In
prostate cancer metastases to
bone, cancer cell-derived
cytokines stimulate RANKL expression by cells of the osteoblast lineage, which in turn activates osteoclastic
bone resorption. However, it is unclear whether cells of the osteoblast lineage signal back to
prostate cancer cells, and if so, whether such direct cross-talk can be targeted therapeutically. Using the human
prostate cancer cell line, PC3, we identified two novel signalling pathways acting between cells of the osteoblast lineage and
cancer cells. First, exposure to RANKL stimulated the expression and release of
IL-6 by PC3 cells in vitro (which is known to promote RANKL expression by osteoblasts). Second, treatment of PC3 cells with
IL-6 increased the expression of RANK, the cognate receptor of RANKL, and enhanced the RANKL-induced release of
IL-6 by PC3 cells. Third, targeted disruption of
IL-6 signaling with
tocilizumab, a clinically available antibody against the human
IL-6 receptor, inhibited skeletal
tumor growth in vivo and reduced serum RANKL levels as well as RANK expression by PC3-derived bone
tumors. Similar effects were achieved when RANK expression was knocked down in PC3 cells. In contrast, disruption of
IL-6 or RANK/RANKL signalling had no effect on PC3
tumor growth in soft tissues, indicating that these signalling pathways act specifically within the bone microenvironment. In conclusion,
prostate cancer cells and cells of the osteoblast lineage communicate via two inter-dependent signaling pathways, which through auto-amplification strongly enhance metastatic
prostate cancer growth in bone. Both pathways may be targeted for effective therapeutic intervention.