DOI
https://doi.org/10.25772/7XHM-5D75
Author ORCID Identifier
https://orcid.org/ 0000-0002-1788-9278
Defense Date
2022
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Clinical and Translational Sciences
First Advisor
Sandro da Rocha
Second Advisor
Douglas Sweet
Third Advisor
Joshua Harrell
Fourth Advisor
Harry Bear
Fifth Advisor
Umesh Desai
Abstract
Breast cancer is the most diagnosed cancer worldwide and the second leading cause of cancer related deaths. About 20% of all breast cancer cases are diagnosed with triple negative breast cancer (TNBC), which has the lowest overall survival rate of any subtype. Because of the lack of hormone receptor expression, chemotherapy is the main treatment option for TNBC patients. Nevertheless, an initial complete response to neoadjuvant treatment is seen in less than 50% of these patients, while many will relapse and develop metastasis leading to a certainty of death. Therefore, a new treatment strategy is necessary. One strategy is to manipulate the immune cells in the tumor microenvironment (TME) of TNBC. Tumor associated macrophages (TAMs) make up to 50% of the cell population in the TME, and their abundance is correlated with worse overall survival in TNBC patients. In this work, we investigated the effectiveness of three macrophage immunotherapies in a primary murine model of TNBC. We demonstrated that treatment with either PLX3397, BLZ945 or all-trans retinoic acid (ATRA) leads to the reduction of the TAM population, while ATRA also reduced the abundance of MDSC in the tumor. This work set the stage for the use of macrophage immunotherapies in combination with other anti-cancer agents to increase the efficacy in treating TNBC patients. We then combined PLX and ATRA with standard of care chemotherapy, doxorubicin (DOX). We showed that in combination with DOX, PLX was still able to reduce the M2-like population, as well as the MDSC population. Furthermore, we showed that combination therapy has a greater efficacy on the reduction of tumor burden than single therapy alone. The use of PLX and ATRA in the treatment of TNBC is very promising and we aim to continue exploring the use of macrophage therapies in combination with standard of care chemotherapy.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
7-23-2022
Included in
Cancer Biology Commons, Nanomedicine Commons, Oncology Commons, Pharmaceutics and Drug Design Commons, Translational Medical Research Commons