Cellular Plasticity: A Route to Senescence Exit and Tumorigenesis

SIMPLE SUMMARY: Senescence is a form of cell cycle arrest induced by stresses such as DNA damage and oncogenes and therefore constitutes a crucial barrier against cancer. Nevertheless, senescent cells can escape or bypass this tumor suppressor mechanism and evolve towards an altered, pre-cancerous genotype. Furthermore, accumulated senescent cells that are not cleared by the immune system secrete pro-inflammatory factors, promoting malignant phenotypes. This pro-tumor activity of senescence is associated with genetic reprogramming and the acquisition of cellular plasticity. In this review, we aim to unravel the interconnection between senescence, senescence-associated pro-inflammatory cytokines and the induction of cellular plasticity, which enables the adaptability of tumor cells at different stages of carcinogenesis. ABSTRACT: Senescence is a dynamic, multistep program that results in permanent cell cycle arrest and is triggered by developmental or environmental, oncogenic or therapy-induced stress signals. Senescence is considered as a tumor suppressor mechanism that prevents the risk of neoplastic transformation by restricting the proliferation of damaged cells. Cells undergoing senescence sustain important morphological changes, chromatin remodeling and metabolic reprogramming, and secrete pro-inflammatory factors termed senescence-associated secretory phenotype (SASP). SASP activation is required for the clearance of senescent cells by innate immunity. Therefore, escape from senescence and the associated immune editing would be a prerequisite for tumor initiation and progression as well as therapeutic resistance. One of the possible mechanisms for overcoming senescence could be the acquisition of cellular plasticity resulting from the accumulation of genomic alterations and genetic and epigenetic reprogramming. The modified composition of the SASP produced by these reprogrammed cancer cells would create a permissive environment, allowing their immune evasion. Additionally, the SASP produced by cancer cells could enhance the cellular plasticity of neighboring cells, thus hindering their recognition by the immune system. Here, we propose a comprehensive review of the literature, highlighting the role of cellular plasticity in the pro-tumoral activity of senescence in normal cells and in the cancer context.