Collective cancer cell calcium activity drives brain metastasis

Communication in multicellular networks is a cancer-intrinsic neural feature and crucial for primary brain tumor growth and resistance, but it is unclear whether brain metastases (BrM), the most common and deadliest brain malignancy, are also driven by communicating cancer networks. Using intravital two-photon microscopy in awake mice, clinical specimens, and Ca2+ integrators, we demonstrate that brain-colonizing breast and lung cancer and melanoma cells display gap-junction-dependent, coordinated Ca2+ activity in multicellular, cancer-cell intrinsic networks, which drives their proliferation. Mechanistically, Ca2+ oscillations induce transcription of immediate early genes, adoption of a neuronal expression profile, and cell cycle progression. While many of those features are enriched in BrM, all investigated cancer cell lines showed collective Ca2+ activity. Therapeutically, blocking Ca2+ activity with gap junction inhibitors reduces BrM burden in mouse models. Here we show communicating cancer cell syncytia as drivers of BrM growth, pointing to a targetable pathomechanism, and potentially a new pan-cancer hallmark. Graphical AbstractIn brief Brain metastases form gap-junction-coupled networks exhibiting spontaneous, coordinated Ca2+ activity linked to immediate early gene activation, neuronal gene programs, and cell cycle progression. Disrupting Ca2+ network communication with gap junction inhibitors induces cell cycle arrest and reduces brain metastatic burden in vivo. O_FIG O_LINKSMALLFIG WIDTH=195 HEIGHT=200 SRC="FIGDIR/small/723715v1_ufig1.gif" ALT="Figure 1"> View larger version (88K): org.highwire.dtl.DTLVardef@23d885org.highwire.dtl.DTLVardef@15c112borg.highwire.dtl.DTLVardef@16b323dorg.highwire.dtl.DTLVardef@af49ac_HPS_FORMAT_FIGEXP M_FIG C_FIG HighlightsO_LIBrain metastases display collective Ca2+ activity in gap-junction-coupled networks C_LIO_LICa2+ co-activity is conserved across cancers but enriched in brain metastasis C_LIO_LICa2+ oscillations robustly induce neuronal gene programs and cell cycle progression C_LIO_LIGap junction inhibition reduces brain metastasis burden in mice C_LI