LAUSR

4175 What are the clinical implications? One key clinical implication of these findings is the suggestion that TNBC cells can develop resistance against therapies, says Dr Grasset, explaining that cancer cell heterogeneity and EMT are both associated with treatment resistance. “Unfortunately, our study demonstrated that TNBC primary tumors and metastases are heterogenous and express markers of EMT,” she says. “Moreover, the presence of EMT markers indicates that TNBC cells are highly mobile and invasive, which could explain why patients often present with distant metastasis.” Furthermore, she adds, the study suggests that cancer cells maintain their aggressive behavior even in distant sites. The study also suggests that multiple cancer states can be found within the same patient and even within the same tumor (primary or metastatic). “This suggests that cancer cells can respond differently to a treatment,” says Dr Grasset. In addition, the findings indicate that cancer cells can modify their gene expression during different processes and adapt to their environment. “All of this sounds really bad,” Dr Grasset says. “However, we are working on identifying key targets to design new therapies against EMT and TNBC metastatic disease.” Dr Ewald noted in the press release1 that the good news is the identification of several proteins (transcription factors) that cells from metastatic sites need to handle the challenges of migrating and thriving. “We may be able to design new therapies that target these transcription factors.”