Abstract

Metaplastic breast carcinoma (MBC) is a clinically aggressive and rare subtype of breast cancer, with similar features to basal-like breast cancers. Due to rapid growth rates and characteristic heterogeneity, MBC is often unresponsive to standard chemotherapies; and novel targeted therapeutic discovery is urgently needed. Histone deacetylase inhibitors (DACi) suppress tumor growth and metastasis through regulation of the epithelial-to-mesenchymal transition axis in various cancers, including basal-like breast cancers. We utilized a new MBC patient-derived xenograft (PDX) to examine the effect of DACi therapy on MBC. Cell morphology, cell cycle-associated gene expressions, transwell migration, and metastasis were evaluated in patient-derived cells and tumors after treatment with romidepsin and panobinostat. Derivations of our PDX model, including cells, spheres, organoids, explants, and in vivo implanted tumors were treated. Finally, we tested the effects of combining DACi with approved chemotherapeutics on relative cell biomass. DACi significantly suppressed the total number of lung metastasis in vivo using our PDX model, suggesting a role for DACi in preventing circulating tumor cells from seeding distal tissue sites. These data were supported by our findings that DACi reduced cell migration, populations, and expression of mesenchymal-associated genes. While DACi treatment did affect cell cycle-regulating genes in vitro, tumor growth was not affected compared to controls. Importantly, gene expression results varied depending on the cellular or tumor system used, emphasizing the importance of using multiple derivations of cancer models in preclinical therapeutic discovery research. Furthermore, DACi sensitized and produced a synergistic effect with approved oncology therapeutics on inherently resistant MBC. This study introduced a role for DACi in suppressing the migratory and mesenchymal phenotype of MBC cells through regulation of the epithelial-mesenchymal transition axis and suppression of the CTC population. Preliminary evidence that DACi treatment in combination with MEK1/2 inhibitors exerts a synergistic effect on MBC cells was also demonstrated.

Highlights

  • Metaplastic breast carcinoma (MBC) is a rare breast cancer subtype, comprising 0.45–1% of all breast cancers

  • FRA-1 expression was downregulated in romidepsin-treated spheres and patient-derived xenograft (PDX)-Os but had increased expression in implanted tumors. These findings show the differences in Deacetylase inhibition in metaplastic breast carcinoma gene expression changes in cells compared to that in spheres, Patient-derived xenograft organoids (PDX-O), and tumor implants; and emphasize the importance of further analysis beyond the effects in monolayer cell populations in order to identify mechanisms of deacetylase inhibitors (DACi) on triple negative breast cancer (TNBC)

  • The results of this study showed DACi suppression of migration and mesenchymal phenotypes in MBC, compared to DMSO controls

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Summary

Introduction

Metaplastic breast carcinoma (MBC) is a rare breast cancer subtype, comprising 0.45–1% of all breast cancers. A defining feature of MBC is the rapid tumor growth rate; this aggressive clinical presentation contributes to the lower survival rates of patients with MBC compared to patients afflicted with other intraductal carcinomas [4, 5] When compared to another breast cancer subtype that has limited therapeutic targets and high rates of metastasis and relapse, TNBC patients afflicted with MBC have worse disease-free survival and overall survival [6, 7]. Despite these differences, MBCs are therapeutically managed to other invasive breast carcinomas, with surgical resection in combination with radiation and/or chemotherapy [8].

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