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2015 ; 2
(8
): 684-92
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How to target small cell lung cancer
#MMPMID26425658
Hamilton G
; Rath B
; Ulsperger E
Oncoscience
2015[]; 2
(8
): 684-92
PMID26425658
show ga
Small cell lung cancer (SCLC) is a highly malignant disease with dismal
prognosis. Although great progress has been made in investigating genetic
aberrations and putative drivers of this tumor entity, the mechanisms of rapid
dissemination and acquisition of drug resistance are not clear. The majority of
SCLC cases are characterized by inactivation of the tumor suppressors p53 and
retinoblastoma (Rb) and, therefore, interchangeable drivers will be difficult to
target successfully. Access to pure cultures of SCLC circulating tumor cells
(CTCs) and study of their tumor biology has revealed a number of new potential
targets. Most important, expression of chitinase-3-like-1/YKL-40 (CHI3L1) which
controls expression of vascular epithelial growth factor (VEGF) and matrix
metalloproteinase-9 (MMP9) was newly described in these cells. The process
switching CHI3L1-negative SCLC cells to CHI3L1-positive CTCs seems to be
associated with cytokines released by inflammatory immune cells. Furthermore,
these CTCs were found to promote monocyte-macrophage differentiation, most likely
of the M2 tumor-promoting type, recently described to express PD-1 immune
checkpoint antigen in SCLC. In conclusion, dissemination of SCLC seems to be
linked to conversion of regular tumor cells to highly invasive CHI3L1-positive
CTCs, which are protected by immune system suppression. Besides the classical
targets VEGF, MMP-9 and PD-1, CHI3L1 constitutes a new possibly drugable molecule
to retard down dissemination of SCLC cells, which may be similarly relevant for
glioblastoma and other tumor entities.