Interferon-gamma is quintessential for NOS2 and COX2 expression in ER- breast tumors that lead to poor outcome

A strong correlation between NOS2 and COX2 tumor expression and poor clinical outcomes in ER breast cancer has been established. However, the mechanisms of tumor induction of these enzymes are unclear. Analysis of The Cancer Genome Atlas (TCGA) revealed correlations between NOS2 and COX2 expression and Th1 cytokines. Herein, single-cell RNAseq analysis of TNBC cells shows potent NOS2 and COX2 induction by IFN gamma combined with IL1 beta or TNF alpha. Given that IFN gamma is secreted by cytolytic lymphocytes, which improve clinical outcomes, this role of IFN gamma presents a dichotomy. To explore this conundrum, tumor NOS2, COX2, and CD8(+) T cells were spatially analyzed in aggressive ER-, TNBC, and HER2 + breast tumors. High expression and clustering of NOS2-expressing tumor cells occurred at the tumor/stroma interface in the presence of stroma-restricted CD8(+) T cells. High expression and clustering of COX2-expressing tumor cells extended into immune desert regions in the tumor core where CD8(+) T cell penetration was limited or absent. Moreover, high NOS2-expressing tumor cells were proximal to areas with increased satellitosis, suggestive of cell clusters with a higher metastatic potential. Further in vitro experiments revealed that IFN gamma + IL1 beta/TNF alpha increased the elongation and migration of treated tumor cells. This spatial analysis of the tumor microenvironment provides important insight into distinct neighborhoods where stroma-restricted CD8(+) T cells exist proximal to NOS2-expressing tumor niches that could have increased metastatic potential.