A hybrid breast cancer/mesenchymal stem cell population enhances chemoresistance and metastasis.

Abstract

Patients with triple negative breast cancer remain at risk for metastatic disease despite treatment. The acquisition of chemoresistance is a major cause of tumor relapse and death, but the mechanisms are far from understood. We have demonstrated that breast cancer cells (BCCs) can engulf mesenchymal stem/stromal cells (MSCs), leading to enhanced dissemination. Here, we show that clinical samples of primary invasive carcinoma and chemoresistant breast cancer metastasis contain a unique hybrid cancer cell population co-expressing pan-cytokeratin and the MSC marker fibroblast activation protein-alpha. We show that hybrid cells form in primary tumors and that they promote breast cancer metastasis and chemoresistance. Using single cell microfluidics and in vivo models, we found that within the hybrid cell population are polyploid senescent cells that contribute to metastatic dissemination. Our data reveal that WNT5A plays a crucial role in supporting the chemoresistance properties of hybrid cells. Furthermore, we identify that WNT5A mediates hybrid cell formation through a phagocytosis-like mechanism that requires BCC-derived Interleukin 6 and MSC-derived C-C Motif Chemokine Ligand 2. These findings reveal hybrid cell formation as a novel mechanism of chemoresistance and suggest that interrupting this mechanism may be a potential strategy to overcome breast cancer drug resistance.