1. Targeting stromal remodeling and cancer stem cell plasticity overcomes chemoresistance in triple negative breast cancer
- Author
-
Cazet, AS, Hui, MN, Elsworth, BL, Wu, SZ, Roden, D, Chan, CL, Skhinas, JN, Collot, R, Yang, J, Harvey, K, Johan, MZ, Cooper, C, Nair, R, Herrmann, D, McFarland, A, Deng, N, Ruiz-Borrego, M, Rojo, F, Trigo, JM, Bezares, S, Caballero, R, Lim, E, Timpson, P, O’Toole, S, Watkins, DN, Cox, TR, Samuel, MS, Martín, M, Swarbrick, A, Cazet, AS, Hui, MN, Elsworth, BL, Wu, SZ, Roden, D, Chan, CL, Skhinas, JN, Collot, R, Yang, J, Harvey, K, Johan, MZ, Cooper, C, Nair, R, Herrmann, D, McFarland, A, Deng, N, Ruiz-Borrego, M, Rojo, F, Trigo, JM, Bezares, S, Caballero, R, Lim, E, Timpson, P, O’Toole, S, Watkins, DN, Cox, TR, Samuel, MS, Martín, M, and Swarbrick, A
- Abstract
The cellular and molecular basis of stromal cell recruitment, activation and crosstalk in carcinomas is poorly understood, limiting the development of targeted anti-stromal therapies. In mouse models of triple negative breast cancer (TNBC), Hedgehog ligand produced by neoplastic cells reprograms cancer-associated fibroblasts (CAFs) to provide a supportive niche for the acquisition of a chemo-resistant, cancer stem cell (CSC) phenotype via FGF5 expression and production of fibrillar collagen. Stromal treatment of patient-derived xenografts with smoothened inhibitors (SMOi) downregulates CSC markers expression and sensitizes tumors to docetaxel, leading to markedly improved survival and reduced metastatic burden. In the phase I clinical trial EDALINE, 3 of 12 patients with metastatic TNBC derived clinical benefit from combination therapy with the SMOi Sonidegib and docetaxel chemotherapy, with one patient experiencing a complete response. These studies identify Hedgehog signaling to CAFs as a novel mediator of CSC plasticity and an exciting new therapeutic target in TNBC.
- Published
- 2018