In 80 percent of women, by the time ovarian cancer is diagnosed, it has spread to the pad of fat cells, called the omentum. Often, cancer growth in the omentum exceeds the growth of the original ovarian cancer.
“This fatty tissue, which is extraordinarily rich in energy-dense lipids, acts as a launching pad and energy source for the likely lethal spread of ovarian cancer,” said study author Ernst Lengyel, MD, PhD, professor of obstetrics and gynecology at the University of Chicago.
“The cells that make up the omentum contain the biological equivalent of jet fuel. They feed the cancer cells, enabling them to multiply rapidly. Gaining a better understanding of this process could help us learn how to disrupt it,” Lengyel stated.
The researchers found that ovarian cancer cells injected into the abdomen of healthy mice find their way to the omentum within 20 minutes.
Once ovarian cancer cells reach the omentum, they quickly develop the tools to devour the sustenance provided by this fatty tissue, reprogramming their metabolism to thrive on lipids acquired from fat cells.
Ovarian cancer can rapidly convert the entire omentum, a soft fat pad, into a solid mass of cancer cells.
The researchers believe that a protein known as fatty acid binding protein (FABP4), a fat carrier, may be crucial to this process and could be a target for treatment.
When the researchers compared primary ovarian cancer tissue with ovarian cancer tissue, which had spread to the omentum, they found that tumour cells next to omental fat cells produced high levels of FABP4.
When they inhibited FABP4, the transfer of nutrients from fat cells to cancer cells was drastically reduced. Inhibition of FABP4 also reduced tumour growth and the ability of tumours to generate new blood vessels.
"Therefore,” the authors wrote, “FABP4 emerges as an excellent target in the treatment of intra-abdominally disseminating tumours, which preferentially metastasises to adipose tissue such as ovarian, gastric, and colon cancers."
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