Cell-to-Cell Communication in Cancer
Credit: iStock
Cells need to interact with one another to maintain homeostasis and facilitate cell growth, death and differentiation. This cell-to-cell communication is critical in tumor development, as it enables cancer cells to reprogram the surrounding tumor microenvironment to achieve survival processes such as immune evasion and drug resistance.
Circulating tumor cells (CTCs), which arise when a cancer begins to metastasize, rely on cell-to-cell communication for protection against physical and immune pressures as they migrate round the body.
This article explores how cell-to-cell communication can be targeted for novel treatment methods.
Download this article to discover:
- How CTCs can be used as early diagnostic and treatment markers
- How immunotherapy hijacks cell-to-cell communication to kill cancer cells
- Novel methods for targeting metastasis
Cell-to-Cell Communication in Cancer
Article Published: February 6, 2024 | Kerry Taylor-Smith
Credit: iStock
The body is made up of trillions of cells constantly adjusting to their environment
and exchanging millions of signals essential for survival. Their communication
must be carefully controlled because any disruption can result in mistakes, such as
the abnormal proliferation of cells we see in cancer.1
We typically think of a cancerous tumor as a bunch of abnormal cells gone rogue –
cells that have rapidly and uncontrollably multiplied because their cell signaling
pathways have gone awry. However, the situation is more complicated; these cells
communicate with each other and other cells in their environment and work
together in a strategic fashion.2
This article will explore cell-to-cell communication’s role in cancer development, its
influence on metastasis and how research is expanding our knowledge of the
disease.
What is cell-to-cell communication?
“Essentially, cell-to-cell communication describes how cells interact with each other
to maintain a state of homeostasis or normality,” explains Dr. Eric Rahrmann,
senior research associate at Cancer Research UK’s Cambridge Institute. “It’s much
like a conversation between people where a cell engages another cell by sending
out signals or physical interactions and the receiving cell responds to this signal.
For example, a cell could secrete a peptide and the neighboring cell receives the
signal, interprets and actions it. The process is essential in normal human
development and functioning, especially in differentiation and specialization of
cells such as stem cells.”
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“Cells communicate with each other in many ways, including secreting hormones
that bind to receptors in neighboring cells and through direct contact with each
other’s surfaces,” adds Dr. Stuart S. Martin, professor of pharmacology at the
University of Maryland School of Medicine and deputy director and associate
director of basic research at the Marlene and Stewart Greenebaum
Comprehensive Cancer Center. “These signals and contacts determine cell growth,
cell death and cell differentiation.”
In cancer, cell-to-cell communication is corrupted by cells miscuing and sending
out signals that allow a self-serving environment to be created, evading the cues of
cell-to-cell communication. “If cell A has a mutation and no longer responds to
signals from cell B, it can grow exponentially and create a tumor,” Rahrmann
explains.
Cell-to-cell communication has a critical role in tumor development and evolution
as it enables cancer cells to reprogram the surrounding tumor microenvironment –
and cells located elsewhere. Communication between tumor-causing cells and
other cells supports several processes necessary for tumor development and
distribution such as angiogenesis, immune escape, invasion and multi-drug
resistance.
This communication may be via membrane receptors and ligands or via soluble
molecules like growth factors, cytokines and chemokines. Additionally, microRNAs
and extracellular vesicles have recently been identified as additional means of cell
communication. Circulating microRNAs are often deregulated in many cancers
and, and as they affect all the disease’s hallmarks, they may be good biomarkers
for cancers, while extracellular vesicles released from cancerous cells contribute to
tumor growth and distribution.3
Cell-to-cell communication and metastasis
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Metastasis occurs when cancer cells break away from their original location and
travel via the bloodstream to set up camp in other organs in the body like the
lungs, bone, brain or liver. Metastasis is the leading cause of death from cancer,
explains Martin: “The original tumor almost never causes the patient to die.
Instead, when these cancer cells form new tumors in the distant organs, these new
metastatic tumors are what causes patient death.”
“The process of metastasis is actually very inefficient and the cancerous cells
undergo many changes to survive their journey and be successful in their new
environment,” says Rahrmann. “Communication enables the process to become
more efficient in many ways, for example, tumor cells may partner with
neutrophils, a type of white blood cell in the immune system, to create a protumor
environment.”
Tumor cells sometimes migrate together, like an island moving through the
bloodstream with its own microenvironment, searching for a new site. These cells
change how they communicate with non-cancerous cells – vasculature or immune
cells for example – to enable their survival. “Cell induction creates signals which
change and support the tumor cells rather than normal cells,” Rahrmann explains.
Migrating tumor cells are known as circulating tumor cells or CTCs, and work in the
past decade has revealed that when they cluster together, their ability to
successfully form metastatic tumors is up to 50 times higher. “Cell-to-cell
communication between the tumor cells in the CTC cluster can help the tumor cells
survive the harsh environments they encounter during metastasis,” says Martin.
“In the bloodstream, CTCs face strong physical pressures of flow and constriction
as well as immune cell attack. In the distant tissues, the growth environment is
very different than the original tissues, so many CTCs will die or stop growing
permanently. CTCs in a cluster gain protection from the cell-to-cell communication,
to both survive in the bloodstream and successfully regrow in the distant organ,”
he continues.
Martin’s lab focuses on rapidly testing patient tumor cells for metastatic behaviors,
rather than growth. “In this way, we can determine within a few hours which drugs
can potentially reduce the risk of metastasis most effectively for the specific cells
from that patient's tumor,” explains Martin. His team developed a microfluidic
technology that can test small amounts of patient tumor cells recovered from
needle biopsies or blood samples. “We can determine multiple metastatic
behaviors in these tumor cells within a few hours, and whether specific drug
treatments can reduce the metastatic activity in these cells and lower the risk of
metastasis,” Martin says.
Cancer’s ability to metastasize has also been linked to the electrical activity of cells,
and research has demonstrated prostate cancer cells’ ability to alter their baseline
voltage to open sodium ion channels in their membranes. This channel can be
opened by cancer cells to let in ions that make them more likely to metastasize;
closing the channel could be a way to stop it from happening.2
Conversely, Rahrmann et al. have identified that the loss of function of sodium leak
channel non-selective protein (NALCN) in gastrointestinal cancers promotes
metastatic disease by enhancing the release of CTCs. By viewing metastasis as a
“normal phenomenon” rather than something unique to cancer, they found that
NALCN regulates both normal and cancerous epithelial cell dissemination,
divorcing the process of metastasis from cancer.4
“These normal disseminated epithelial-like cells can ‘metastasize’ to distant organs,
but instead of making tumors, they contribute to apparently normal structures in
these tissues such as kidney tubules,” Rahrmann says. “For this to occur, seeded
circulating epithelial-like stem cells must communicate with neighboring cells in
their new environment to mimic or adapt to a new cell state.”
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Research has changed the way we think about cancer, and therefore how we
approach treating it. Now we know that different parts of the tumor signal to each
other to coordinate growth, blocking their conversation could pave the way for
new treatment strategies.
Additionally, tumor cells can mask themselves, tricking the immune system into
thinking they are “normal” cells, says Rahrmann: “Tumor cells engage with
receptors that mask the tumor; they adopt the tissue’s features to make it look like
they belong. Cell-to-cell communication allows the tumor cell to engage with
normal cells, allowing them to exist. There are huge ongoing efforts to disrupt cells
masking as normal cells and reveal their identity. For example, small molecule
inhibitors are being used to block the masking signal, let the immune system
recognize them and inhibit the activity of tumor cells.”
Rahrmann notes several types of immunotherapies that are useful in treating
cancer, including monoclonal antibody therapies designed to recognize specific
proteins on cancer cells, just like the body would. It hijacks cell-to-cell
communication so drug therapies can be released into the tumor and kill the
disease; examples include trastuzumab and rituximab, which work in different
ways to kill cancer cells or stop them from growing.5
Another is CAR T-cell therapy, a type of adoptive cell transfer, which involves
harvesting a patient’s immune cells and teaching them to identify and target tumor
cells. A receptor designed to recognize and target a specific protein on the cancer
cells is added to the immune cells and, once administered back to the patient,
these cells kill the tumor.6
Future treatments will continue to be aimed at blocking cell-to-cell communication,
Martin says, and there are already several existing therapies used to treat breast
cancer. These include selective estrogen receptor modulators (SERMS) like
tamoxifen or raloxifene, which block the estrogen signals that help breast cancer
cells grow, as well as aromatase inhibitors like letrozole, anastrozole and
exemestane, which block estrogen production.
“These drugs are already important tools to block cell-to-cell communication in
breast cancer, and hopefully serve as a model to develop similar cell-to-cell
communication targeting,” he says.
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Other research is focused on metastasis as there are “very few drugs that target
these metastatic steps and limited options for following the process of metastasis
more carefully in patients,” Martin says. “This is where new methods for detecting
cancer in patients through liquid biopsies and new imaging methods in animal
models of cancer can help identify critical steps for stopping metastasis.”
Current research is also helping to reveal important limitations of our existing and
previous methods, Martin adds: “For example, current clinical imaging can only
detect a tumor once it reaches a size of between 10 million and 100 million cells.
As an inevitable result, the methods for monitoring patients and developing new
cancer treatments have focused on reducing the growth of very large tumors.”
As cancer evolves and evades treatment, therapies and treatment must also
change, and new research, particularly on cell-to-cell communication, is teaching
us more and more about how to treat and manage this devastating disease.
About the interviewees:
Dr. Eric Rahrmann is a senior research associate in the laboratory of Professor Richard Gilbertson at
Cancer Research UK (CRUK) - Cambridge Institute (within the University of Cambridge) and training
director for CRUK Cambridge Cancer Centre Brain Cancer Virtual Institute. The group aim to
improve the accuracy of brain tumor classification and treatment.
Dr. Stuart S. Martin is a professor of pharmacology at the University of Maryland School of Medicine
and deputy director and associate director of basic research at the Marlene and Stewart
Greenebaum Comprehensive Cancer Center. His lab is working to apply engineering and physical
sciences to improve the understanding of cancer metastasis.
References (Click to expand)
+
References
1. ‘We need to talk’: how and why cells communicate and what happens
when things go wrong. Babraham Institute. Published March 18, 2022.
Accessed 8th December 2023. https://www.babraham.ac.uk/blog/how-docellscommunicate?
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2. Owens J. Understanding Cell-to-Cell Communication in
Cancer. Technology Networks. Published August 1, 2023. Accessed 8th
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cell-communication-in-cancer-
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signaling: how to turn bad language into positive one. J Exp Clin Cancer Res.
2019;38(1):128. doi: 10.1186/s13046-019-1122-2
4. Rahrmann EP, Shorthouse D, Jassim A, et al. The NALCN channel
regulates metastasis and nonmalignant cell dissemination. Nat Genet.
2022;54(12):1827-1838. doi: 10.1038/s41588-022-01182-0
5. Monoclonal Antibodies (MABs). Cancer Research UK. Accessed 8th
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