Anti-Cancer Activity of Verteporfin in Cholangiocarcinoma

SIMPLE SUMMARY: Cholangiocarcinoma (CCA) is a highly lethal malignancy, and its prognosis is poor. There are unmet needs to develop effective therapies. The overexpression of Hippo/YAP pathway and the association of Hippo/YAP pathway with an immunosuppressive microenvironment is indicated with bulk RNA sequencing data. In this study, we investigated the antitumoral effect of verteporfin in CCA YAP/AKT murine models. We found that verteporfin reduced liver weight and tumor formation in CCA YAP/AKT mice. Our results also showed the change in immune cell composition in liver/tumors with the treatment of verteporfin as well as the inhibition of cancer stemness. Our data suggest the potential application of verteporfin in patients with an overexpression of Hippo/YAP pathway. ABSTRACT: Cholangiocarcinoma (CCA) is a heterogenous malignancy that arises from the biliary epithelium and has a poor clinical prognosis. The Hippo/yes-associated protein (YAP) pathway has been reported to affect various aspects of tumorigenesis, with high expression of YAP1 being negatively associated with survival in CCA patients. Thus, we investigated the antitumoral effect of verteporfin, a YAP1 pathway inhibitor, in YAP1/AKT hydrodynamic tail vein injected murine models. We also used flow cytometry and single-cell RNA sequencing (scRNA-seq) to analyze the change in the immune cell profile and malignant cell stemness following verteporfin treatment. Our results demonstrated reduced liver weight and tumor formation in verteporfin-treated groups compared to that of a vehicle-treated group. Immune cell profiling through flow cytometry showed that relative to the vehicle, verteporfin induced a higher ratio of tumor-associated macrophage (TAM) M1/M2 and increased the percentage of activated CD8 T cell population (CD8+CD25+ and CD8+CD69+). scRNA-seq analysis showed significantly increased TAM M1 populations following verteporfin treatment and decreased proportions of stem-like cells within the malignant cell population. In summary, this study indicates that in CCA YAP/AKT murine models, verteporfin reduces tumorigenesis by polarizing anti-tumoral TAM and activating CD8 T cells and decreasing stem-like malignant cell proportions in the tumor microenvironment.