摘要
Breast cancer is the second leading cause of cancer-associated death in women in the United States, with more than 90% of those deaths attributed to metastasis. Breast cancer metastasis is incurable and possesses few treatment options and a poor overall prognosis due in part to confounding metastatic attributes, particularly the acquisition of dormancy-associated phenotypes. Dormant disseminated tumor cells can persist for years-to-decades before recurring as highly aggressive, secondary lesions. Dormancy-associated phenotypes are exhibited by breast cancer stem cells (BCSCs), which undergo tumor initiation and unlimited self-renewal. In addition to their specialized abilities to circumvent chemotherapeutic insults, BCSCs also upregulate autophagy during metastatic dormancy as a means to survive in nutrient poor conditions and environmental stress. As such, therapeutic targeting of autophagy is actively being pursued as an attractive strategy to alleviate metastatic disease and the recurrence of dormant BCSCs. Here we review the molecular and cellular features of autophagy, as well as its paradoxical role in both suppressing and promoting mammary tumor development and metastatic progression. Finally, we highlight the clinical challenges associated with therapeutic targeting of autophagy in metastatic breast cancers.
基金
Research support was provided in part by the National Institutes of Health(CA236273)to Schiemann WP,and(T32GM008803 and T32CA059366)to Flynn ALB.Additional support was graciously provided by the METAvivor Foundation to Schiemann WP,and by pilot funding from the Case Comprehensive Cancer Center's Research Innovation Fund,which is supported by the Case Council and Friends of the Case Comprehensive Cancer Center to Schiemann WP,and from the Case Clinical&Translational Science Collaborative to Schiemann WP
