Deciphering the Role of Cancer Stem Cells in Breast Cancer Brain Colonization Using a Novel Patient‐Derived Model

Brain metastases from breast cancer (BCBM) are fatal and lack effective treatments. Their cellular and molecular drivers remain poorly understood, partly due to limited preclinical models that fail to capture patient tumor heterogeneity. Cancer stem-like cells (CSCs) are implicated in metastatic dissemination; however, their specific role in brain metastasis remains unclear. In this study, CSCs are isolated from human BCBM specimens and characterized for stem-like properties, including CD44 and ALDH1 expression, sphere formation, tumorigenicity, and in vitro and in vivo self-renewal. Intra-nipple and intra-cardiac xenograft models demonstrate CSC ability to generate brain and bone metastases that recapitulate patient-specific dissemination patterns. Transcriptomic and functional analyses reveal cellular heterogeneity and identify a metastasis-initiating cell (MIC) subpopulation enriched in stemness and adhesion-related pathways. These MICs exhibit enhanced adhesion to brain endothelium and undergo brain-specific transcriptomic reprogramming that enables vascular co-option, resistance to stromal stress, and survival-promoting interactions with brain-resident cells. High-throughput drug screening indicates broad therapeutic resistance within the CSC compartment. Through the comprehensive characterization of BCBM-derived CSCs, this study establishes a clinically relevant model that identifies CSCs and the MIC subpopulation as key drivers of brain metastatic progression and as promising targets for the development of effective therapeutic strategies.

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Publication Details

Journal
Advanced Healthcare Materials
Published
2026-03-27
DOI
https://doi.org/10.1002/adhm.202505789
Primary Topic
Cancer Cells and Metastasis
Type
article
Field-Weighted Citation Impact
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article

Deciphering the Role of Cancer Stem Cells in Breast Cancer Brain Colonization Using a Novel Patient‐Derived Model

Bianca Pollo, Valentina Gambino, Massimiliano Del Bene, Maria Grazia Filippone et al.
Advanced Healthcare Materials
Cancer Cells and Metastasis
article

Deciphering the Role of Cancer Stem Cells in Breast Cancer Brain Colonization Using a Novel Patient‐Derived Model

Bianca Pollo, Valentina Gambino, Massimiliano Del Bene, Maria Grazia Filippone, Elena Zaccheroni, Ignacio A. Romero, Brunella Costanza, Elena Ceccacci, Daniela Osti, Giovanni Bertalot, Marcello Del Corvo, Yinxiu Zhan, B B Weksler, Camilla Cerutti, Salvatore Pece, Giuseppina Giardina, Cristina Richichi, Stefania Faletti, Teresa Gravina, Maria Giovanna Jodice, Adriana Marinaro, Davide Corà, D. Tosoni, M. Patanè, Elisabetta Munzone, Francesco DiMeco, Pierre‐Olivier Couraud, Giuliana Pelicci
article en

Abstract

Brain metastases from breast cancer (BCBM) are fatal and lack effective treatments. Their cellular and molecular drivers remain poorly understood, partly due to limited preclinical models that fail to capture patient tumor heterogeneity. Cancer stem-like cells (CSCs) are implicated in metastatic dissemination; however, their specific role in brain metastasis remains unclear. In this study, CSCs are isolated from human BCBM specimens and characterized for stem-like properties, including CD44 and ALDH1 expression, sphere formation, tumorigenicity, and in vitro and in vivo self-renewal. Intra-nipple and intra-cardiac xenograft models demonstrate CSC ability to generate brain and bone metastases that recapitulate patient-specific dissemination patterns. Transcriptomic and functional analyses reveal cellular heterogeneity and identify a metastasis-initiating cell (MIC) subpopulation enriched in stemness and adhesion-related pathways. These MICs exhibit enhanced adhesion to brain endothelium and undergo brain-specific transcriptomic reprogramming that enables vascular co-option, resistance to stromal stress, and survival-promoting interactions with brain-resident cells. High-throughput drug screening indicates broad therapeutic resistance within the CSC compartment. Through the comprehensive characterization of BCBM-derived CSCs, this study establishes a clinically relevant model that identifies CSCs and the MIC subpopulation as key drivers of brain metastatic progression and as promising targets for the development of effective therapeutic strategies.

Advanced Healthcare Materials
Università degli Studi del Piemonte Orientale “Amedeo Avogadro” (IT), Inserm (FR), University of Milan (IT), University of Trento (IT), The Open University (GB), Université Paris Cité (FR), Cornell University (US), Ospedale Santa Chiara (IT), Institut Cochin (FR), Fondazione IRCCS Istituto Neurologico Carlo Besta (IT), European Institute of Oncology (IT)
Good health and well-being
Openalex Percentile: Top 5%
Cancer Cells and Metastasis
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