Cancer Stem Cell Markers and Therapy Resistance in Triple-Negative Breast Carcinoma
DOI:
https://doi.org/10.5281/zenodo.22274734Keywords:
Cancer stem cells; Triple-negative breast carcinoma; Aldehyde dehydrogenase; Chemotherapy resistance; Tumour heterogeneityAbstract
Background: In triple-negative breast carcinoma the term cancer stem cell is applied to populations defined either by CD44
and CD24 surface phenotype or by aldehyde dehydrogenase activity.
Objective: To test whether the two marker systems identify the same cells, and whether the measurements support claims
about chemoresistance, prognosis and targeted treatment.
Methods: Narrative review of marker-scoring series, functional assays, prognostic meta-analyses and one randomised trial.
Findings: The systems barely overlap: across 466 carcinomas approximately 1% of cells were both marker-positive, and the
same 54 metastatic biopsies scored 34/54 for one system against 16/54 for the other. Chemotherapy raised marker-positive
cells from 4.7% to 13.6% (N = 31), yet a randomised trial of 123 patients showed no benefit.
Conclusions: The evidence supports reproducible enrichment of marker-positive cells after cytotoxic therapy. It does not
support treating either marker system as identifying a single resistant compartment, or as a clinical decision tool.
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