A mouse model of metastasis-induced breast cancer cachexia with non-cachectic controls bearing isogenic primary tumors

Background Patients with advanced cancer frequently develop cachexia, an involuntary weight-loss condition that correlates strongly with metastatic burden. Despite this clinical association, metastasis is rarely considered in preclinical research of cancer cachexia, which is in part due to the lack of rigorously established animal models to investigate metastasis-associated cancer cachexia. Methods To establish an animal model of metastasis-associated cancer cachexia, here we focused on syngeneic mouse models of breast cancer. Using the metastatic 4T1 murine breast cancer cell line and its isogenic non-metastatic 67NR cell line, we generated primary tumors via orthotopic injection into the mammary fat pad and surgically resected the primary tumor to allow sufficient time for spontaneous metastatic outgrowth, or generated experimental lung metastases by direct intravenous injection into the tail vein. Across these tumor-bearing groups, we systematically characterized the metastatic burden and cachectic phenotypes of the mice, including body weight, food intake, body composition, muscle mass, grip strength, locomotor activity, energy expenditure, and respiratory exchange ratio. To isolate the contribution of reduced food intake to the cachectic phenotypes, we pair-fed orthotopic 4T1 tumor-bearing mice (which were non-cachectic) to mice with 4T1 lung metastases (which were cachectic). We further measured muscle atrophy gene expression and profiled circulating cytokines and metabolic hormones for the mouse groups. Results Body weight loss occurred exclusively in mice bearing lung metastases from 4T1 tumors, with no weight loss observed in mice bearing either primary 4T1 tumors or 67NR lung tumors, thus presenting a model of cancer cachexia that is driven by 4T1 lung metastasis. Comprehensive cachexia characterization demonstrated that the 4T1 metastasis model recapitulates all key features of cachexia, manifesting as reduced food intake (or anorexia), depletion of adipose tissues, loss of lean mass including muscle mass loss, and reduced grip strength. Pair-feeding non-cachectic primary 4T1 tumor-bearing mice to 4T1 metastatic mice led to the same losses in body weight, fat, and lean mass as in cachectic mice, but no change in grip strength, indicating that anorexia is the primary driver of tissue wasting whereas muscle weakness arises through a food intake-independent mechanism. Moreover, we identified distinct circulating cytokines and metabolic hormones associated with the metastasis-driven cachexia. Conclusions Our results establish a metastasis-induced breast cancer cachexia model with a tightly matched control group, providing a platform for the field to identify metastasis-derived cachectic mediators and pathways.