Plasticity of Lgr5-Negative Cancer Cells Drives Metastasis in Colorectal Cancer

Arianna Fumagalli, Koen C. Oost, Lennart Kester, Jessica Morgner, Laura Bornes, Lotte Bruens, Lisa Spaargaren, Maria Azkanaz, Tim Schelfhorst, Evelyne Beerling, Maria C. Heinz, Daniel Postrach, Danielle Seinstra, Anieta M. Sieuwerts, John W.M. Martens, Stefan van der Elst, Martijn van Baalen, Debajit Bhowmick, Nienke Vrisekoop, Saskia I.J. EllenbroekSaskia J.E. Suijkerbuijk, Hugo J. Snippert, Jacco van Rheenen

Research output: Contribution to journalArticlepeer-review

117 Citations (Scopus)


Colorectal cancer stem cells (CSCs) express Lgr5 and display extensive stem cell-like multipotency and self-renewal and are thought to seed metastatic disease. Here, we used a mouse model of colorectal cancer (CRC) and human tumor xenografts to investigate the cell of origin of metastases. We found that most disseminated CRC cells in circulation were Lgr5 and formed distant metastases in which Lgr5+ CSCs appeared. This plasticity occurred independently of stemness-inducing microenvironmental factors and was indispensable for outgrowth, but not establishment, of metastases. Together, these findings show that most colorectal cancer metastases are seeded by Lgr5 cells, which display intrinsic capacity to become CSCs in a niche-independent manner and can restore epithelial hierarchies in metastatic tumors.

Original languageEnglish
Pages (from-to)569-578.e7
JournalCell Stem Cell
Issue number4
Publication statusPublished - 2 Apr 2020
Externally publishedYes


  • cancer stem cells
  • circulating tumor cells
  • colorectal cancer
  • intravital microscopy
  • Lgr5
  • metastasis
  • microenvironment
  • plasticity


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