New insight into cancer metastasis

Images of cancer cells

Breaking up. In the two top images, the Twist gene is dormant, and the cancer cells are held together. In the bottom images, Twist is expressed in the tumor, and the cancer cells lose their adhesion to each other. As a result, the cells can now disperse throughout the body, making metastasis possible.

June 24, 2004

Tags: Weinberg LabCancer

CAMBRIDGE, Mass. — Scientists know a great deal about how tumors originate and develop, but relatively little about how cancer manages to metastasize and invade distant tissues and organs. Now, a team of researchers led by Whitehead Member Robert Weinberg has discovered that tumors spread by reactivating and commandeering a “sleeper” protein that should have been shut off permanently in early embryo development.

“As a result, cancer cells acquire in one fell swoop many of the abilities they need to execute the complex stages of metastasis,” says Weinberg, who also is a professor of biology at MIT.

Metastasis is a highly inefficient, multi-step process that requires cancer cells to jump through many hoops. The cells first must invade a nearby tissue, then make their way into the blood or lymphatic vessels. Next they must migrate through the bloodstream to a distant site, exit the bloodstream, and establish new colonies. The entire operation involves so many steps that it raises an obvious question: How do cancer cells cobble these behaviors together and acquire the ability to do all this? According to the new study, they don’t. Rather, they hijack an existing cellular process and use it to disperse throughout the body.

Reporting in the June 25 issue of the journal Cell, the research team headed by Weinberg describes how a breast carcinoma in mice misappropriates a protein called Twist. Twist is a gene regulator, meaning that it tells genes when to turn on and when to turn off. But Twist is mainly active in early embryonic development, where it enables cells to move from one part of an embryo to another and allocates these cells into different tissues. As an embryo develops, Twist’s functions no longer are necessary, and it soon becomes dormant in most tissues throughout the rest of an organism’s life.

Through a process that still is somewhat unclear to researchers, tumor cells reactivate this long-dormant protein and thereby acquire the ability to move throughout the body.

The research was conducted in two phases. First, Whitehead postdoctoral fellows Jing Yang and Sendurai Mani compared metastatic and non-metastatic cancer cells taken from mouse tumors. Using microarray technology to determine levels of gene expression, they found certain genes that were active only in the metastatic cells. The gene that stood out among all the others was one coding for the protein Twist.

Next, Yang isolated highly metastatic cancer cells and disabled the Twist gene. When she injected these cells into mammary glands of mice, the mice developed primary, localized breast tumors—but the tumors were unable to metastasize. Furthermore, their study showed that Twist caused breast cells to separate from one another, losing their cell-to-cell adhesion and scattering, thereby allowing these cells to travel to distant organ sites, like dandelion seeds scattered in the winds.

“Twist is probably the first gene regulator that has been tied so definitively to human cancer metastasis,” says Yang.

Andrea Richardson, a pathologist at Brigham and Women’s Hospital and coauthor on the paper, correlated these finding with her lab’s data taken from human breast cancer studies—essentially re-analyzing her lab’s data in light of Yang’s. She found that Twist is highly expressed in invasive lobular carcinoma, a unique type of breast cancer where breast tumor cells completely lose their cell-to-cell adhesion and infiltrate other tissues.

“In many mouse studies you have great models and come up with something and it cures the mice, but then it never seems to work in people,” says Richardson. “In this case we were seeing the exact same phenotype and gene expression correlation in human breast tumors.”

Although clinical applications of this research are still unclear, Richardson can see the potential for developing a Twist inhibitor, a drug that wouldn’t kill a tumor but rather stop its metastatic capabilities. “Something like that would turn cancer into a chronic disease, rather than a deadly one,” she suggests.

Yang also can see potential to apply these findings diagnostically. “With breast cancer patients diagnosed with a primary tumor, it’s hard to tell whether or not that tumor will generate metastases,” she says. “Some small tumors will metastasize, some large ones won’t. Here we might be able to discover if a tumor is ready to invade and metastasize or not by finding out if the Twist gene is on or off.”

For now, the discovery of Twist’s role is only the beginning. Says Weinberg, “There are a number of other regulatory proteins that have been studied in other labs and have properties very similar to those of Twist. The other regulators undoubtedly will play important roles in other types of human metastatic cancer.”

Written by David Cameron.

Full citation for print version
© Cell, Vol. 117 No. 8 pp 927-939
“Twist, a Master Regulator of Morphogenesis, Plays an Essential Role in Tumor Metastasis”
Authors: Jing Yang (1), Sendurai A. Mani (1), Joana Liu Donaher (1), Sridhar Ramaswamy (2,3), Raphael A. Itzykson (4), Christophe Come (5), Pierre Savagner (5), Inna Gitelman (6), Andrea Richardson (7), and Robert A. Weinberg (1)

(1) Whitehead Institute for Biomedical Research, Cambridge, MA
(2) Cancer Genomics Program Broad Institute, Cambridge, MA
(3) MGH Center for Cancer Research, Charlestown, MA
(4) Ecole Normale Superieure, Paris, France
(5) EMI 0229 INSERM CRLC Val d’Aurelle-Paul Lamarque 34298 Montpellier Cedex 5, France
(6) Department of Molecular Genetics & Development, Ben Gurion University of the Negev, Beer Sheva, Israel
(7) Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School
Boston, MA

This research was supported by the National Institutes of Health, MIT/Ludwig Fund for Cancer Research, and Harvard SPORE in Breast Cancer.

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