[HTML][HTML] IL-6 mediates platinum-induced enrichment of ovarian cancer stem cells

Y Wang, X Zong, S Mitra, AK Mitra, D Matei… - JCI insight, 2018 - ncbi.nlm.nih.gov
Y Wang, X Zong, S Mitra, AK Mitra, D Matei, KP Nephew
JCI insight, 2018ncbi.nlm.nih.gov
In high-grade serous ovarian cancer (OC), chemotherapy eliminates the majority of tumor
cells, leaving behind residual tumors enriched in OC stem cells (OCSC). OCSC, defined as
aldehyde dehydrogenase–positive (ALDH+), persist and contribute to tumor relapse.
Inflammatory cytokine IL-6 is elevated in residual tumors after platinum treatment, and we
hypothesized that IL-6 plays a critical role in platinum-induced OCSC enrichment. We
demonstrate that IL-6 regulates stemness features of OCSC driven by ALDH1A1 expression …
Abstract
In high-grade serous ovarian cancer (OC), chemotherapy eliminates the majority of tumor cells, leaving behind residual tumors enriched in OC stem cells (OCSC). OCSC, defined as aldehyde dehydrogenase–positive (ALDH+), persist and contribute to tumor relapse. Inflammatory cytokine IL-6 is elevated in residual tumors after platinum treatment, and we hypothesized that IL-6 plays a critical role in platinum-induced OCSC enrichment. We demonstrate that IL-6 regulates stemness features of OCSC driven by ALDH1A1 expression and activity. We show that platinum induces IL-6 secretion by cancer-associated fibroblasts in the tumor microenvironment, promoting OCSC enrichment in residual tumors after chemotherapy. By activating STAT3 and upregulating ALDH1A1 expression, IL-6 treatment converted non-OCSC to OCSC. Having previously shown altered DNA methylation in OCSC, we show here that IL-6 induces DNA methyltransferase 1 (DNMT1) expression and the hypomethylating agent (HMA) guadecitabine induced differentiation of OCSC and reduced—but did not completely eradicate—OCSC. IL-6 neutralizing antibody (IL-6-Nab) combined with HMA fully eradicated OCSC, and the combination blocked IL-6/IL6-R/pSTAT3–mediated ALDH1A1 expression and eliminated OCSC in residual tumors that persisted in vivo after chemotherapy. We conclude that IL-6 signaling blockade combined with an HMA can eliminate OCSC after platinum treatment, supporting this strategy to prevent tumor recurrence after standard chemotherapy.
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