The importance of understanding the basis of tumor cell invasiveness, dissemination and dormancy in the periphery as factors leading to the outgrowth of overt metastases is highlighted by the emergence of recurrent and/or metastatic disease in breast cancer patients that were "successfully" treated years before. The overarching hypothesis of this proposal is that a process known as autophagy promotes some of the most aggressive and intractable features of metastatic breast cancer, namely increased tumor cell dissemination, increased tumor cell dormancy that can lead to disease recurrence and that autophagy promotes the "stem cell state", that is in turn linked to drug resistance. By genetically and chemically modulating the ability of the cell to induce autophagy, we will examine for the first time whether we can exploit the dependence of invasive cells on autophagy to eliminate them from the body and thereby prevent cancer from recurring or metastasizing effectively. Autophagy is a catabolic process activated in response to nutrient deprivation and/or hypoxia and is associated with cell cycle arrest, reduced growth, turnover of cellular constituents but also cell survival. There are three new concepts that are being proposed and tested: (1) autophagy plays differing roles in tumorigenesis depending on whether it is acting early in the process, where it likely acts to suppress tumor development, or late in the process, where we propose it acts to promote progression to invasiveness and metastasis.
(Aim 1); (2) autophagy is required for tumor cell migration by promoting focal adhesion complex turnover and that the Ulk-1/FIP200 complex plays a dual role activating autophagy and inhibiting focal adhesion turnover that explains how autophagy and cell migration are coordinated (Aim 2);(3) autophagy is required for maintaining characteristics of tumor cells that are known as "stem-like". These properties include the ability to re-seed tumors when serially transplanted in vivo, to self-renew under such conditions and to give rise to "differentiated" tumor cells that lack such stem cell lik properties (Aim 3). We will also examine how autophagy promotes drug resistance of tumor cells. The proposed work is significant in putting forward a novel set of hypotheses to explain the role of autophagy in breast cancer metastasis and while each aim of the proposal is distinct in its own right, there is the possibility that by determining the extent to which tumor cell migration, invasiveness, dormancy and the stem cell nature of tumor propagating cells are dependent on autophagy, that we will make a major advance in understanding how these different features of advanced breast cancer are linked. Hence, it is predicted that our work will contribute to our understanding of how best to prevent tumor cell dissemination that is predicted to lead to reduced metastasis, limit disease recurrence and improved survival rates amongst breast cancer patients. In summary, this project will address several highly significant scientific questions and bring new perspective to the clinically relevant problem of breast cancer metastasis.

Public Health Relevance

The importance of understanding the mechanistic basis of how tumor cells escape the primary tumor and spread to distant organs where they survive in a dormant or stem-like state before growing out to form overt metastases is highlighted by the emergence of recurrent and/or metastatic disease in breast cancer patients that were treated for their primary cancer years earlier. We will test the role of autophagy, an adaptive response to nutrient deprivation, in breast cancer metastasis with the goal of providing a novel understanding of the factors that determine how and when tumor cells become invasive, disseminate, remain dormant or grow out as overt metastases.

National Institute of Health (NIH)
Research Project (R01)
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Tumor Progression and Metastasis Study Section (TPM)
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Woodhouse, Elizabeth
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University of Chicago
Internal Medicine/Medicine
Schools of Medicine
United States
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