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基底样乳腺癌通过 AXL 信号刺激癌症干细胞特性,从而诱导化疗耐药。

Basal-like mammary carcinomas stimulate cancer stem cell properties through AXL-signaling to induce chemotherapy resistance.

机构信息

Max Planck Institute for Multidisciplinary Sciences, Translational Molecular Imaging, Göttingen, Germany.

Department of Gynecology and Obstetrics, University Medical Center Göttingen, Göttingen, Germany.

出版信息

Int J Cancer. 2023 May 1;152(9):1916-1932. doi: 10.1002/ijc.34429. Epub 2023 Feb 1.

Abstract

Basal-like breast cancer (BLBC) is the most aggressive and heterogeneous breast cancer (BC) subtype. Conventional chemotherapies represent next to surgery the most frequently employed treatment options. Unfortunately, resistant tumor phenotypes often develop, resulting in therapeutic failure. To identify the early events occurring upon the first drug application and initiating chemotherapy resistance in BLBC, we leveraged the WAP-T syngeneic mammary carcinoma mouse model and we developed a strategy combining magnetic-activated cell sorting (MACS)-based tumor cell enrichment with high-throughput transcriptome analyses. We discovered that chemotherapy induced a massive gene expression reprogramming toward stemness acquisition to tolerate and survive the cytotoxic treatment in vitro and in vivo. Retransplantation experiments revealed that one single cycle of cytotoxic drug combination therapy (Cyclophosphamide, Adriamycin and 5-Fluorouracil) suffices to induce resistant tumor cell phenotypes in vivo. We identified Axl and its ligand Pros1 as highly induced genes driving cancer stem cell (CSC) properties upon chemotherapy in vivo and in vitro. Furthermore, from our analysis of BLBC patient datasets, we found that AXL expression is also strongly correlated with CSC-gene signatures, a poor response to conventional therapies and worse survival outcomes in those patients. Finally, we demonstrate that AXL inhibition sensitized BLBC-cells to cytotoxic treatment in vitro. Together, our data support AXL as a promising therapeutic target to optimize the efficiency of conventional cytotoxic therapies in BLBC.

摘要

基底样乳腺癌(BLBC)是最具侵袭性和异质性的乳腺癌(BC)亚型。除了手术之外,传统的化疗是最常采用的治疗选择。不幸的是,经常会出现耐药的肿瘤表型,导致治疗失败。为了确定首次应用药物并引发 BLBC 化疗耐药的早期事件,我们利用 WAP-T 同源乳腺肿瘤小鼠模型,开发了一种结合基于磁激活细胞分选(MACS)的肿瘤细胞富集与高通量转录组分析的策略。我们发现,化疗诱导了大规模的基因表达重编程,以获得干性,从而耐受和在体外及体内存活细胞毒性治疗。再移植实验表明,一个周期的细胞毒性药物联合治疗(环磷酰胺、阿霉素和 5-氟尿嘧啶)足以在体内诱导耐药肿瘤细胞表型。我们发现 Axl 及其配体 Pros1 是体内和体外化疗后驱动癌症干细胞(CSC)特性的高度诱导基因。此外,我们对 BLBC 患者数据集的分析发现,AXL 表达也与 CSC 基因特征强烈相关,与这些患者对常规治疗的反应较差和生存结果较差有关。最后,我们证明 AXL 抑制可使 BLBC 细胞对体外细胞毒性治疗敏感。总之,我们的数据支持 AXL 作为一种有前途的治疗靶点,以优化 BLBC 中传统细胞毒性治疗的效率。

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