YAP1 mediates gastric adenocarcinoma peritoneal metastases that are attenuated by YAP1 inhibition

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<jats:sec><jats:title>Objective</jats:title><jats:p>Peritoneal carcinomatosis (PC; malignant ascites or implants) occurs in approximately 45% of advanced gastric adenocarcinoma (GAC) patients and associated with a poor survival. The molecular events leading to PC are unknown. The yes-associated protein 1 (<jats:italic>YAP1</jats:italic>) oncogene has emerged in many tumour types, but its clinical significance in PC is unclear. Here, we investigated the role of YAP1 in PC and its potential as a therapeutic target.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Patient-derived PC cells, patient-derived xenograft (PDX) and patient-derived orthotopic (PDO) models were used to study the function of YAP1 in vitro and in vivo. Immunofluorescence and immunohistochemical staining, RNA sequencing (RNA-Seq) and single-cell RNA-Seq (sc-RNA-Seq) were used to elucidate the expression of YAP1 and PC cell heterogeneity. LentiCRISPR/Cas9 knockout of YAP1 and a YAP1 inhibitor were used to dissect its role in PC metastases.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>YAP1 was highly upregulated in PC tumour cells, conferred cancer stem cell (CSC) properties and appeared to be a metastatic driver. Dual staining of YAP1/EpCAM and sc-RNA-Seq revealed that PC tumour cells were highly heterogeneous, YAP1<jats:sup>high</jats:sup> PC cells had CSC-like properties and easily formed PDX/PDO tumours but also formed PC in mice, while genetic knockout YAP1 significantly slowed tumour growth and eliminated PC in PDO model. Additionally, pharmacologic inhibition of YAP1 specifically reduced CSC-like properties and suppressed tumour growth in YAP1<jats:sup>high</jats:sup> PC cells especially in combination with cytotoxics in vivo PDX model.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>YAP1 is essential for PC that is attenuated by YAP1 inhibition. Our data provide a strong rationale to target YAP1 in clinic for GAC patients with PC.</jats:p></jats:sec>

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  • Gut

    Gut 70 (1), 55-66, 2020-04-27

    BMJ

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