Research and Analysis of the Mechanisms Involved in the Emergence of Breast Cancer Stem Cells (RepriM)

From a cellular perspective, breast cancers appear to develop hierarchically from a small contingent of cancer stem cells (CSCs). The presence of CSCs in tumor tissue is associated with an increased risk of recurrence and metastasis, as well as a worse prognosis. Thus, these CSCs exhibit resistance to conventional anti-tumor treatments such as radiotherapy and chemotherapy. Moreover, these treatments would favor the emergence of these CSCs and the reprogramming of non-CSCs in CSCs. It has been demonstrated in neoadjuvant that the proportion of CSCs before any treatment is correlated with chemoresistance and that a resurgence of CSCs after chemotherapy is correlated with a poor prognosis. However, the mechanisms involved in the emergence of CSCs by reprogramming of non-CSCs are not yet known. The Oscar Lambret Center proposes a monocentric prospective interventional study based on the cellular and molecular analysis of the tumor, serum and circulating cells, before, during and at the end of the treatment for each patient receiving a neoadjuvant chemotherapy for breast cancer. The identification of the mechanisms contributing to the enrichment of CSCs resistant to chemotherapy could lead to therapeutic solutions.

Sex

Female

Minimum age

18 Years

Inclusion Criteria:

* Women over 18
* With a mammary adenocarcinoma histologically proven
* Who cannot benefit from a first-conserving surgery or with aggressiveness criteria on the initial biopsy (triple negative tumor, grade III histoprognostic, high Ki67, HER2 overexpressed) after presentation in multidisciplinary meeting.
* Absence of prior chemotherapy.
* Requiring a neoadjuvant chemotherapy with anthracyclines and taxanes selected in multidisciplinary meeting.
* Informed consent signed by the patient before the implementation of any specific procedure to the study.

Exclusion Criteria:

* Metastatic disease. The extension work-up is carried out according to the reference system of the participating center.
* Other histological type.
* Patient refusing the conservation of samples.
* Patient included in a clinical trial protocol with an experimental molecule (during this study).