P2X7 a new therapeutic target to block vesicle-dependent metastasis in colon carcinoma: Role of the A2A/CD39/CD73 axis

Extracellular vesicle-driven cancer metastasis represents a therapeutic challenge due to the lack of effective blocking drugs. Our study shows that activation of the P2X7 receptor on colon carcinoma cells causes the release of vesicles carrying CD39 and CD73 ectonucleotidases. These vesicles increase ATP and adenosine levels and, when in vivo administered, significantly enhance colon carcinoma metastasis and circulating levels of vesicles after fourteen days from their injection. Blocking P2X7 prevents vesicular release and substantially reduces vesicle-mediated tumor spreading, positioning P2X7 as a promising therapeutic target for inhibiting extracellular vesicle-mediated dissemination in colon cancer. Additionally, these vesicles upregulate the expression of P2X7 and A2A receptors within the metastatic niche. Antagonists of P2X7 and A2A used alone or in combination effectively inhibit tumor growth in vivo, decreasing metastasis engraftment and IL-17 and IL-23 release. Interestingly, the levels of both cytokines were also reduced by combined P2X7 and A2A blockade in non-tumor-bearing mice. Moreover, P2X7 and A2A upraise in metastatic and APC-mutated colon carcinoma patients and in Apc-disrupted rats. Our findings shed light on the crosstalk of P2X7/CD73/CD39 and A2A in colon cancer metastasis. We propose a novel mechanism facilitating metastatic dissemination and an innovative therapeutic strategy to target receptor signaling and vesicular release.