Preoperative or neoadjuvant therapy (NT) is increasingly used in patients with locally advanced or inflammatory breast cancer (BC) to allow optimal surgery. Although a pathologic complete response has been associated with increased survival, many patients do not respond and/or develop lethal metastatic disease after NT. Our preliminary data indicate that chemotherapy induces blood levels of monocyte chemoattractant proteins (MCPs), which can stimulate the cancer stem-like cell (CSC) phenotype to promote tumor malignancy. The goal of this study is to dissect the mechanisms through which NT regimens induce the CSC phenotype in breast tumors. We will investigate both a MCP-mediated systemic mechanism and a local mechanism mediated by cancer-secreted miRNAs, and will test intervention strategies that block these events during chemotherapy. The overall goal is to design interventions that maximize the beneficial effects of anticancer treatment by preventing NT-induced CSC expansion.
In Aim 1, we will first use human and mouse BC cells to determine how receptor activation by MCPs leads to Numb degradation and Notch activation to promote CSCs. Additional effectors mediating MCPs' effect on cancer cells will be identified. Mouse tumor models will be used to determine the effect of MCPs on non-cancer cells in the tumor microenvironment, which may in turn regulate the cytokine environment to influence CSCs.
In Aim 2, we will determine if the chemotherapy-induced miRNAs identified in our preliminary study synergistically stimulate CSCs with systemically elevated MCPs.
In Aim 3, patient-derived xenograft tumor models and mouse tumor models will be used to determine the anti-CSC effects of various agents targeting the herein identified pathways. We will then determine if NT induces monocyte expansion in BC patients and if MCP-initiated signaling is associated with CSC frequency in primary human BCs. Results from the proposed work will provide a mechanistic and pre-clinical basis for a future clinical trial using one of the CCR2 inhibitors previously developed for non-cancer diseases to target treatment-induced CSCs in BC patients. Improving our understanding of the interplay between hematopoietic cells, bulk cancer cells, and CSC populations after NT will allow the development of improved combinatorial therapies to reduce therapeutic resistance and tumor relapse. It may also provide insight into the clinical application of therapeutic regimens tailored to the need of individual patients, ultimately leading to an increased success of anticancer treatment.

Public Health Relevance

Preoperative chemotherapy is increasingly used to treat certain groups of breast cancer patients, but many patients do not respond and/or develop lethal metastatic disease after treatment. Our previous study suggests that chemotherapy causes increased levels of monocyte chemoattractant proteins in the blood that can stimulate cancer stem-like cells to promote malignancy. In the proposed study, we will carry out in-depth dissection of this previously unrecognized effect of conventional chemotherapy, and will test novel strategies to block this effect and maximize the beneficial effects of chemotherapy in breast cancer treatment.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA206911-04
Application #
9983624
Study Section
Cancer Molecular Pathobiology Study Section (CAMP)
Program Officer
Kondapaka, Sudhir B
Project Start
2017-08-01
Project End
2022-07-31
Budget Start
2020-08-01
Budget End
2021-07-31
Support Year
4
Fiscal Year
2020
Total Cost
Indirect Cost
Name
University of California, San Diego
Department
Pathology
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093
Yan, Wei; Wu, Xiwei; Zhou, Weiying et al. (2018) Cancer-cell-secreted exosomal miR-105 promotes tumour growth through the MYC-dependent metabolic reprogramming of stromal cells. Nat Cell Biol 20:597-609
Shen, Wen; Guo, Kaizhu; Adkins, Gary Brent et al. (2018) A Single Extracellular Vesicle (EV) Flow Cytometry Approach to Reveal EV Heterogeneity. Angew Chem Int Ed Engl 57:15675-15680
Chin, Andrew R; Yan, Wei; Cao, Minghui et al. (2018) Polarized Secretion of Extracellular Vesicles by Mammary Epithelia. J Mammary Gland Biol Neoplasia 23:165-176
Liu, Liang; Yang, Lin; Yan, Wei et al. (2018) Chemotherapy Induces Breast Cancer Stemness in Association with Dysregulated Monocytosis. Clin Cancer Res 24:2370-2382
Liu, Xuxiang; Cao, Minghui; Palomares, Melanie et al. (2018) Metastatic breast cancer cells overexpress and secrete miR-218 to regulate type I collagen deposition by osteoblasts. Breast Cancer Res 20:127