Human bone marrow adipocytes drive prostate cancer bone metastasis progression via lipid-mediated induction of Angiopoietin-like 4

Bone is the main metastatic site in advanced prostate cancer (PCa) and contains bone marrow adipocytes (BMAds), which account for more than 70% of adult bone marrow. However, their role in the progression of PCa metastases remains poorly understood. Herein, we developed a physiologically relevant 3D culture model using primary human BMAds from red hematopoietic rich-areas (rBMAds) and we showed that rBMAds engage in metabolic crosstalk with PCa cells. Specifically, rBMAds release free fatty acids (FFAs) through a non-canonical lipolytic pathway and these FFAs are taken up by PCa cells inducing a transcriptional reprogramming that promotes motility. Among the responsive genes, Angiopoietin like 4 (ANGPTL4) is the most upregulated via a peroxisome proliferator-activated receptor γ-dependent mechanism, and its silencing abolishes the rBMAd-driven migratory and invasive phenotype. Clinically, elevated ANGPTL4 expression is associated with poor overall survival specifically in PCa bone metastases, is maintained during metastatic progression, and is indicative of aggressive disease. Together, our findings uncover a novel adipocyte-tumor interaction and identify ANGPTL4 as a key mediator and potential therapeutic target in bone-metastatic PCa.