Change Is in the Air: The Hypoxic Induction of Phenotype Switching in Melanoma

Melanoma cells can switch from a highly proliferative, less invasive state to a highly invasive, less proliferative state, a phenomenon termed phenotype switching. This results in a highly heterogenous tumor, where a slow-growing, aggressive population of cells may resist tumor therapy, and it predicts tumor recurrence. Here we discuss the observation made by Widmer et al. that hypoxia may drive phenotype switching

Direct and indirect effects of retinoic acid on human Th2 cytokine and chemokine expression by human T lymphocytes

BACKGROUND: Vitamin A (VA) deficiency induces a type 1 cytokine response and exogenously provided retinoids can induce a type 2 cytokine response both in vitro and in vivo. The precise mechanism(s) involved in this phenotypic switch are inconsistent and have been poorly characterized in humans. In an effort to determine if retinoids are capable of inducing Th2 cytokine responses in human T cell cultures, we stimulated human PBMCs with immobilized anti-CD3 mAb in the presence or absence of all-trans retinoic acid (ATRA) or 9-cis-RA. RESULTS: Stimulation of human PBMCs and purified T cells with ATRA and 9-cis-RA increased mRNA and protein levels of IL-4, IL-5, and IL-13 and decreased levels of IFN-γ, IL-2, IL-12p70 and TNF-α upon activation with anti-CD3 and/or anti-CD28 mAbs. These effects were dose-dependent and evident as early as 12 hr post stimulation. Real time RT-PCR analysis revealed a dampened expression of the Th1-associated gene, T-bet, and a time-dependent increase in the mRNA for the Th2-associated genes, GATA-3, c-MAF and STAT6, upon treatment with ATRA. Besides Th1 and Th2 cytokines, a number of additional proinflammatory and regulatory cytokines including several chemokines were also differentially regulated by ATRA treatment. CONCLUSION: These data provide strong evidence for multiple inductive roles for retinoids in the development of human type-2 cytokine responses

Cancer-Associated Fibroblasts Neutralize the Anti-tumor Effect of CSF1 Receptor Blockade by Inducing PMN-MDSC Infiltration of Tumors.

Tumor-associated macrophages (TAM) contribute to all aspects of tumor progression. Use of CSF1R inhibitors to target TAM is therapeutically appealing, but has had very limited anti-tumor effects. Here, we have identified the mechanism that limited the effect of CSF1R targeted therapy. We demonstrated that carcinoma-associated fibroblasts (CAF) are major sources of chemokines that recruit granulocytes to tumors. CSF1 produced by tumor cells caused HDAC2-mediated downregulation of granulocyte-specific chemokine expression in CAF, which limited migration of these cells to tumors. Treatment with CSF1R inhibitors disrupted this crosstalk and triggered a profound increase in granulocyte recruitment to tumors. Combining CSF1R inhibitor with a CXCR2 antagonist blocked granulocyte infiltration of tumors and showed strong anti-tumor effects

Inhibition of age-related therapy resistance in melanoma by rosiglitazone-mediated induction of Klotho

PURPOSE: Aging is a poor prognostic factor for melanoma. We have shown that melanoma cells in an aged microenvironment, are more resistant to targeted therapy than identical cells in a young microenvironment. This is dependent on age-related secreted factors. Klotho is an age-related protein, whose serum levels decrease dramatically by age 40. Studies on klotho in cancer have focused on the expression of klotho in the tumor cell. We have shown that exogenous klotho inhibits internalization and signaling of Wnt5A, which drives melanoma metastasis and resistance to targeted therapy. We investigate here whether increasing klotho in the aged microenvironment could be an effective strategy for the treatment of melanoma. EXPERIMENTAL DESIGN: PPARγ increases klotho levels, and is increased by glitazones. Using rosiglitazone, we queried the effects of rosiglitazone on Klotho/ Wnt5A crosstalk, in vitro and in vivo, and the implications of that for targeted therapy in young vs. aged animals. RESULTS: We show that rosiglitazone increases klotho and decreases Wnt5A in tumor cells, reducing the burden of both BRAF-inhibitor sensitive, and BRAF inhibitor-resistant tumors in aged, but not young mice. However, when used in combination with PLX4720, tumor burden was reduced in both young and aged mice, even in resistant tumors. CONCLUSIONS: Using glitazones as adjuvant therapy for melanoma may provide a new treatment strategy for older melanoma patients who have developed resistance to vemurafenib. As klotho has been shown to play a role in other cancers too, our results may have wide relevance for multiple tumor types

Deconstructing tumor heterogeneity: the stromal perspective.

Significant advances have been made towards understanding the role of immune cell-tumor interplay in either suppressing or promoting tumor growth, progression, and recurrence, however, the roles of additional stromal elements, cell types and/or cell states remain ill-defined. The overarching goal of this NCI-sponsored workshop was to highlight and integrate the critical functions of non-immune stromal components in regulating tumor heterogeneity and its impact on tumor initiation, progression, and resistance to therapy. The workshop explored the opposing roles of tumor supportive versus suppressive stroma and how cellular composition and function may be altered during disease progression. It also highlighted microenvironment-centered mechanisms dictating indolence or aggressiveness of early lesions and how spatial geography impacts stromal attributes and function. The prognostic and therapeutic implications as well as potential vulnerabilities within the heterogeneous tumor microenvironment were also discussed. These broad topics were included in this workshop as an effort to identify current challenges and knowledge gaps in the field

Is Cancer Inevitable?

How can new understandings about cancer cell interactions help doctors better control, and eventually cure, cancer?Cancer is a formidable enemy. In fact, people born in America since 1960 face a one in two chance of being diagnosed with cancer in their lifetimes. However, there's growing evidence that fewer cancers will be death sentences for patients. New approaches and understandings are transforming the medical world, increasing success rates for remissions, disease management, and cures. Dr. Ashani Weeraratna is at the forefront of this new level of care. In Is Cancer Inevitable?, Weeraratna—a pioneering melanoma researcher whose work explores the role aging plays in cancer cells' spread and drug resistance—gives readers an inside look at several of the latest cancer advances. Detailing the actions that are reducing the disease's impact and exploring what the future may hold, she explains how the molecular mechanisms involved in metastasis and the cells' microenvironments influence cancer's development and progression. Over the years, she writes, our understanding of how cancer cells move throughout the body, change as they plant themselves in the body's microenvironments, and even communicate with one another have led to major insights about how cancer works. With compelling detail, she takes us inside her lab, revealing how new insights are leading to major breakthroughs, even among patients with Stage IV cancer. She also explains how age-related changes in the microenvironment contribute to multiple aspects of melanoma formation and development. Such scholarship, she argues, is moving us toward a day when more patients will be declared cancer-free. An inspiring and deeply personal book, Is Cancer Inevitable? offers readers newfound hope.Features• Explores key insights and studies developed in recent years that have greatly influenced the world of cancer research, including how aging microenvironments within our bodies encourage metastasis and therapy resistance• Guides readers through Dr. Ashani Weeraratna's personal story of coming to the United States from Lesotho at the age of 17 and rising to become one of the pioneers in her field• Brings readers inside Weeraratna's lab, describing both the processes and the missions of her work • Raises awareness about how cancer works within the body and what any patient or family encountering the disease needs to understand—while also offering them hope based on new and forthcoming diagnostic and treatment methods• Outlines why we will never control—let alone cure—cancer if we don't find a common purpose and come together in collaboration, inviting the greatest minds from around the world to participate in finding and implementing solutionsJohns Hopkins WavelengthsIn classrooms, field stations, and laboratories in Baltimore and around the world, the Bloomberg Distinguished Professors of Johns Hopkins University are opening the boundaries of our understanding of many of the world's most complex challenges. The Johns Hopkins Wavelengths book series brings readers inside their stories, illustrating how their pioneering discoveries benefit people in their neighborhoods and across the globe in artificial intelligence, cancer research, food systems' environmental impacts, health equity, science diplomacy, and other critical arenas of study. Through these compelling narratives, their insights will spark conversations from dorm rooms to dining rooms to boardrooms

Autophagy- An emerging target for melanoma therapy [version 1; referees: 2 approved]

Melanoma accounts for only 5% of all cancers but is the leading cause of skin cancer death due to its high metastatic potential. Patients with metastatic melanoma have a 10-year survival rate of less than 10%. While the clinical landscape for melanoma is evolving rapidly, lack of response to therapies, as well as resistance to therapy remain critical obstacles for treatment of this disease. In recent years, a myriad of therapy resistance mechanisms have been unravelled, one of which is autophagy, the focus of this review. In advanced stages of malignancy, melanoma cells hijack the autophagy machinery in order to alleviate drug-induced and metabolic stress in the tumor microenvironment, thereby promoting resistance to multiple therapies, tumor cell survival, and progression.  Autophagy is an essential cellular process that maintains cellular homeostasis through the recycling of intracellular constituents. Early studies on the role of autophagy in cancer generated controversy as to whether autophagy was pro- or anti-tumorigenic. Currently, there is a consensus that autophagy is tumor-suppressive in the early stages of cancer and tumor-promoting in established tumors.  This review aims to highlight current understandings on the role of autophagy in melanoma malignancy, and specifically therapy resistance; as well as to evaluate recent strategies for therapeutic autophagy modulation