Despite recent therapeutic advances in cancer treatment, metastasis remains the principal cause of cancer death. An incomplete view of the mechanisms that drive metastasis has been a major barrier to rational development of effective therapeutics and prognostic diagnostics for patients. The mechanisms contributing to metastatic dissemination can be diverse and tumor-type dependent. Skin cancers are prime examples of this. Whereas skin basal cell carcinoma rarely metastasize, cutaneous melanoma are often highly metastatic. Intra-tumor heterogeneity (ITH) has been proposed as a major driver of metastatic dissemination where the magnitude of heterogeneity has not been fully addressed yet. In the action “INHuMAN” we proposed to address the magnitude of intratumoral heterogeneity in melanoma and identify cell populations at the origin of metastasis. Combining single cell RNA sequencing with clinically relevant mouse models we were able to identify and characterize a cell state that presumably sits at the origin of metastasis. Importantly, the data strongly suggested that this population is not fueling tumor growth. Our initial screening assays identified a melanoma population with stemness characteristics indicating that these cells maintain melanoma growth. We developed models and tools to further study this population and by following the fate of individual cells and their spatial distribution in the tissue we identified a specialized cellular niche, called perivascular niche, that maintains tumor growth and is not linked to metastasis. Instead, the metastatic population was driven by a Transcription Factor called PRRX1, where these Metastatic Initiating Cells (MICs) where preferentially at the invading front of primary melanoma tumors. Importantly, the existence and the spatial location of the two cell states were confirmed in human biopsies.
In this call we have characterized this cellular plasticity and based on this data we have initiated projects to better characterize when and how cells transit, in order to block this phenotypic switch. The outcome of this fundamental action can be subjected to translational research that potentially can lead to the development of treatment strategies (personalized or not) to eradicate this devastating disease and improve patient’s survival.