The Stress-Inducible BCL2A1 Is Required for Ovarian Cancer Metastatic Progression in the Peritoneal Microenvironment

SIMPLE SUMMARY: Cancer metastasis is still the main cause of cancer-related mortality. Peritoneal metastases are the first presentation of advanced ovarian cancer, and metastatic cancer cells tend to disseminate trans-peritoneally in the peritoneal cavity. Hypoxia is a critical factor in governing transcoelomic metastases of ovarian cancer. Therefore, targeting hypoxia appears to be a promising approach to arrest cancer metastasis. In the present work, we identified that BCL2A1, a BCL2 family member, is significantly induced by hypoxia and other physiological stresses by NF-κB signaling and followed by a gradual degradation. The upregulated BLC2A1 has been shown to enhance ovarian cancer survival, tumor growth, and tumor dissemination by suppressing intrinsic cell apoptosis. These data indicate BCL2A1 is an early response factor in the stressed tumor microenvironment, and targeting BCL2A1 may be a potential therapeutic approach in eradicating peritoneal metastases of ovarian cancer. ABSTRACT: Emerging evidence indicates that hypoxia plays a critical role in governing the transcoelomic metastasis of ovarian cancer. Hence, targeting hypoxia may be a promising approach to prevent the metastasis of ovarian cancer. Here, we report that BCL2A1, a BCL2 family member, acts as a hypoxia-inducible gene for promoting tumor progression in ovarian cancer peritoneal metastases. We demonstrated that BCL2A1 was induced not only by hypoxia but also other physiological stresses through NF-κB signaling and then was gradually reduced by the ubiquitin-proteasome pathway in ascites-derived ovarian cancer cells. The upregulated BCL2A1 was frequently found in advanced metastatic ovarian cancer cells, suggesting its clinical relevance in ovarian cancer metastatic progression. Functionally, BCL2A1 enhanced the foci formation ability of ovarian cancer cells in a stress-conditioned medium, colony formation in an ex vivo omental tumor model, and tumor dissemination in vivo. Under stress conditions, BCL2A1 accumulated and colocalized with mitochondria to suppress intrinsic cell apoptosis by interacting with the BH3-only subfamily BCL2 members HRK/BAD/BID in ovarian cancer cells. These findings indicate that BCL2A1 is an early response factor that maintains the survival of ovarian cancer cells in the harsh tumor microenvironment.