Publications by Patrik Aouad | EPFL Graph Search

Epithelial-mesenchymal plasticity determines estrogen receptor positive breast cancer dormancy and epithelial reconversion drives recurrence

Giovanna Ambrosini, Patrik Aouad, Cathrin Brisken, Fabio De Martino, Kelly Spry Maggs, Hazel Margaret Quinn, Georgios Sflomos, Céline Marie Victoria Stibolt, Yueyun Zhang

More than 70% of human breast cancers (BCs) are estrogen receptor α-positive (ER+). A clinical challenge of ER+ BC is that they can recur decades after initial treatments. Mechanisms governing latent disease remain elusive due to lack of adequate in vivo models. We compare intraductal xenografts of ER+ and triple-negative (TN) BC cells and demonstrate that disseminated TNBC cells proliferate similarly as TNBC cells at the primary site whereas disseminated ER+ BC cells proliferate slower, they decrease CDH1 and increase ZEB1,2 expressions, and exhibit characteristics of epithelial-mesenchymal plasticity (EMP) and dormancy. Forced E-cadherin expression overcomes ER+ BC dormancy. Cytokine signalings are enriched in more active versus inactive disseminated tumour cells, suggesting microenvironmental triggers for awakening. We conclude that intraductal xenografts model ER + BC dormancy and reveal that EMP is essential for the generation of a dormant cell state and that targeting exit from EMP has therapeutic potential.

2022

Intraductal xenografts model estrogen receptor-positive (ER+) breast cancer dormancy and reveal a critical role for epithelial-mesenchymal transition (EMT) in its establishment

Patrik Aouad

Compared to estrogen receptor-negative (ER-) breast cancer (BC), ER+ BC often manifests with a latent disease that recurs decades after initial diagnosis. The mechanisms governing dormancy and distant recurrence of ER+ tumors remain elusive due to the lack of preclinical models. Here, we compared the tumor progression of ER+ and triple negative (TN; ER-, progesterone receptor and human epidermal growth factor receptor 2-negative) BCs by grafting cell lines- and patient-derived tumor cells into the milk ducts of immunocompromised mice. In the intraductal model, both ER+ and TN BC cells disseminate already during the in situ stage. TN disseminated tumor cells (DTCs) proliferate and form macro-metastases, while DTCs from ER+ BC xenografts have low proliferative indices, are arrested in the G0/G1 phase of the cell cycle, and express the dormancy marker p27. Dormant DTCs display mesenchymal and niche-specific characteristics, as revealed by three-dimensional single cell resolution imaging, and show molecular features of Epithelial-Mesenchymal Transition (EMT) with decreased CDH1, and in-creased ZEB1, ZEB2, and VIM expression levels. Surprisingly, EMT is neither detected in primary tumor cells, nor required for their invasion or dissemination, but is acquired upon their establishment in distant sites. In ex vivo cultures, dormant lung and brain DTCs, revert back to a proliferative state within 3 weeks through a Mesenchymal-Epithelial Transition (MET). In vivo, CDH1 restoration in dormant DTCs overcomes dormancy and increases the growth and proliferation of lung metastases, while decreasing the expression of EMT-transcription factors (MET). We conclude that the intraductal model provides exciting new experimental opportunities to study ER+ BC metastasis dormancy, and reveals that EMT could be exploited therapeutically to promote dormancy and prevent distant recurrence.

EPFL2021

Intraductal xenografts show lobular carcinoma cells rely on their own extracellular matrix and LOXL1

Giovanna Ambrosini, Patrik Aouad, Ayyakkannu Ayyanan, Laura Battista, Cathrin Brisken, Philipp Bucher, Fabio De Martino, Maryse Fiche, Valentina Scabia, Georgios Sflomos

Invasive lobular carcinoma (ILC) is the most frequent special histological subtype of breast cancer, typically characterized by loss of E‐cadherin. It has clinical features distinct from other estrogen receptor‐positive (ER+) breast cancers but the molecular mechanisms underlying its characteristic biology are poorly understood because we lack experimental models to study them. Here, we recapitulate the human disease, including its metastatic pattern, by grafting ILC‐derived breast cancer cell lines, SUM‐44 PE and MDA‐MB‐134‐VI cells, into the mouse milk ducts. Using patient‐derived intraductal xenografts from lobular and non‐lobular ER+ HER2− tumors to compare global gene expression, we identify extracellular matrix modulation as a lobular carcinoma cell‐intrinsic trait. Analysis of TCGA patient datasets shows matrisome signature is enriched in lobular carcinomas with overexpression of elastin, collagens, and the collagen modifying enzyme LOXL1. Treatment with the pan LOX inhibitor BAPN and silencing of LOXL1 expression decrease tumor growth, invasion, and metastasis by disrupting ECM structure resulting in decreased ER signaling. We conclude that LOXL1 inhibition is a promising therapeutic strategy for ILC.

2021

The secreted protease Adamts18 links hormone action to activation of the mammary stem cell niche

Giovanna Ambrosini, Patrik Aouad, Dalya Ataca, Cathrin Brisken, Philipp Bucher, Marian Caikovski, Céline Berthe Constantin, Csaba Ferenc László, Renuga Devi Rajaram, Marie Shamseddin

Estrogens and progesterone control breast development and carcinogenesis via their cognate receptors expressed in a subset of luminal cells in the mammary epithelium. How they control the extracellular matrix, important to breast physiology and tumorigenesis, remains unclear. Here we report that both hormones induce the secreted protease Adamts18 in myoepithelial cells by controlling Wnt4 expression with consequent paracrine canonical Wnt signaling activation. Adamts18 is required for stem cell activation, has multiple binding partners in the basement membrane and interacts genetically with the basal membrane-specific proteoglycan, Col18a1, pointing to the basement membrane as part of the stem cell niche. In vitro, ADAMTS18 cleaves fibronectin; in vivo, Adamts18 deletion causes increased collagen deposition during puberty, which results in impaired Hippo signaling and reduced Fgfr2 expression both of which control stem cell function. Thus, Adamts18 links luminal hormone receptor signaling to basement membrane remodeling and stem cell activation. How hormonal signaling in the mammary epithelium controls the surrounding extracellular matrix is unclear. Here, the authors show that a secreted protease, Adamts18, induced by upstream estrogen-progesterone activated Wnt4 in myoepithelial cells, remodels the basement membrane and contributes to mammary epithelial stemness.

2020

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Estrogen receptor α-positive (ER-positive) or 'luminal' breast cancers were notoriously difficult to establish as patient-derived xenografts (PDXs). We and others recently demonstrated that the microenvironment is critical for ER-positive tumor cells; when grafted as single cells into milk ducts of NOD Scid gamma females, >90% of ER-positive tumors can be established as xenografts and recapitulate many features of the human disease in vivo. This intraductal approach holds promise for personalized medicine, yet human and murine stroma are organized differently and this and other species specificities may limit the value of this model. Here, we analyzed 21 ER-positive intraductal PDXs histopathologically. We found that intraductal PDXs vary in extent and define four histopathological patterns: flat, lobular, in situ and invasive, which occur in pure and combined forms. The intraductal PDXs replicate earlier stages of tumor development than their clinical counterparts. Micrometastases are already detected when lesions appear in situ. Tumor extent, histopathological patterns and micrometastatic load correlate with biological properties of their tumors of origin. Our findings add evidence to the validity of the intraductal model for in vivo studies of ER-positive breast cancer and raise the intriguing possibility that tumor cell dissemination may occur earlier than currently thought. © 2018 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.

2018

Oestrogen receptor alpha AF-1 and AF-2 domains have cell population-specific functions in the mammary epithelium

Patrik Aouad, Dalya Ataca, Ayyakkannu Ayyanan, Cathrin Brisken, Stéphanie Cagnet, Valentina Scabia, Georgios Sflomos

Oestrogen receptor alpha (ER alpha) is a transcription factor with ligand-independent and ligand-dependent activation functions (AF)-1 and -2. Oestrogens control postnatal mammary gland development acting on a subset of mammary epithelial cells (MECs), termed sensor cells, which are ER alpha-positive by immunohistochemistry (IHC) and secrete paracrine factors, which stimulate ER alpha-negative responder cells. Here we show that deletion of AF-1 or AF-2 blocks pubertal ductal growth and subsequent development because both are required for expression of essential paracrine mediators. Thirty percent of the luminal cells are ER alpha-negative by IHC but express Esr1 transcripts. This low level ER alpha expression through AF-2 is essential for cell expansion during puberty and growth-inhibitory during pregnancy. Cell-intrinsic ER alpha is not required for cell proliferation nor for secretory differentiation but controls transcript levels of cell motility and cell adhesion genes and a stem cell and epithelial mesenchymal transition (EMT) signature identifying ER alpha as a key regulator of mammary epithelial cell plasticity.

NATURE PUBLISHING GROUP2018