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Ovarian cancer is the most lethal gynecological cancer and is characterized by widespread peritoneal dissemination and the formation of malignant ascites1. This extensive peritoneal metastasis represents a major clinical challenge and is associated with poor clinical outcomes. Unlike most solid carcinomas that metastasize via the blood, ovarian cancer primarily disseminates within the peritoneal cavity. Tumor cells exist as multicellular aggregates/spheroids during the process of metastasis2. The fact that suspension culture can enrich ovarian cancer stem/tumor-initiating cells further suggests that these spheroids may be associated with both tumor aggressiveness and enhanced chemoresistance3,4. There are differences in drug response between 2D and 3D cultures, which presumably have different molecular mechanisms5.
The essential interaction with the mesothelium constructs the primary microenvironment for ovarian tumor progression. These mesothelial cells lie on an extracellular matrix (ECM), where fibronectin is a ubiquitous constituent. A link between the increased expression of mesothelial cell-derived fibronectin and tumor progression has been shown. Fibronectin is abundantly present in malignant ascites6,7. Ovarian cancer cells are also able to induce the secretion of fibronectin from mesothelial cells in order to promote early ovarian cancer metastasis8.
Emerging evidence shows that mechanical stimuli, including shear stress, can modulate cell morphology, gene expression, and, thus, the phenotypes of tumor cells9,10,11. As malignant ascites develop and accumulate during tumor progression, ovarian tumor cells are exposed to fluid flow and the resulting shear stress. A number of groups, ours included, have shown the impact of shear stress on ovarian cancer progression, including cytoskeleton modifications, epithelial-to-mesenchymal transitions, and cancer stemness12,13,14,15. Thus, a physiologically relevant microenvironment is important for the investigation of tumor peritoneal metastasis. However, current in vitro hydrodynamic culture systems have limitations on mimicking and controlling a constant, low, physiologically relevant shear stress16,17,18,19. Conventional in vitro approaches focusing on either the cellular or mechanical environment are still limited in mimicking the complexity of the intraperitoneal microenvironment with proper physiological relevance.
Here, in order to engineer a new model of the peritoneum to overcome the limitations of conventional strategies and to advance the study of the intraperitoneal compartment in cancer metastasis, a 3D microfluidic-based platform with controlled fluid flow was designed. In this model, ovarian cancer spheroids were co-cultured with primary human peritoneal mesothelial cells in microfluidic chips under continuous fluidic flow (Figure1A). The mesothelial cells were plated on fibronectin. Non-adherent ovarian cancer spheroids were seeded into microfluidic channels with continuous flow medium perfused by a syringe pump. Both the 3D environment and the dynamic mechanical forces are very important factors of the metastatic cascade. This platform can be used for investigating the intraperitoneal microenvironment in terms of complex cellular and co-culture interactions, as well as with regard to dynamic mechanical cues.