Vol.:(0123456789) 1 3
Clinical & Experimental Metastasis (2018) 35:393–402
https://doi.org/10.1007/s10585-018-9905-y
RESEARCH PAPER
Alternative splicing and cancer metastasis: prognostic and therapeutic
applications
Diego M. Marzese
1
· Ayla O. Manughian‑Peter
1
· Javier I. J. Orozco
1
· Dave S. B. Hoon
1,2
Received: 23 February 2018 / Accepted: 22 May 2018 / Published online: 29 May 2018
© Springer Science+Business Media B.V., part of Springer Nature 2018
Abstract
Metastatic cells exhibit an extraordinary phenotypic plasticity, not only in adapting to unfamiliar microenvironments but also
in surviving aggressive treatments and immune responses. A major source of phenotypic variability is alternative splicing
(AS) of the pre-messenger RNA. This process is catalyzed by one of the most complex pieces of cellular molecular regula-
tory events, the spliceosome, which is composed of ribonucleoproteins and polypeptides termed spliceosome factors. With
strong evidence indicating that AS afects nearly all genes encoded by the human genome, aberrant AS programs have a
signifcant impact on cancer cell development and progression. In this review, we present insights about the genomic and
epigenomic factors afecting AS, summarize the most recent fndings linking aberrant AS to metastatic progression, and
highlight potential prognostic and therapeutic applications.
Keywords Cancer metastasis · Alternative splicing · Epigenetics · Prognostic · Therapeutics
Introduction
Metastatic tumor cells have an intrinsic phenotypic plastic-
ity conveyed by genetic and epigenetic alterations allowing
them to adapt to and survive variable regional and systemic
impediments imposed by the immune system, therapeu-
tic treatments, and unfamiliar micro-environments, inde-
pendent of the tumor origin [1, 2]. Alternative pre-mRNA
splicing (AS) is one of the major sources of protein vari-
ability in human cells [3]. During the splicing process,
specific non-coding sequences of precursor messenger
RNAs (pre-mRNA) are recognized and removed to form
a mature mRNA [3]. Thus, this fnely regulated process
generates multiple mRNA transcripts and protein isoforms
with related, distinct, or even opposing functions from a
single gene unit [3]. The AS process is regulated by a com-
plex molecular machine deemed the spliceosome, which is
composed of nuclear ribonucleoproteins and polypeptides
denominated spliceosome factors (SFs). Since AS controls
almost all human genes, subtle alterations in this process
have a signifcant impact on human diseases, such as the
generation of tumor-promoting and metastasis-specific
splice variants in cancer [4, 5]. From a holistic perspective,
variations in the expression level of SFs leads to hyper-var-
iability in the individual cell-type specifc splicing program.
This often becomes even more pronounced in tumor cells
that have a higher adaptation potential and dynamic phe-
notype compared to their normal origin. The activation of
AS programs of genes in a cancer cell can create aggressive
tumor clones that allow them to survive and metastasize
more efciently. Nonetheless, one of the most promising
aspects of spliceosome alterations is that there are at least
two major levels at which aberrant splicing can be modu-
lated; frst is the design of splicing site-specifc antisense
oligonucleotides (ASOs) that target abnormal exons in pre-
spliced mRNA. This approach has demonstrated extraordi-
nary results in patients with Duchenne muscular dystrophy
(DMD) [6] and in patients with spinal muscular atrophy
(SMA) [7]. The second level of splicing modulation has
been translated into a new generation of antitumor drugs
Presented at the 7th International Cancer Metastasis Symposium
in San Francisco, CA from April 20–22, 2017 (www.cancermeta
stasis.org).
* Dave S. B. Hoon
hoond@jwci.org
1
Department of Translational Molecular Medicine, John
Wayne Cancer Institute, Santa Monica, CA, USA
2
Sequencing Center, John Wayne Cancer Institute,
Santa Monica, CA, USA