Capillary constrictions prime cancer cell tumorigenicity through PIEZO1

Metastasis is a hallmark of cancer and is responsible for the majority of cancer-related deaths. Evidence suggests that even a single cancer cell can spread and seed a secondary tumour. However, not all circulating tumour cells have this ability, which implies that dissemination and distal growth require adaptative mechanisms during circulation. Here we report that constriction during microcapillary transit will trigger reprogramming of melanoma cells to a tumorigenic cancer stem cell-like state. Using a microfluidic device mimicking physiological flow rates and gradual capillary narrowing, we showed that compression through narrow channels lead to cell and nuclear deformation, rapid changes in chromatin state and increased calcium handling through the mechanosensor PIEZO1. Within minutes of microcapillary transit, cells show increased regulation of transcripts associated with metabolic reprogramming and metastatic processes, which culminates in the adoption of cancer stem cell-like properties. Squeezed cells displayed elevated melanoma stem cell markers, increased propensity for trans-endothelium invasion, and characteristics of enhanced tumorigenicity in vitro and in vivo. Pharmacological disruption of channel activity inhibited the stem cell-like state, while the selective PIEZO1 activator Yoda1 primed this state irrespective of constriction. Finally, deletion of PIEZO1 led to complete abrogation of the constriction-induced stem cell-like state. Together, this work demonstrates that compressive forces during circulation can reprogram circulating cancer cells to tumorigenic stem cell-like states that are primed for extravasation and metastatic colonization.