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Association of breast cancer stem cells identified by aldehyde dehydrogenase 1 expression with resistance to sequential paclitaxel and epirubicin-based chemotherapy for breast cancers
Clinical Cancer Research, 06/17/09

Tanei T et al. - In a trial to investigate whether cancer stem cells were clinically significant for resistance to chemotherapy in human breast cancers, it was reported that breast cancer stem cells identified as ALDH1-positive, but not CD44+/CD24–, play a significant role in resistance to chemotherapy. ALDH1-positive thus seems to be a more significantly predictive marker than CD44+/CD24– for the identification of breast cancer stem cells in terms of resistance to chemotherapy.

Methods

Primary breast cancer pts (n=108) treated with neoadjuvant chemotherapy consisting of sequential paclitaxel and epirubicin-based chemotherapy were included.
Breast cancer stem cells were identified by immunohistochemical staining of CD44/CD24 and aldehyde dehydrogenase 1 (ALDH1) in tumor tissues obtained before and after neoadjuvant chemotherapy.
CD44+/CD24– tumor cells or ALDH1-positive tumor cells were considered stem cells.

Results

30 (27.8%) pts achieved pathologic complete response (pCR).
ALDH1-positive tumors were significantly associated with a low pCR rate (9.5% vs 32.2%), but there was no significant association between CD44+/CD24– tumor cell proportions and pCR rates.
Changes in the proportion of CD44+/CD24– or ALDH1-positive tumor cells before and after neoadjuvant chemotherapy were studied in 78 pts who did not achieve pCR.
Proportion of ALDH1-positive tumor cells increased significantly after neoadjuvant chemotherapy, but that of CD44+/CD24– tumor cells did not.

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