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CSCs in Breast Cancer—One Size Does Not Fit All: Therapeutic Advances in Targeting Heterogeneous Epithelial and Mesenchymal CSCs

by 1,2,3,4, 1,2,3,4, 5, 5,* and 1,2,3,4,6,*
1
Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada
2
China-Canada Centre of Research for Digestive Diseases, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada
3
Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, 725 South Wanping Road, Shanghai 200032, China
4
Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada
5
Institute of Chinese Traditional Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, 725 Wanping South Road, Shanghai 200032, China
6
Ottawa Institute of Systems Biology, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada
*
Authors to whom correspondence should be addressed.
Cancers 2019, 11(8), 1128; https://doi.org/10.3390/cancers11081128
Received: 16 June 2019 / Revised: 2 August 2019 / Accepted: 4 August 2019 / Published: 7 August 2019
Unlike other breast cancer subtypes, triple-negative breast cancer (TNBC) has no specific targets and is characterized as one of the most aggressive subtypes of breast cancer that disproportionately accounts for the majority of breast cancer-related deaths. Current conventional chemotherapeutics target the bulk tumor population, but not the cancer stem cells (CSCs) that are capable of initiating new tumors to cause disease relapse. Recent studies have identified distinct epithelial-like (E) ALDH+ CSCs, mesenchymal-like (M) CD44+/CD24 CSCs, and hybrid E/M ALDH+/CD44+/CD24 CSCs. These subtypes of CSCs exhibit differential signal pathway regulations, possess plasticity, and respond differently to treatment. As such, co-inhibition of different subtypes of CSCs is key to viable therapy. This review serves to highlight different pathway regulations in E and M CSCs in TNBC, and to further describe their role in disease progression. Potential inhibitors targeting E and/or M CSCs based on clinical trials are summarized for further investigation. Since future research needs to adopt suitable tumor models and take into account the divergence of E and M CSCs for the development of effective treatments, TNBC models for clinically translatable studies are further discussed. View Full-Text
Keywords: breast cancer; triple negative breast cancer; cancer stem cell; epithelial; mesenchymal; Wnt; YAP; NF-κB; hypoxia breast cancer; triple negative breast cancer; cancer stem cell; epithelial; mesenchymal; Wnt; YAP; NF-κB; hypoxia
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Sulaiman, A.; McGarry, S.; Han, X.; Liu, S.; Wang, L. CSCs in Breast Cancer—One Size Does Not Fit All: Therapeutic Advances in Targeting Heterogeneous Epithelial and Mesenchymal CSCs. Cancers 2019, 11, 1128.

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Cancers, EISSN 2072-6694, Published by MDPI AG
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