The sialyl-glycolipid stage-specific embryonic antigen 4 marks a subpopulation of chemotherapy-resistant breast cancer cells with mesenchymal features

Andrea Aloia, Evgeniya Petrova, Stefan Tomiuk, Ute Bissels, Olivier Déas, Massimo Saini, Franziska Maria Zickgraf, Steve Wagner, Saskia Spaich, Marc Sütterlin, Andreas Schneeweiss, Manuel Reitberger, Silvia Rüberg, Bernhard Gerstmayer, David Agorku, Sebastian Knöbel, Annalisa Terranegra, Monica Falleni, Laura Soldati, Martin Ronald SprickAndreas Trumpp, Jean Gabriel Judde, Andreas Bosio, Stefano Cairo, Olaf Hardt

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Abstract

Introduction: Chemotherapy resistance resulting in incomplete pathologic response is associated with high risk of metastasis and early relapse in breast cancer. The aim of this study was to identify and evaluate biomarkers of treatment-resistant tumor cells. Methods: We performed a cell surface marker screen in triple-negative breast cancer patient-derived xenograft models treated with standard care genotoxic chemotherapy. Global expression profiling was used to further characterize the identified treatment-resistant subpopulations. Results: High expression of sialyl-glycolipid stage-specific embryonic antigen 4 (SSEA4) was found in residual tumor cells surviving chemotherapy and in samples from metastatic patients who relapsed after neoadjuvant chemotherapy. Gene and microRNA (miRNA) expression profiling linked SSEA4 positivity with a mesenchymal phenotype and a deregulation of drug resistance pathways. Functional assays demonstrated a direct link between epithelial-mesenchymal transition (EMT) and SSEA4 expression. Interestingly, SSEA4 expression, EMT, and drug resistance seemed to be regulated posttranscriptionally. Finally, high expression of CMP-N-acetylneuraminate-β-galactosamide-aα-2,3-sialyltransferase 2 (ST3GAL2), the rate-limiting enzyme of SSEA4 synthesis, was found to be associated with poor clinical outcome in breast and ovarian cancer patients treated with chemotherapy. Conclusions: In this study, we identified SSEA4 as highly expressed in a subpopulation of tumor cells resistant to multiple commonly used chemotherapy drugs, as well as ST3GAL2, the rate-limiting enzyme of SSEA4 synthesis, as a predictive marker of poor outcome for breast and ovarian cancer patients undergoing chemotherapy. Both biomarkers and additionally identified regulatory miRNAs may be used to further understand chemoresistance, to stratify patient groups in order to avoid ineffective and painful therapies, and to develop alternative treatment regimens for breast cancer patients.

Original languageEnglish
Article number146
JournalBreast Cancer Research
Volume17
Issue number1
DOIs
Publication statusPublished - 25 Nov 2015

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Glycolipids
Breast Neoplasms
Drug Therapy
Epithelial-Mesenchymal Transition
MicroRNAs
Drug Resistance
Ovarian Neoplasms
Biomarkers
Triple Negative Breast Neoplasms
Sialyltransferases
Cytidine Monophosphate
Residual Neoplasm
Gene Expression Profiling
Enzymes
Therapeutics
stage-specific embryonic antigen-4
Heterografts
Neoplasms
Neoplasm Metastasis
Phenotype

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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The sialyl-glycolipid stage-specific embryonic antigen 4 marks a subpopulation of chemotherapy-resistant breast cancer cells with mesenchymal features. / Aloia, Andrea; Petrova, Evgeniya; Tomiuk, Stefan; Bissels, Ute; Déas, Olivier; Saini, Massimo; Zickgraf, Franziska Maria; Wagner, Steve; Spaich, Saskia; Sütterlin, Marc; Schneeweiss, Andreas; Reitberger, Manuel; Rüberg, Silvia; Gerstmayer, Bernhard; Agorku, David; Knöbel, Sebastian; Terranegra, Annalisa; Falleni, Monica; Soldati, Laura; Sprick, Martin Ronald; Trumpp, Andreas; Judde, Jean Gabriel; Bosio, Andreas; Cairo, Stefano; Hardt, Olaf.

In: Breast Cancer Research, Vol. 17, No. 1, 146, 25.11.2015.

Research output: Contribution to journalArticle

Aloia, A, Petrova, E, Tomiuk, S, Bissels, U, Déas, O, Saini, M, Zickgraf, FM, Wagner, S, Spaich, S, Sütterlin, M, Schneeweiss, A, Reitberger, M, Rüberg, S, Gerstmayer, B, Agorku, D, Knöbel, S, Terranegra, A, Falleni, M, Soldati, L, Sprick, MR, Trumpp, A, Judde, JG, Bosio, A, Cairo, S & Hardt, O 2015, 'The sialyl-glycolipid stage-specific embryonic antigen 4 marks a subpopulation of chemotherapy-resistant breast cancer cells with mesenchymal features', Breast Cancer Research, vol. 17, no. 1, 146. https://doi.org/10.1186/s13058-015-0652-6
Aloia, Andrea ; Petrova, Evgeniya ; Tomiuk, Stefan ; Bissels, Ute ; Déas, Olivier ; Saini, Massimo ; Zickgraf, Franziska Maria ; Wagner, Steve ; Spaich, Saskia ; Sütterlin, Marc ; Schneeweiss, Andreas ; Reitberger, Manuel ; Rüberg, Silvia ; Gerstmayer, Bernhard ; Agorku, David ; Knöbel, Sebastian ; Terranegra, Annalisa ; Falleni, Monica ; Soldati, Laura ; Sprick, Martin Ronald ; Trumpp, Andreas ; Judde, Jean Gabriel ; Bosio, Andreas ; Cairo, Stefano ; Hardt, Olaf. / The sialyl-glycolipid stage-specific embryonic antigen 4 marks a subpopulation of chemotherapy-resistant breast cancer cells with mesenchymal features. In: Breast Cancer Research. 2015 ; Vol. 17, No. 1.
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abstract = "Introduction: Chemotherapy resistance resulting in incomplete pathologic response is associated with high risk of metastasis and early relapse in breast cancer. The aim of this study was to identify and evaluate biomarkers of treatment-resistant tumor cells. Methods: We performed a cell surface marker screen in triple-negative breast cancer patient-derived xenograft models treated with standard care genotoxic chemotherapy. Global expression profiling was used to further characterize the identified treatment-resistant subpopulations. Results: High expression of sialyl-glycolipid stage-specific embryonic antigen 4 (SSEA4) was found in residual tumor cells surviving chemotherapy and in samples from metastatic patients who relapsed after neoadjuvant chemotherapy. Gene and microRNA (miRNA) expression profiling linked SSEA4 positivity with a mesenchymal phenotype and a deregulation of drug resistance pathways. Functional assays demonstrated a direct link between epithelial-mesenchymal transition (EMT) and SSEA4 expression. Interestingly, SSEA4 expression, EMT, and drug resistance seemed to be regulated posttranscriptionally. Finally, high expression of CMP-N-acetylneuraminate-β-galactosamide-aα-2,3-sialyltransferase 2 (ST3GAL2), the rate-limiting enzyme of SSEA4 synthesis, was found to be associated with poor clinical outcome in breast and ovarian cancer patients treated with chemotherapy. Conclusions: In this study, we identified SSEA4 as highly expressed in a subpopulation of tumor cells resistant to multiple commonly used chemotherapy drugs, as well as ST3GAL2, the rate-limiting enzyme of SSEA4 synthesis, as a predictive marker of poor outcome for breast and ovarian cancer patients undergoing chemotherapy. Both biomarkers and additionally identified regulatory miRNAs may be used to further understand chemoresistance, to stratify patient groups in order to avoid ineffective and painful therapies, and to develop alternative treatment regimens for breast cancer patients.",
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AU - Aloia, Andrea

AU - Petrova, Evgeniya

AU - Tomiuk, Stefan

AU - Bissels, Ute

AU - Déas, Olivier

AU - Saini, Massimo

AU - Zickgraf, Franziska Maria

AU - Wagner, Steve

AU - Spaich, Saskia

AU - Sütterlin, Marc

AU - Schneeweiss, Andreas

AU - Reitberger, Manuel

AU - Rüberg, Silvia

AU - Gerstmayer, Bernhard

AU - Agorku, David

AU - Knöbel, Sebastian

AU - Terranegra, Annalisa

AU - Falleni, Monica

AU - Soldati, Laura

AU - Sprick, Martin Ronald

AU - Trumpp, Andreas

AU - Judde, Jean Gabriel

AU - Bosio, Andreas

AU - Cairo, Stefano

AU - Hardt, Olaf

PY - 2015/11/25

Y1 - 2015/11/25

N2 - Introduction: Chemotherapy resistance resulting in incomplete pathologic response is associated with high risk of metastasis and early relapse in breast cancer. The aim of this study was to identify and evaluate biomarkers of treatment-resistant tumor cells. Methods: We performed a cell surface marker screen in triple-negative breast cancer patient-derived xenograft models treated with standard care genotoxic chemotherapy. Global expression profiling was used to further characterize the identified treatment-resistant subpopulations. Results: High expression of sialyl-glycolipid stage-specific embryonic antigen 4 (SSEA4) was found in residual tumor cells surviving chemotherapy and in samples from metastatic patients who relapsed after neoadjuvant chemotherapy. Gene and microRNA (miRNA) expression profiling linked SSEA4 positivity with a mesenchymal phenotype and a deregulation of drug resistance pathways. Functional assays demonstrated a direct link between epithelial-mesenchymal transition (EMT) and SSEA4 expression. Interestingly, SSEA4 expression, EMT, and drug resistance seemed to be regulated posttranscriptionally. Finally, high expression of CMP-N-acetylneuraminate-β-galactosamide-aα-2,3-sialyltransferase 2 (ST3GAL2), the rate-limiting enzyme of SSEA4 synthesis, was found to be associated with poor clinical outcome in breast and ovarian cancer patients treated with chemotherapy. Conclusions: In this study, we identified SSEA4 as highly expressed in a subpopulation of tumor cells resistant to multiple commonly used chemotherapy drugs, as well as ST3GAL2, the rate-limiting enzyme of SSEA4 synthesis, as a predictive marker of poor outcome for breast and ovarian cancer patients undergoing chemotherapy. Both biomarkers and additionally identified regulatory miRNAs may be used to further understand chemoresistance, to stratify patient groups in order to avoid ineffective and painful therapies, and to develop alternative treatment regimens for breast cancer patients.

AB - Introduction: Chemotherapy resistance resulting in incomplete pathologic response is associated with high risk of metastasis and early relapse in breast cancer. The aim of this study was to identify and evaluate biomarkers of treatment-resistant tumor cells. Methods: We performed a cell surface marker screen in triple-negative breast cancer patient-derived xenograft models treated with standard care genotoxic chemotherapy. Global expression profiling was used to further characterize the identified treatment-resistant subpopulations. Results: High expression of sialyl-glycolipid stage-specific embryonic antigen 4 (SSEA4) was found in residual tumor cells surviving chemotherapy and in samples from metastatic patients who relapsed after neoadjuvant chemotherapy. Gene and microRNA (miRNA) expression profiling linked SSEA4 positivity with a mesenchymal phenotype and a deregulation of drug resistance pathways. Functional assays demonstrated a direct link between epithelial-mesenchymal transition (EMT) and SSEA4 expression. Interestingly, SSEA4 expression, EMT, and drug resistance seemed to be regulated posttranscriptionally. Finally, high expression of CMP-N-acetylneuraminate-β-galactosamide-aα-2,3-sialyltransferase 2 (ST3GAL2), the rate-limiting enzyme of SSEA4 synthesis, was found to be associated with poor clinical outcome in breast and ovarian cancer patients treated with chemotherapy. Conclusions: In this study, we identified SSEA4 as highly expressed in a subpopulation of tumor cells resistant to multiple commonly used chemotherapy drugs, as well as ST3GAL2, the rate-limiting enzyme of SSEA4 synthesis, as a predictive marker of poor outcome for breast and ovarian cancer patients undergoing chemotherapy. Both biomarkers and additionally identified regulatory miRNAs may be used to further understand chemoresistance, to stratify patient groups in order to avoid ineffective and painful therapies, and to develop alternative treatment regimens for breast cancer patients.

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