Unravelling the in vivo traits of vasculogenic mimicry

Abstract Vasculogenic mimicry (VM) describes the ability of cancer cells to acquire endothelial properties and form vessel-like channels that facilitate tumour blood supply. While the molecular drivers of VM have been well-explored in cell cultures and biopsies, an in vivo description remains elusive. Here, we used graph theory to define VM biomarkers and elucidate the spatiotemporal dynamics of VM using in vitro and in vivo breast cancer models with and without anti-angiogenic treatment. Optical microscopy was used to assess pseudo-vascular networks in vitro while photoacoustic imaging across scales was applied in vivo to identify and locate haemoglobin contrast-derived blood vessel morphology and functionality. VM was associated with greater oxygenation heterogeneity and poorer anti-angiogenic response, reflected as stable meshed networks in vitro and blood-containing circular structures in vivo . We demonstrate for the first time a multi-scale approach bridging the in vitro-in vivo translational gap to assess anti-vascular treatment resistance and the therapeutic potential in vasculogenic mimicry-rich tumours, exploring novel avenues in preclinical drug screening and systemic drug delivery.