Inflammation awakens dormant cancer cells by modulating the epithelial–mesenchymal phenotypic state

J Jingwei Zhang (State Key Laboratory and Institute of Elemento-Organic Chemistry, College of Chemistry, Frontiers Science Center for New Organic Matter) J Jingwen Zhang L Longfei Han (State Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences) S Shiyi Wu (Whitehead Institute for Biomedical Research) J Jie Li E Elinor Ng Eaton (Whitehead Institute for Biomedical Research) B Bingbing Yuan (Center of Excellence for Renewable Energy and Storage Technologies (CREST), Division of Physical Science and Engineering, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia.) F Ferenc Reinhardt (Whitehead Institute for Biomedical Research) H Hao Li P Patrick C. Strasser (Whitehead Institute for Biomedical Research) S Sunny Das (Whitehead Institute for Biomedical Research) J Joana Liu Donaher (Whitehead Institute for Biomedical Research) M Md Imtiaz Khalil (Whitehead Institute for Biomedical Research) H Haiping Jiang A Alexander Deuschel (Whitehead Institute for Biomedical Research) D Danni Lin C Carolin Sebastiany (Whitehead Institute for Biomedical Research) M Mariana Maranga (Whitehead Institute for Biomedical Research) S Salomé Shubitidze (Whitehead Institute for Biomedical Research) X Xiaofei Liu (School of Pharmaceutical Sciences) A Arthur W. Lambert (Whitehead Institute for Biomedical Research) Y Yun Zhang Y Yana Liu (New Cornerstone Science Laboratory, MOE Key Laboratory for Analytical Science of Food Safety and Biology, Fujian Key Laboratory of Analysis and Testing Technology for Food Safety and Health, College of Chemistry) L Lufei Sui (Vascular Biology Program, Boston Children’s Hospital) S Sarah Elmiligy (The David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology) U Umberto Pozza (Whitehead Institute for Biomedical Research) R Rauf Günsay (Whitehead Institute for Biomedical Research) R Ranjan Mishra (Whitehead Institute for Biomedical Research) J Jose Velarde (Whitehead Institute for Biomedical Research) S Sonia Iyer (Whitehead Institute for Biomedical Research) W Whitney S. Henry (Whitehead Institute for Biomedical Research) K Kipp Weiskopf (Whitehead Institute for Biomedical Research) G Guihai Feng (State Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences) T Tobiloba E. Oni (Whitehead Institute for Biomedical Research) R Randolph S. Watnick (Vascular Biology Program, Boston Children’s Hospital) X Xin Li R Robert A. Weinberg

Abstract

The awakening of dormant disseminated cancer cells appears to be responsible for the clinical relapses of patients whose primary tumors have been successfully cured months and even years earlier. In the present study, we demonstrate that dormant breast cancer cells lodged in the lungs reside in a highly mesenchymal, nonproliferative phenotypic state. The awakening of these cells is not triggered by a cancer cell-autonomous process. Instead, lung inflammation induced by the chemotherapeutic agent bleomycin effectively awakens dormant cancer cells, providing useful models for studying metastatic awakening. Mechanistically, the awakened cells shift from a highly mesenchymal to a quasi-mesenchymal phenotypic state in which they acquire tumorigenicity and proliferative ability. Once awakened, these cells can stably reside in this quasi-mesenchymal state and maintain their tumor-initiating ability, doing so without ongoing heterotypic signaling from the lung microenvironment. Epidermal growth factor receptor ligands released by the cells of the injured tissue microenvironment, including notably M2 type macrophages, promote dormant cancer cells to move toward this quasi-mesenchymal state, a transition that is critical for the awakening process. An understanding of the mechanisms of metastatic awakening may lead in the future to treatment strategies designed to prevent such awakening and resulting metastatic relapse.

Article Details

Volume / Issue Vol. 122, Issue 36
Published September 09, 2025
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (37)

J

Jingwei Zhang

State Key Laboratory and Institute of Elemento-Organic Chemistry, College of Chemistry, Frontiers Science Center for New Organic Matter

J

Jingwen Zhang

L

Longfei Han

State Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences

S

Shiyi Wu

Whitehead Institute for Biomedical Research

J

Jie Li

E

Elinor Ng Eaton

Whitehead Institute for Biomedical Research

B

Bingbing Yuan

Center of Excellence for Renewable Energy and Storage Technologies (CREST), Division of Physical Science and Engineering, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia.

F

Ferenc Reinhardt

Whitehead Institute for Biomedical Research

H

Hao Li

P

Patrick C. Strasser

Whitehead Institute for Biomedical Research

S

Sunny Das

Whitehead Institute for Biomedical Research

J

Joana Liu Donaher

Whitehead Institute for Biomedical Research

M

Md Imtiaz Khalil

Whitehead Institute for Biomedical Research

H

Haiping Jiang

A

Alexander Deuschel

Whitehead Institute for Biomedical Research

D

Danni Lin

C

Carolin Sebastiany

Whitehead Institute for Biomedical Research

M

Mariana Maranga

Whitehead Institute for Biomedical Research

S

Salomé Shubitidze

Whitehead Institute for Biomedical Research

X

Xiaofei Liu

School of Pharmaceutical Sciences

A

Arthur W. Lambert

Whitehead Institute for Biomedical Research

Y

Yun Zhang

Y

Yana Liu

New Cornerstone Science Laboratory, MOE Key Laboratory for Analytical Science of Food Safety and Biology, Fujian Key Laboratory of Analysis and Testing Technology for Food Safety and Health, College of Chemistry

L

Lufei Sui

Vascular Biology Program, Boston Children’s Hospital

S

Sarah Elmiligy

The David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology

U

Umberto Pozza

Whitehead Institute for Biomedical Research

R

Rauf Günsay

Whitehead Institute for Biomedical Research

R

Ranjan Mishra

Whitehead Institute for Biomedical Research

J

Jose Velarde

Whitehead Institute for Biomedical Research

S

Sonia Iyer

Whitehead Institute for Biomedical Research

W

Whitney S. Henry

Whitehead Institute for Biomedical Research

K

Kipp Weiskopf

Whitehead Institute for Biomedical Research

G

Guihai Feng

State Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences

T

Tobiloba E. Oni

Whitehead Institute for Biomedical Research

R

Randolph S. Watnick

Vascular Biology Program, Boston Children’s Hospital

X

Xin Li

R

Robert A. Weinberg