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In der Nachsorge des Medulloblastoms wird standardmäßig auf die Bildgebung mittels Magnetresonanztomographie zurück gegriffen. Da die Erkrankung vor allem entlang der Liquorwege in Form einer kranialen oder spinalen Meningeose metastasiert, wurde anhand Daten der Therapieoptimierungsstudie "HIT 2000" verglichen, welche Lokalisation am häufigsten betroffen ist. Es zeigte sich, dass zu einem hohen Prozentanteil vor allem eine kombinierte Meningeose im Rezidiv oder Progress auftritt, gefolgt von einer kranialen Metastasierung. Dennoch gibt es eine Gruppe an Patienten, die eine isolierte spinale Meningeose entwickeln.
Non-small cell lung cancer (NSCLC) is the deadliest form of lung cancer and has a poor prognosis due to its high rate of metastasis. Notably, metastasis is one of the leading causes of death among cancer patients. Despite the clinical importance, the cellular and molecular mechanisms that govern the initiation, establishment and progression of metastasis remain unclear. Moreover, knowledge gained on metastatic process was largely based on cultured or in vitro manipulated cells that were reintroduced into immune-compromised recipient mice. In the present study, a spontaneous metastasis mouse model for NSCLC was generated with a heritable fluorescent tag (DsRed) driven by CAG (combination of cytomegalovirus early enhancing element and chicken beta actin) promoter in alveolar type II cells (SpC-rtTA/TetO-Cre/LSL-DsRed). This approach is essential, keeping in mind the reprogramming nature of Myc oncogene (Rapp et al, 2009). Such genetic lineage tracing approach not only allowed us to monitor molecular and cellular changes during development of primary tumor but also led us to identify the different stages of secondary tumor development in distant organs. Upon combined expression of oncogenic C Raf-BXB and c-Myc (MYC-BXB-DsRed) in lung alveolar type II epithelial cells, macroscopic lung tumors arose comprising of both cuboidal and columnal cellular features. C Raf-BXB induced tumors (CRAF-DsRed) exhibit cuboidal morphology and is non-metastatic whereas Myc-BXB induced lung tumors (Myc-BXB-DsRed) present cuboidal-columnar cellular features and is able to undergo metastasis mainly in liver. Surprisingly, cystic lesions which were negative for SpC (Surfactant protein C) and CCSP (Clara cell secretory protein), strongly expressed DsRed proteins indicating its origin from lung alveolar type II cells. Moreover, early lung progenitor markers such as GATA4 (GATA-binding protein 4) and TTF1 (Thyroid Transcription Factor 1) were still expressed in these early cystic lesions suggesting metastasis as a faulty recapitulation of ontogeny (Rapp et al, 2008). Interestingly, mixed cystic lesions and metastatic tumors contained DsRed and SpC positive cells. These results demonstrate secondary tumor progression from cystic, mixed cystic to malignant transformation. Our results shed tremendous light on reprogramming of metastasizing cells during secondary tumor development. Moreover, such fluorescent tagged metastatic mice model can also be used to track the migration ability of metastatic cancer cell to different organs and its potential to differentiate into other cell types such as blood vessel or stromal cell within the primary tumor.
Non–Small-Cell Lung Cancer (NSCLC) is the most frequent human lung cancer and a major cause of death due to its high rate of metastasis1. These facts emphasize the urgent need for the investigation of new targets for anti-metastatic therapy. Up to now a number of genes and gene products have been identified that positively or negatively affect the probability of established human tumor cell lines to metastasize2. Previously, together with the group of Professor Ulf Rapp, we have described the first conditional mouse model for metastasis of NSCLC and identified a gene, c-MYC, that is able to orchestrate all steps of this process. We could identify potential markers for detection of metastasis and highlighted GATA4, which is exclusively expressed during lung development, as a target for future therapeutic intervention2. However, the mechanism underlying this metastatic conversion remained to be identified, and was therefore the focus of the present work. Here, GATA4 is identified as a MYC target in the development of metastasis and epigenetic alterations at the GATA4 promoter level are shown after MYC expression in NSCLC in vivo and in vitro. Such alterations include site-specific demethylation that accompanies the displacement of the MYC-associated zinc finger protein (MAZ) from the GATA4 promoter, which leads to GATA4 expression. Histone modification analysis of the GATA4 promoter revealed a switch from repressive histone marks to active histone marks after MYC binding, which corresponds to active GATA4 expression. This work identifies a novel epigenetic mechanism by which MYC activates GATA4 leading to metastasis in NSCLC, suggesting novel potential targets for the development of anti-metastatic therapy.