Metastatic Organotropism Differential Treatment Response in Urothelial Carcinoma: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials

CONTEXT

The optimal therapeutic agent with respect to metastatic sites is unclear in advanced urothelial carcinoma (UC).

OBJECTIVE

To investigate the metastatic organotropism differential treatment response in patients with advanced or metastatic UC.

EVIDENCE ACQUISITION

A systematic search and network meta-analysis (NMA) was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. The primary endpoints of interest were the objective response rate, overall survival (OS), and progression-free survival with respect to different metastatic sites.

EVIDENCE SYNTHESIS

Twenty-six trials comprising 9082 patients met our eligibility criteria, and a formal NMA was conducted. Durvalumab plus tremelimumab as first-line systemic therapy was significantly associated with better OS than chemotherapy in visceral metastasis (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.67-0.98). Pembrolizumab as second-line systemic therapy was significantly associated with better OS than chemotherapy in patients with visceral metastasis (HR 0.75, 95% CI 0.60-0.95). Atezolizumab as second-line systemic therapy was significantly associated with better OS than chemotherapy in patients with liver metastasis (in the population of >5% of tumor-infiltrating immune cells) and lymph node metastasis (HR 0.51, 95% CI 0.28-0.96, and HR 0.59, 95% CI 0.37-0.96, respectively).

CONCLUSIONS

Administration of immune-oncology treatments with respect to metastatic sites in patients with advanced or metastatic UC might have a positive impact on survival outcomes in both the first- and the second-line setting. Nevertheless, further investigations focusing on metastatic organotropism differential response with reliable oncological outcomes are needed to identify the optimal management strategy for these patients.

PATIENT SUMMARY

Although the supporting evidence for oncological benefits of therapeutic systemic agents with respect to metastatic sites is not yet strong enough to provide a recommendation in advanced or metastatic urothelial carcinoma, clinicians may take into account tumor organotropism only in discussion with the patient fully informed on the optimal treatment decision to be taken.

Metastasis organotropism in colorectal cancer: advancing toward innovative therapies

Distant metastasis remains a leading cause of mortality among patients with colorectal cancer (CRC). Organotropism, referring to the propensity of metastasis to target specific organs, is a well-documented phenomenon in CRC, with the liver, lungs, and peritoneum being preferred sites. Prior to establishing premetastatic niches within host organs, CRC cells secrete substances that promote metastatic organotropism. Given the pivotal role of organotropism in CRC metastasis, a comprehensive understanding of its molecular underpinnings is crucial for biomarker-based diagnosis, innovative treatment development, and ultimately, improved patient outcomes. In this review, we focus on metabolic reprogramming, tumor-derived exosomes, the immune system, and cancer cell-organ interactions to outline the molecular mechanisms of CRC organotropic metastasis. Furthermore, we consider the prospect of targeting metastatic organotropism for CRC therapy.

The origin of brain malignancies at the blood-brain barrier

Despite improvements in extracranial therapy, survival rate for patients suffering from brain metastases remains very poor. This is coupled with the incidence of brain metastases continuing to rise. In this review, we focus on core contributions of the blood-brain barrier to the origin of brain metastases. We first provide an overview of the structure and function of the blood-brain barrier under physiological conditions. Next, we discuss the emerging idea of a pre-metastatic niche, namely that secreted factors and extracellular vesicles from a primary tumor site are able to travel through the circulation and prime the neurovasculature for metastatic invasion. We then consider the neurotropic mechanisms that circulating tumor cells possess or develop that facilitate disruption of the blood-brain barrier and survival in the brain's parenchyma. Finally, we compare and contrast brain metastases at the blood-brain barrier to the primary brain tumor, glioma, examining the process of vessel co-option that favors the survival and outgrowth of brain malignancies.

Tumor-derived nanoseeds condition the soil for metastatic organotropism

Primary tumors secrete a variety of factors to turn distant microenvironments into favorable and fertile 'soil' for subsequent metastases. Among these 'seeding' factors that initiate pre-metastatic niche (PMN) formation, tumor-derived extracellular vesicles (EVs) are of particular interest as tumor EVs can direct organotropism depending on their surface integrin profiles. In addition, EVs also contain versatile, bioactive cargo, which include proteins, metabolites, lipids, RNA, and DNA fragments. The cargo incorporated into EVs is collectively shed from cancer cells and cancer-associated stromal cells. Increased understanding of how tumor EVs promote PMN establishment and detection of EVs in bodily fluids highlight how tumor EVs could serve as potential diagnostic and prognostic biomarkers, as well as provide a therapeutic target for metastasis prevention. This review focuses on tumor-derived EVs and how they direct organotropism and subsequently modulate stromal and immune microenvironments at distal sites to facilitate PMN formation. We also outline the progress made thus far towards clinical applications of tumor EVs.

Mercury toxicology in Epinephelidae fishes: A multiple tissue approach in two groupers species from southwestern Atlantic (SE-Brazil)

Epinephelidae fishes are important to reef ecosystems, as well as for commercial fishing and cultural heritage. Additionally, most of these species are at some risk of extinction, as Epinephelus marginatus and Hyporthodus nigritus. This study aimed to determine total mercury (THg) concentrations and burden on eight tissues of E. marginatus and H. nigritus. A Cold Vapor/Atomic Absorption Spectrometer was used for the THg determination. THg concentrations and burden varied significantly between tissues in both species. The highest concentrations were determined in the liver, and the greatest burden was in muscle. The gonad concentrations were higher than the toxicological threshold. General trends of increase in THg concentrations and burden along growth were observed. Mercury is a threat for both species evaluated, raising this concern for other Epinephelidae species.

Bioaccumulation of inorganic and organic mercury in the cuttlefish Sepia officinalis: Influence of ocean acidification and food type

The bioaccumulation of mercury (Hg) in marine organisms through various pathways has not yet been fully explored, particularly in cephalopods. This study utilises radiotracer techniques using the isotope ²⁰³Hg to investigate the toxicokinetics and the organotropism of waterborne inorganic Hg (iHg) and dietary inorganic and organic Hg (methylHg, MeHg) in juvenile common cuttlefish Sepia officinalis. The effect of two contrasting CO₂ partial pressures in seawater (400 and 1600 μatm, equivalent to pH 8.08 and 7.54, respectively) and two types of prey (fish and shrimp) were tested as potential driving factors of Hg bioaccumulation. After 14 days of waterborne exposure, juvenile cuttlefish showed a stable concentration factor of 709 ± 54 and 893 ± 117 at pH 8.08 and 7.54, respectively. The accumulated dissolved i²⁰³Hg was depurated relatively rapidly with a radiotracer biological half-life (Tb_1/2) of 44 ± 12 and 55 ± 16 days at pH 8.08 and 7.54, respectively. During the whole exposure period, approximately half of the i²⁰³Hg was found in the gills, but i²⁰³Hg also increased in the digestive gland. When fed with ²⁰³Hg-radiolabelled prey, cuttlefish assimilated almost all the Hg provided (>95%) independently of the prey type. Nevertheless, the prey type played a major role on the depuration kinetics with Hg Tb_1/2 approaching infinity in fish fed cuttlefish vs. 25 days in shrimp fed cuttlefish. Such a difference is explained by the different proportion of Hg species in the prey, with fish prey containing more than 80% of MeHg vs. only 30% in shrimp. Four days after ingestion of radiolabelled food, iHg was primarily found in the digestive organs while MeHg was transferred towards the muscular tissues. No significant effect of pH/pCO₂ variation was observed during both the waterborne and dietary exposures on the bioaccumulation kinetics and tissue distribution of i²⁰³Hg and Me²⁰³Hg. Dietary exposure is the predominant pathway of Hg bioaccumulation in juvenile cuttlefish.

Glycosylation as a regulator of site-specific metastasis

Metastasis is considered to be responsible for 90% of cancer-related deaths. Although it is clinically evident that metastatic patterns vary by primary tumor type, the molecular mechanisms underlying the site-specific nature of metastasis are an area of active investigation. One mechanism that has emerged as an important player in this process is glycosylation, or the addition of sugar moieties onto protein and lipid substrates. Glycosylation is the most common post-translational modification, occurring on more than 50% of translated proteins. Many of those proteins are either secreted or expressed on the cell membrane, thereby making glycosylation an important mediator of cell-cell interactions, including tumor-microenvironment interactions. It has been recently discovered that alteration of glycosylation patterns influences cancer metastasis, both globally and in a site-specific manner. This review will summarize the current knowledge regarding the role of glycosylation in the tropism of cancer cells for several common metastatic sites, including the bone, lung, brain, and lymph nodes.

Antiadhesive nanosome elicits role of glycocalyx of tumor cell-derived exosomes in the organotropic cancer metastasis

Despite emerging importance of tumor cells-derived exosomes in cancer metastasis, the heterogeneity of exosome populations has largely hampered systemic characterization of their molecular composition, biogenesis, and functions. This study communicates a novel method for predicting and targeting pre-metastatic sites based on an exosome model "fluorescent cancer glyconanosomes" displaying N-glycans of cultured tumor cells. Glycoblotting by antiadhesive quantum dots provides a nice tool to shed light on the pivotal functions of the glycocalyx reconstructed from four cancer cell types without bias due to other compositions of exosomes. In vivo imaging revealed that circulation, clearance, and organotropic biodistribution of cancer glyconanosomes in mice depend strongly on cancer cell-type-specific N-glycosylation patterns, the compositions of key glycotypes, particularly dominant abundances of high mannose-type N-glycans and the position-specific sialylation. Notably, organ biodistribution of cancer glyconanosomes is reproducible artificially by mimicking cancer cell-type-specific N-glycosylation patterns, demonstrating that nanosomal glycoblotting method serves as promising tools for predicting and targeting pre-metastatic sites determined by the glycocalyx of extracellular vesicles disseminated from the primary cancer site.

One and multi-compartments toxico-kinetic modeling to understand metals' organotropism and fate in Gammarus fossarum

The use of freshwater invertebrates for biomonitoring has been increasing for several decades, but little is known about relations between external exposure concentration of metals and their biodistribution among different tissues. One and multi-compartments toxicokinetic (TK) models are powerful tools to formalize and predict how a contaminant is bioaccumulated. The aim of this study is to develop modeling approaches to improve knowledge on dynamic of accumulation and fate of Cd and Hg in gammarid's organs. Gammarids were exposed to dissolved metals (11.1 ± 1.2 µg.L^-1 of Cd or 0.27 ± 0.13 µg.L^-1 of Hg) before a depuration phase. At each sampling days, their organs (caeca, cephalon, intestine and remaining tissues) were separated by dissection before analyses. Results allowed us to determine that i) G.fossarum takes up Cd as efficiently as the mussel M.galloprovincialis, but eliminates it more rapidly, ii) organs which accumulate and depurate the most, in terms of concentrations, are caeca and intestine for both metals; iii) the one-compartment TK models is the most relevant for Hg, while the multi-compartments TK model allows a better fit to Cd data, demonstrating dynamic transfer of Cd among organs.

Distribution of mercury species in different tissues and trophic levels of commonly consumed fish species from the south Bay of Biscay (France)

Mercury (Hg) is a contaminant of global concern in marine ecosystems, notably due to its ability to accumulate and concentrate in food webs. Concentrations of total mercury (THg), methylmercury (MeHg) and inorganic mercury (IHg) were assessed and compared in different tissues (liver, muscle, and gonads) of three common fish species (hake Merluccius merluccius, red mullet Mullus surmuletus, and sole Solea solea) from the continental shelf from the southern part of the Bay of Biscay. Several studies investigated Hg concentration in fish muscle, but few assessed concentrations in other organs, despite the importance of such data to understand contaminant organotropism and metabolization. Results showed that trophic position and feeding habitat are required to understand the variability of Hg concentration in muscle between fish species. In addition, high MeHg/THg ratio in muscle could be explained by the predatory behavior of the studied fish species and the biomagnification of this Hg species within the food web, MeHg. Despite differences between species, Hg concentration was always higher in muscle (from 118 ± 64 to 338 ± 101 ng g^-1 w.w.) and liver (from 122 ± 108 to 271 ± 95 ng g^-1 w.w.). These results can be related to physiological processes especially the MeHg detoxification strategies.

The metabolic adaptation mechanism of metastatic organotropism

Metastasis is a complex multistep cascade of cancer cell extravasation and invasion, in which metabolism plays an important role. Recently, a metabolic adaptation mechanism of cancer metastasis has been proposed as an emerging model of the interaction between cancer cells and the host microenvironment, revealing a deep and extensive relationship between cancer metabolism and cancer metastasis. However, research on how the host microenvironment affects cancer metabolism is mostly limited to the impact of the local tumour microenvironment at the primary site. There are few studies on how differences between the primary and secondary microenvironments promote metabolic changes during cancer progression or how secondary microenvironments affect cancer cell metastasis preference. Hence, we discuss how cancer cells adapt to and colonize in the metabolic microenvironments of different metastatic sites to establish a metastatic organotropism phenotype. The mechanism is expected to accelerate the research of cancer metabolism in the secondary microenvironment, and provides theoretical support for the generation of innovative therapeutic targets for clinical metastatic diseases.

Mercury in the tissues of five cephalopods species: First data on the nervous system

Mercury (Hg), one of the elements most toxic to biota, accumulates within organisms throughout their lifespan and biomagnifies along trophic chain. Due to their key role in marine systems, cephalopods constitute a major vector of Hg in predators. Further, they grow rapidly and display complex behaviours, which can be altered by neurotoxic Hg. This study investigated Hg concentrations within 81 cephalopod specimens sampled in the Bay of Biscay, which belonged to five species: Eledone cirrhosa, Sepia officinalis, Loligo vulgaris, Todaropsis eblanae and Illex coindetii. Hg concentrations were measured in the digestive gland, the mantle muscle and the optic lobes of the brain. The digestive gland and the mantle were tissues with the most concentrated Hg among all species considered (up to 1.50 μg.g^-1 dw), except E. cirrhosa. This benthic cephalopod had 1.3-fold higher Hg concentrations in the brain (up to 1.89 μg.g^-1 dw) than in the mantle, while other species had 2-fold lower concentrations of Hg in the brain than in the mantle. Brain-Hg concentrations can be predicted from muscle-Hg concentrations for a given species, which facilitates the assessment of Hg toxicokinetics in cephalopods. In the most contaminated E. cirrhosa individual, the chemical form of Hg in its digestive gland, mantle muscle and optic lobes, was determined using High energy-Resolution X-ray Absorption Near Edge Structure (HR XANES) spectroscopy. In the digestive gland, 33 ± 11% of total Hg was inorganic Hg speciated as a dicysteinate complex (Hg(Cys)₂), which suggested that the demethylation of dietary MeHg occurs in this organ. All Hg found in the mantle muscle and the optic lobes is methylated and bound to one cysteinyl group (MeHgCys complex), which implies that dietary MeHg is distributed to these tissues via the bloodstream. These results raised the questions regarding interspecific differences observed regarding Hg brain concentrations and the possible effect of Hg on cephalopod functional brain plasticity and behaviour.

Heterogeneity of CTC contributes to the organotropism of breast cancer

Circulating tumor cells (CTCs) are viewed as pro-metastasis precursors shed from primary tumors or metastatic sites. The phenotypic and molecular heterogeneity of CTCs is associated with breast cancer progression and prognosis. Therefore, we divided CTCs into several subtypes according to their differences in biomarker status, epithelial/mesenchymal phenotype, aggregation status, and other factors to summarize their characteristics. Considering that the organ-specific metastasis is a hallmark of breast cancer, we adopted the "seed and soil" model to further analyze the relationship between the heterogeneity of CTCs and the organotropism of breast cancer. We speculated that CTCs might not only develop their genetic potential but communicate with surroundings, including chemokine systems, hemocytes, and extracellular matrix components, to regulate the organ-specific metastases of breast cancer.

Brain metastasis models: What should we aim to achieve better treatments?

Brain metastasis is emerging as a unique entity in oncology based on its particular biology and, consequently, the pharmacological approaches that should be considered. We discuss the current state of modelling this specific progression of cancer and how these experimental models have been used to test multiple pharmacologic strategies over the years. In spite of pre-clinical evidences demonstrating brain metastasis vulnerabilities, many clinical trials have excluded patients with brain metastasis. Fortunately, this trend is getting to an end given the increasing importance of secondary brain tumors in the clinic and a better knowledge of the underlying biology. We discuss emerging trends and unsolved issues that will shape how we will study experimental brain metastasis in the years to come.

Understanding the organ tropism of metastatic breast cancer through the combination of liquid biopsy tools

BACKGROUND

Liquid biopsy provides real-time data about prognosis and actionable mutations in metastatic breast cancer (MBC). The aim of this study was to explore the combination of circulating tumour DNA (ctDNA) analysis and circulating tumour cells (CTCs) enumeration in estimating target organs more susceptible to MBC involvement.

METHODS

This retrospective study analysed 88 MBC patients characterised for both CTCs and ctDNA at baseline. CTCs were isolated through the CellSearch kit, while ctDNA was analysed using the Guardant360 NGS-based assay. Sites of disease were collected on the basis of imaging. Associations were explored both through uni- and multivariate logistic regression and Fisher's exact test and the random forest machine learning algorithm.

RESULTS

After multivariate logistic regression, ESR1 mutation was the only significant factor associated with liver metastases (OR 8.10), while PIK3CA was associated with lung localisations (OR 3.74). CTC enumeration was independently associated with bone metastases (OR 10.41) and TP53 was associated with lymph node localisations (OR 2.98). The metastatic behaviour was further investigated through a random forest machine learning algorithm. Bone involvement was described by CTC enumeration and alterations in ESR1, GATA3, KIT, CDK4 and ERBB2, while subtype, CTC enumeration, inflammatory BC diagnosis, ESR1 and KIT aberrations described liver metastases. PIK3CA, MET, AR, CTC enumeration and TP53 were associated with lung organotropism. The model, moreover, showed that AR, CCNE1, ESR1, MYC and CTC enumeration were the main drivers in HR positive MBC metastatic pattern.

CONCLUSIONS

These results indicate that ctDNA and CTCs enumeration could provide useful insights regarding MBC organotropism, suggesting a possible role for future monitoring strategies that dynamically focus on high-risk organs defined by tumourbiology.

Tissue-specific bioaccumulation of a wide range of legacy and emerging persistent organic contaminants in swordfish (Xiphias gladius) from Seychelles, Western Indian Ocean

Swordfish (Xiphias gladius) is a major marine resource of high economic value to industrial and artisanal fisheries. As a top predator with a long lifespan, it is prone to accumulate high levels of contaminants. The bioaccumulation of a wide range of both legacy and emerging persistent organic contaminants was investigated in the muscle, liver and gonads of swordfish collected from the Seychelles, western Indian Ocean. The detection of all target contaminants, some at frequencies above 80%, highlights their widespread occurrence, albeit at low levels. Mean concentrations in muscle were 5637, 491 and 331 pg g^-1 ww for organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs) and perfluoroalkyl substances (PFASs), respectively. ∑BFR mean concentrations were far below, i.e. 47 pg g^-1 ww. The data are among the first obtained for such a high diversity of contaminants in an oceanic top predator worldwide and constitute a benchmark of the contamination of Indian Ocean ecosystems.

A specific gene expression signature for visceral organ metastasis in breast cancer

BACKGROUND

Visceral organ metastasis is associated with poor survival outcomes in terms of metastasis free- and overall survival in breast carcinomas. Identification of a gene expression profile in tumours that selects a subpopulation of patients that is more likely to develop visceral organ metastases will help elucidate mechanisms for the development of distant metastases and could be of clinical value. With this study we aimed to determine genomic predictors that would help to distinguish breast cancer patients with more likelihood to develop visceral metastasis.

METHODS

Gene expression profiling data of 157 primary tumours from breast cancer patients who developed distant metastases were analyzed and differentially expressed genes between the group of tumours with visceral metastasis and the those without visceral metastases were identified. Published data were used to validate our findings. Multivariate logistic regression tests were applied to further investigate the association between the gene-expression-signature and clinical variables. Survival analyses were performed by the Kaplan-Meier method.

RESULTS

Fourteen differentially expressed genes (WDR6, CDYL, ATP6V0A4, CHAD, IDUA, MYL5, PREP, RTN4IP1, BTG2, TPRG1, ABHD14A, KIF18A, S100PBP and BEND3) were identified between the group of tumours with and without visceral metastatic disease. Five of these genes (CDYL, ATP6V0A4, PREP, RTN4IP1 and KIF18A) were up-regulated and the other genes were down-regulated. This gene expression signature was validated in the training and in the independent data set (p 2.13e- 08 and p 9.68e- 06, respectively). Multivariate analyses revealed that the 14-gene-expression-signature was associated with visceral metastatic disease (p 0.001, 95% CI 1.43-4.27), independent of other clinicopathologic features. This signature has been also found to be associated with survival status of the patients (p < .001).

CONCLUSION

We have identified an unique gene expression signature which is specific to visceral metastasis. This 14-gene-expression-signature may play a role in identifying the subgroup of patients with potential to develop visceral metastasis.

Surviving at a distant site: The organotropism of metastatic breast cancer

Many cancers demonstrate a non-random distribution of sites for distant relapse while others have the propensity to metastasize to multiple organ systems. One of the notable recent findings is that the breast cancer subtypes differ not only in their biological characteristics as primary tumors but also in their capacity for metastatic progression. This information could potentially be utilized in treatment decision making and surveillance strategies.

Mechanisms of T cell organotropism

Protective immunity relies upon T cell differentiation and subsequent migration to target tissues. Similarly, immune homeostasis requires the localization of regulatory T cells (Tregs) to the sites where immunity takes place. While naïve T lymphocytes recirculate predominantly in secondary lymphoid tissue, primed T cells and activated Tregs must traffic to the antigen rich non-lymphoid tissue to exert effector and regulatory responses, respectively. Following priming in draining lymph nodes, T cells acquire the 'homing receptors' to facilitate their access to specific tissues and organs. An additional level of topographic specificity is provided by T cells receptor recognition of antigen displayed by the endothelium. Furthermore, co-stimulatory signals (such as those induced by CD28) have been shown not only to regulate T cell activation and differentiation, but also to orchestrate the anatomy of the ensuing T cell response. We here review the molecular mechanisms supporting trafficking of both effector and regulatory T cells to specific antigen-rich tissues.

A novel gene expression signature for bone metastasis in breast carcinomas

Metastatic cancer remains the leading cause of death for patients with breast cancer. To understand the mechanisms underlying the development of distant metastases to specific sites is therefore important and of potential clinical value. From 157 primary breast tumours of the patients with known metastatic disease, gene expression profiling data were generated and correlated to metastatic behaviour including site-specific metastasis, metastasis pattern and survival outcomes. We analysed gene expression signatures specifically associated with the development of bone metastases. As a validation cohort, we used a published dataset of 376 breast carcinomas for which gene expression data and site-specific metastasis information were available. 80.5 % of luminal-type tumours developed bone metastasis as opposed to 41.7 % of basal and 55.6 % of HER2-like tumours. A novel 15-gene signature identified 82.4 % of the tumours with bone metastasis, 85.2 % of the tumours which had bone metastasis as first site of metastasis and 100 % of the ones with bone metastasis only (p 9.99e-09), in the training set. In the independent dataset, 81.2 % of the positive tested tumours had known metastatic disease to the bone (p 4.28e-10). This 15-gene signature showed much better correlation with the development of bone metastases than previously identified signatures and was predictive in both ER-positive as well as in ER-negative tumours. Multivariate analyses revealed that together with the molecular subtype, our 15-gene expression signature was significantly correlated to bone metastasis status (p <0.001, 95 % CI 3.86-48.02 in the training set; p 0.001, 95 % CI 1.54-5.00 in the independent set). The 15 genes, APOPEC3B, ATL2, BBS1, C6orf61, C6orf167, MMS22L, KCNS1, MFAP3L, NIP7, NUP155, PALM2, PH-4, PGD5, SFT2D2 and STEAP3, encoded mainly membrane-bound molecules with molecular function of protein binding. The expression levels of the up-regulated genes (NAT1, BBS1 and PH-4) were also found to be correlated to epithelial to mesenchymal transition status of the tumour. We have identified a novel 15-gene expression signature associated with the development of bone metastases in breast cancer patients. This bone metastasis signature is the first to be identified using a supervised classification approach in a large series of patients and will help forward research in this area towards clinical applications.

Bioaccumulation of human waterborne protozoa by zebra mussel (Dreissena polymorpha): interest for water biomonitoring

Cryptosporidium parvum, Giardia duodenalis and Toxoplasma gondii are ubiquitous pathogens, which waterborne transmission has been largely demonstrated. Since they can be found in various watercourses, interactions with aquatic organisms are possible. Protozoan detection for watercourses biomonitoring is currently based on large water filtration. The zebra mussel, Dreissena polymorpha, is a choice biological model in ecotoxicological studies which are already in use to detect chemical contaminations in watercourses. In the present study, the zebra mussel was tested as a new tool for detecting water contamination by protozoa. In vivo exposures were conducted in laboratory experiments. Zebra mussel was exposed to various protozoan concentrations for one week. Detection of protozoa was realized by Taqman real time qPCR. Our experiments evidenced C. parvum, G. duodenalis and T. gondii oocyst bioaccumulation by mussels proportionally to ambient contamination, and significant T. gondii prevalence was observed in muscle tissue. To our knowledge, this is the first study that demonstrates T. gondii oocyst accumulation by zebra mussel. The results from this study highlight the capacity of zebra mussels to reveal ambient biological contamination, and thus to be used as a new effective tool in sanitary biomonitoring of water bodies.