Abstract 3084: Progesterone receptor mediated crosstalk between cancer associated fibroblasts (CAFs) and ER+/PR+ breast cancer cells through CAF-secreted FGF2
Authors: Spartz Angela K. , Diep Caroline H. , Lange Carol A. , El-Ashry Dorraya 
Published: June 2023

Abstract
Late recurring ER+ breast cancer emerges in post-menopausal women despite low/no hormone conditions. Cancer associated fibroblasts (CAFs) represent a major player in the promotion of metastasis, stemness and chemotherapy resistance in breast cancer. Progesterone receptors (PR) are emerging as drivers of stemness and metastasis in ER+ breast cancers. We propose that CAFs provide a mechanism to turn on ligand-independent PR signaling pathways through the secretion of paracrine factors.
Methods: Tumorsphere assays were used to measure stem cell expansion. Cell clustering assays were used to measure CAF/tumor cell interactions. ChIP assays were used to measure PR direct binding to stemness gene regulatory elements.
Results: Using the ER(+) T47D cell series (i.e., PR-null variants or cells expressing either endogenous PR (T47DCO) or PR-A or PR-B isoforms), we observed that CAF conditioned media (CM) increased tumorsphere formation in PR+ cells relative to PR-null and controls. Similar results were obtained with MCF7L cell models. CAF CM activated MAPK/ERK kinases and induced rapid phosphorylation of PR at Ser294. Physical interaction between CAFs and PR expressing T47D and MCF7L cells in clustering assays demonstrated PR driven co-cluster formation. CAF-derived FGF2 increased PR dependent tumorsphere and co-cluster formation. Blockage of FGF2 with the inhibitor, PD173074, decreased CAF CM-induction of tumorspheres and co-cluster formation. Previous data demonstrated that the cell adhesion molecule, CD44, is implicated in CAF/BC co-cluster formation. Both FGF2 and progestins increased CD44 expression in ER+ breast cancer cell models. Chromatin immunoprecipitation (ChIP) assays demonstrated that both PR isoforms are recruited to PRE-containing regions in the CD44 gene in response to progestin. Finally, we compared the gene expression profiles of breast cancer cells from T47DCO mono-clusters and CAF/T47DCO co-clusters using Single Cell RNA Seq. Among the differentially expressed genes identified were two genes implicated in tamoxifen resistance, BAMBI and NR2F2.
Conclusion: We propose a model in which clustering between CAFs and ER+/PR+ breast cancer cells is promoted by the CAF secreted factor, FGF2. FGF2 promotes PR activation and upregulation of CD44 expression, which may further increase physical cell-cell interactions. Importantly, CAF-derived FGF2 can also act through PR to initiate MAPK/ERK signaling pathways that drive stemness and endocrine therapy resistance. Our studies of the interactions between PR+ breast cancer cells with CAFs either in the primary tumor or in the circulation (as CAF/CTC clusters) suggest the need to include anti-progestins as a component of endocrine therapy in late recurring ER+ breast cancer.
Citation Format: Angela K. Spartz, Caroline H. Diep, Carol A. Lange, Dorraya El-Ashry. Progesterone receptor mediated crosstalk between cancer associated fibroblasts (CAFs) and ER+/PR+ breast cancer cells through CAF-secreted FGF2 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3084.