Abstract

The tumor microenvironment is known to play a key role in altering the properties and behavior of nearby cancer cells. Its influence on resistance to endocrine therapy and cancer relapse, however, is poorly understood. Here we investigate the interaction of mammary fibroblasts and estrogen receptor-positive breast cancer cells in three-dimensional culture models in order to characterize gene expression, cellular changes, and the secreted protein factors involved in the cellular cross-talk. We show that fibroblasts, which are the predominant cell type found in the stroma adjacent to the cancer cells in a tumor, induce an epithelial-to-mesenchymal transition in the cancer cells, leading to hormone-independent growth, a more invasive phenotype, and resistance to endocrine therapy. Here, we applied a label-free chemical imaging modality, Fourier transform infrared (FT-IR) spectroscopic imaging, to identify cells that had transitioned to hormone-independent growth. Both the molecular and chemical profiles identified here were translated from cell culture to patient samples: a secreted protein signature was used to stratify patient populations based on gene expression and FT-IR was used to characterize breast tumor patient biopsies. Our findings underscore the role of mammary fibroblasts in promoting aggressiveness and endocrine therapy resistance in ER-positive breast cancers and highlight the utility of FT-IR for the further characterization of breast cancer samples.

Highlights

  • More than 70% of breast cancers diagnosed in the US are estrogen receptor positive (ER+) [1,2]

  • Our findings reveal that the interaction of ER+ breast cancer cells with mammary fibroblasts promotes a more aggressive and endocrine therapy-resistant state

  • Mammary fibroblasts induce a downregulation in the level of cellular ERa and promote a more rapidly proliferating hormone-independent state in ER+ breast cancer cells

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Summary

Introduction

More than 70% of breast cancers diagnosed in the US are estrogen receptor positive (ER+) [1,2]. ER+ tumors generally have more favorable prognoses compared to other subtypes and can be treated with targeted endocrine therapies such as tamoxifen [3]. Though many ER+ patients initially respond favorably to targeted therapy, up to 30% of treated cancers recur [3,4]. It would be advantageous to identify at the time of initial diagnosis the patients who will not respond to endocrine therapy in the longterm so that their care can be managed differently. The factors underlying recurrence arising from endocrine resistance are not fully understood, but it is increasingly appreciated that the microenvironment of the tumor cells can play a critical role in impacting the behavior of the cancer cells [6,7]

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