Lung cancer remains the leading cause of cancer-related death due to poor treatment responses arising from tumor heterogeneity and epigenetic aberrations. Here we show that adverse prognosis associated with epigenetically silenced tumour suppressor RASSF1A is a consequence of increased extracellular matrix, tumour stiffness and metastatic dissemination in vivo and in vitro. We find that lung cancer cells with methylated RASSF1A display constitutive nuclear YAP1 and expression of prolyl4hydroxylase2 (P4HA2) into extracellular matrix that correlates with increases collagen deposition. Furthermore, we identify an epigenetic axis in tumour cells where elevated ECM impedes the intrinsic suppression of WNT signaling (via TPBG/5T4) triggering b-catenin-YAP1 activation and thus results in a cancer stem-like programming. As key drivers, we identified RASSF1A and P4HA2 mediating the ECM-dependent stemness and metastatic dissemination in vivo. Re-expression of RASSF1A or inhibition of P4HA2 activity reverse these effects and increase levels of lung differentiation markers (TTF-1, Mucin5B) in vivo and in vitro. Our study identifies an epigenetic program to cancer stemness and metastatic progression of lung adenocarcinoma and P4HA2 as potential target for uncoupling ECM signals towards cancer stemness. D.P. designed the research, performed experiments and analysed data. Y.J. and A.R. assisted with animal work, I.V. provided and analysed LC-MS/MS, J.B. performed the fibrotic staining, C.B. performed AFM, E.O.N and D.P. wrote manuscript.
Conflict of interestThe authors declare no conflict of interest.
The paper explainedProblem Lung cancer is the leading cause of cancer-related death worldwide with limited improvement in survival over 30 years due to late diagnosis and poor therapeutic options. Epigenetic inactivation of RASSF1A correlates with lung cancer onset, metastasis, poor prognosis and therapeutic responses, however, mechanistic explanation for these clinical associations in human tumours has been lacking.
ResultsHere we demonstrate that RASSF1A methylation in lung adenocarcinomas is a consequence of triggering signals from ECM due to expression of P4HA2 into extracellular matrix, that in turn induces cancer stem-like cells programming and metastatic dissemination in vivo and in vitro. Re-expression of RASSF1A or inhibition of P4HA2 activity converses these processes and switch into lung cancer differentiation accompanied by better prognosis and clinical survival.
ImpactOur study demonstrates an importance of tumour microenvironment in epigenetic regulation of cancer stemness and metastatic progression of lung adenocarcinoma and targeting P4HA2 as a new anti-tumour therapy agent.