VEGF-C-expressing TAMs rewire the metastatic fate of breast cancer cells
Kaveri Banerjee,
Thomas Kerzel,
Tove Bekkhus,
Sabrina de Souza Ferreira,
Tatjana Wallmann,
Majken Wallerius,
Laura-Sophie Landwehr,
Dennis Alexander Agardy,
Nele Schauer,
Anna Malmerfeldt,
Jonas Bergh,
Margarita Bartish,
Johan Hartman,
Arne Östman,
Mario Leonardo Squadrito,
Charlotte Rolny
Affiliations
Kaveri Banerjee
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden
Thomas Kerzel
San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; Vita Salute San Raffaele University, 20132 Milan, Italy
Tove Bekkhus
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden
Sabrina de Souza Ferreira
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden
Tatjana Wallmann
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden
Majken Wallerius
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden
Laura-Sophie Landwehr
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden
Dennis Alexander Agardy
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden
Nele Schauer
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden
Anna Malmerfeldt
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden
Jonas Bergh
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden; Breast Center, Karolinska Comprehensive Cancer Center and Karolinska University Hospital, 17176 Stockholm, Sweden
Margarita Bartish
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden; Gerald Bronfman Department of Oncology, Segal Cancer Centre, Lady Davis Institute and Jewish General Hospital, McGill University, Montreal, QC H3T 1E2, Canada
Johan Hartman
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden; Department of Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, 17176 Stockholm, Sweden
Arne Östman
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden
Mario Leonardo Squadrito
San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; Vita Salute San Raffaele University, 20132 Milan, Italy; Corresponding author
Charlotte Rolny
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden; Corresponding author
Summary: The expression of pro-lymphangiogenic VEGF-C in primary tumors is associated with sentinel lymph node metastasis in most solid cancer types. However, the impact of VEGF-C on distant organ metastasis remains unclear. Perivascular tumor-associated macrophages (TAMs) play a crucial role in guiding hematogenous spread of cancer cells by establishing metastatic pathways within the tumor microenvironment. This process supports breast cancer cell intravasation and metastatic dissemination. We show here that VEGF-C-expressing TAMs reduce the dissemination of mammary cancer cells to the lungs while concurrently increasing lymph node metastasis. These TAMs express podoplanin and interact with normalized tumor blood vessels expressing VEGFR3. Moreover, clinical data suggest inverse association between VEGF-C-expressing TAMs and breast cancer malignancy. Thus, our study elucidates the paradoxical role of VEGF-C-expressing TAMs in redirecting cancer cells to preferentially disseminate to lymph nodes rather than to lungs, partially achieved by normalizing tumor blood vessels and promoting lymphangiogenesis.