Chemotherapy-triggered changes in stromal compartment drive tumor invasiveness and progression of breast cancer

J Exp Clin Cancer Res. 2021 Sep 27;40(1):302. doi: 10.1186/s13046-021-02087-2.

Abstract

Background: Chemotherapy remains a standard treatment option for breast cancer despite its toxic effects to normal tissues. However, the long-lasting effects of chemotherapy on non-malignant cells may influence tumor cell behavior and response to treatment. Here, we have analyzed the effects of doxorubicin (DOX) and paclitaxel (PAC), commonly used chemotherapeutic agents, on the survival and cellular functions of mesenchymal stromal cells (MSC), which comprise an important part of breast tumor microenvironment.

Methods: Chemotherapy-exposed MSC (DOX-MSC, PAC-MSC) were co-cultured with three breast cancer cell (BCC) lines differing in molecular characteristics to study chemotherapy-triggered changes in stromal compartment of the breast tissue and its relevance to tumor progression in vitro and in vivo. Conditioned media from co-cultured cells were used to determine the cytokine content. Mixture of BCC and exposed or unexposed MSC were subcutaneously injected into the immunodeficient SCID/Beige mice to analyze invasion into the surrounding tissue and possible metastases. The same mixtures of cells were applied on the chorioallantoic membrane to study angiogenic potential.

Results: Therapy-educated MSC differed in cytokine production compared to un-exposed MSC and influenced proliferation and secretory phenotype of tumor cells in co-culture. Histochemical tumor xenograft analysis revealed increased invasive potential of tumor cells co-injected with DOX-MSC or PAC-MSC and also the presence of nerve fiber infiltration in tumors. Chemotherapy-exposed MSC have also influenced angiogenic potential in the model of chorioallantoic membrane.

Conclusions: Data presented in this study suggest that neoadjuvant chemotherapy could possibly alter otherwise healthy stroma in breast tissue into a hostile tumor-promoting and metastasis favoring niche. Understanding of the tumor microenvironment and its complex net of signals brings us closer to the ability to recognize the mechanisms that prevent failure of standard therapy and accomplish the curative purpose.

Keywords: Breast cancer; Cancer progression; Chemotherapy; Mesenchymal stromal cells; Tumor microenvironment.

MeSH terms

  • Animals
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Apoptosis
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / pathology*
  • Cell Proliferation
  • Cell Transformation, Neoplastic / chemically induced
  • Cell Transformation, Neoplastic / pathology*
  • Doxorubicin / administration & dosage
  • Female
  • Humans
  • Mesenchymal Stem Cells / drug effects
  • Mesenchymal Stem Cells / pathology*
  • Mice
  • Mice, SCID
  • Neoplasm Invasiveness
  • Paclitaxel / administration & dosage
  • Tumor Cells, Cultured
  • Xenograft Model Antitumor Assays

Substances

  • Doxorubicin
  • Paclitaxel