Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee, USA.
J Clin Invest. 2013 Mar;123(3):1348-58. doi: 10.1172/JCI65416. Epub 2013 Feb 8.
After an initial response to chemotherapy, many patients with triple-negative breast cancer (TNBC) have recurrence of drug-resistant metastatic disease. Studies with TNBC cells suggest that chemotherapy-resistant populations of cancer stem-like cells (CSCs) with self-renewing and tumor-initiating capacities are responsible for these relapses. TGF-β has been shown to increase stem-like properties in human breast cancer cells. We analyzed RNA expression in matched pairs of primary breast cancer biopsies before and after chemotherapy. Biopsies after chemotherapy displayed increased RNA transcripts of genes associated with CSCs and TGF-β signaling. In TNBC cell lines and mouse xenografts, the chemotherapeutic drug paclitaxel increased autocrine TGF-β signaling and IL-8 expression and enriched for CSCs, as indicated by mammosphere formation and CSC markers. The TGF-β type I receptor kinase inhibitor LY2157299, a neutralizing TGF-β type II receptor antibody, and SMAD4 siRNA all blocked paclitaxel-induced IL8 transcription and CSC expansion. Moreover, treatment of TNBC xenografts with LY2157299 prevented reestablishment of tumors after paclitaxel treatment. These data suggest that chemotherapy-induced TGF-β signaling enhances tumor recurrence through IL-8-dependent expansion of CSCs and that TGF-β pathway inhibitors prevent the development of drug-resistant CSCs. These findings support testing a combination of TGF-β inhibitors and anticancer chemotherapy in patients with TNBC.
在对化疗有初步反应后,许多三阴性乳腺癌 (TNBC) 患者的耐药转移性疾病复发。TNBC 细胞的研究表明,具有自我更新和肿瘤起始能力的化疗耐药癌症干细胞样细胞 (CSC) 群体是这些复发的原因。TGF-β 已被证明可增加人乳腺癌细胞中的干细胞样特性。我们分析了化疗前后配对的原发性乳腺癌活检的 RNA 表达。化疗后的活检显示与 CSC 和 TGF-β 信号相关的基因的 RNA 转录物增加。在 TNBC 细胞系和小鼠异种移植中,化疗药物紫杉醇增加了自分泌 TGF-β 信号和 IL-8 表达,并富集了 CSC,如类乳腺球体形成和 CSC 标志物所示。TGF-β 型 I 受体激酶抑制剂 LY2157299、中和 TGF-β 型 II 受体抗体和 SMAD4 siRNA 均阻断了紫杉醇诱导的 IL8 转录和 CSC 扩增。此外,LY2157299 治疗 TNBC 异种移植物可防止紫杉醇治疗后肿瘤的重新建立。这些数据表明,化疗诱导的 TGF-β 信号通过 IL-8 依赖性 CSC 扩增增强肿瘤复发,而 TGF-β 途径抑制剂可防止耐药性 CSC 的发展。这些发现支持在 TNBC 患者中测试 TGF-β 抑制剂和抗癌化疗的联合治疗。
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