastatic breast cancer is only 2–3 years, and for patients with untreated liver metastasis, it is as short as 4–8 months. Improving the survival of women with breast cancer requires more effective anti-cancer strategies, especially for metastatic disease. Nutrients can influence tumor microenvironments, and cancer metabolism can be manipulated via a dietary modification to enhance anti-cancer strategies. Yet, there are no standard evidence-based recommendations for diet therapies before or during cancer treatment, and few studies provide definitive data that certain diets can mediate tumor progression or therapeutic effectiveness in human cancer. This review focuses on metastatic breast cancer, in particular liver metastatic forms, and recent studies on the impact of diets on disease progression and treatment.

Histopathological growth patterns of liver metastasis: updated consensus guidelines for pattern scoring, perspectives and recent mechanistic insights.

The first consensus guidelines for scoring the histopathological growth patterns (HGPs) of liver metastases were established in 2017. Since then, numerous studies have applied these guidelines, have further substantiated the potential clinical value of the HGPs in patients with liver metastases from various tumour types and are starting to shed light on the biology of the distinct HGPs. In the present guidelines, we give an overview of these studies, discuss novel strategies for predicting the HGPs of liver metastases, such as deep-learning algorithms for whole-slide histopathology images and medical imaging, and highlight liver metastasis animal models that exhibit features of the different HGPs. Based on a pooled analysis of large cohorts of patients with liver-metastatic colorectal cancer, we propose a new cut-off to categorise patients according to the HGPs. An up-to-date standard method for HGP assessment within liver metastases is also presented with the aim of incorporating HGPs into the decision-making processes surrounding the treatment of patients with liver-metastatic cancer. Finally, we propose hypotheses on the cellular and molecular mechanisms that drive the biology of the different HGPs, opening some exciting preclinical and clinical research perspectives.