Katie Parkins1, Veronica Dubois1, Amanda Hamilton2, Ashley Makela1, John Ronald1, and Paula Foster1
1Medical Biophysics, Western University, London, ON, Canada, 2Western University, London, ON, Canada
Synopsis
The mechanisms that influence metastatic growth
rates are poorly understood. One mechanism of interest known as concomitant
tumor resistance (CTR) can be defined as the inhibition of metastatic growth by
existing tumor mass. Conversely, the presence of a primary tumor has also been
shown to increase metastatic outgrowth, termed concomitant tumor enhancement
(CTE). The goal of this research was to use conventional and cellular MRI , and
bioluminescence imaging to study the impact of a primary tumor on the
development of breast cancer brain metastases in a syngeneic mouse model.
Introduction
Metastasis is responsible for the majority of
cancer-related deaths and mechanisms that control metastasis are poorly
understood. One mechanism of interest called concomitant tumor resistance (CTR)
refers to the ability of the primary tumor to restrict the growth of distant
metastases1,2. Removal of a primary tumor can be followed by abrupt
acceleration of residual metastatic disease, and has been observed in both animal
models of breast cancer3 and patients4. Conversely, a
primary tumor can likewise increase metastatic outgrowth, a phenomenon coined
concomitant tumor enhancement (CTE). CTE has been reported in the clinic, with
most cases being related to suspected regressions of hepatic or pulmonary
metastases following nephrectomy for renal cell carcinoma5-8. While
imaging has been used to describe CTR/CTE effects in patients9, the
majority of studies evaluating CTR/CTE in preclinical models have relied on
histological evaluation of tumor burden10,11. The application of
cellular and molecular imaging tools capable of visualizing metastatic
progression in vivo will yield a better understanding of the
mechanism(s) by which CTR/CTE effects occur and under what conditions. In turn,
this may lead to new therapeutic approaches to halt metastatic outgrowth. Here we apply iron-oxide-based cellular MRI
and bioluminescence imaging (BLI) to study the effects of a primary tumor and
its size on metastatic growth of breast cancer cells in a novel syngeneic mouse
model. Methods
BALB/c mice (n=24) received an
injection of vehicle (Control) or 3x105 parental 4T1 cells in the mammary
fat pad (MFP) either 7 days (small MFP) or 14 days (large MFP) prior to
intracardiac injection of 2x104 luciferase-expressing, iron-labeled
brain-seeking 4T1BR5 cells (Figure 1). Cellular MRI and BLI were
performed over the next 2 weeks to measure brain and whole-body cancer cell
viability (BLI), whole-brain single cell arrest (iron-induced MR signal voids),
and the number and volume of metastases at endpoint (MRI). Whole body MRI was
performed on large MFP and control mice on days 9 and 14. BLI was performed on
an optical imaging scanner and MRI was performed on a 3T scanner using
customized gradient and solenoidal RF coils using the iron-sensitive bSSFP
sequence.Results
Iron labeled cells were
visualized in brain MR images as discrete signal voids on day 0 (arrested
cells) which was not significantly different between Control and MFP mice (Figure
2). Brain BLI signal at day 0 was also not significantly different (Figure
2). At day 14, both small and large MFP mouse groups had significantly more
brain metastases (p<0.05) and brain tumor burden (p<0.05) than Control mice
(Figure 3). Whole-body and brain BLI signal at endpoint were not
significantly different between small MFP mice and Control mice, but were
significantly higher for the large MFP group compared to Control mice (Figure
4). Lung metastases were detectable at day 14 with whole body MRI in mice
with a large MFP primary tumor but not Control mice (Figure 5).Discussion
The mechanisms of CTR and
CTE remain unclear. These findings are in contrast to our previous study in
immune compromised mice where we found the presence of a human MDA-MB-231
breast tumor significantly inhibited the growth of MDA-MB-231BR brain
metastases. Other groups have suggested the immune system can play a crucial
role in CTR/CTE effects12. Furthermore, previous studies have shown
that the size of the primary tumor can play a key role in whether a CTE or CTR
effect is observed13. For the
present study, we injected our metastatic cell line at an early time point (day
7) when the primary tumor was relatively small and a late time point (day 14)
when the primary tumor was large. We found the presence of a primary tumor
enhances the growth of brain and body metastases and secondly, this effect
could be amplified by increasing the size of the primary tumor at the time of
secondary injection. Using in vivo
BLI/MRI we could determine this was not related to differences in initial
arrest or clearance of viable cells in the brain, which suggests that the
presence of a primary tumor can increase the proliferative growth of brain metastases
in this syngeneic mouse model. Conclusion
For the first time, we have applied
cellular and molecular imaging tools to evaluate the effect of a primary breast
tumor on the growth of brain metastases in an immune competent model. Our work
highlights new insights into the effects a primary tumor can have on breast cancer metastasis.
Understanding the molecular mechanisms behind stimulation (CTE) versus
inhibition (CTR) of metastatic growth could lead to new targets for therapy that
could prevent recurrence and improve patient outcome.Acknowledgements
No acknowledgement found.References
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