Abstract P5-17-01: Patient-derived organoid models of inflammatory breast cancer
Authors: Rosenbluth JM , Zervantonakis I , Boedicker M , Wagle N , Dillon D , Nakhlis F , Brugge JS , Overmoyer B 
Published: May 2019

Abstract
Background: Inflammatory Breast Cancer (IBC) is an aggressive subtype of breast cancer that is associated with an increased likelihood of early metastasis and a poor prognosis, accounting for approximately 10% of all breast cancer mortality. Currently, there is limited availability of cell line and patient-derived xenograft (PDX) models of IBC. As a result, there is an urgent need for additional model systems to facilitate our understanding of this disease. Organoids have been used to grow breast cancer cells with high efficiency, resulting in long-term cultures with genetic and phenotypic stability; however, the extent to which IBC can be modeled using this system is unknown. We undertook an evaluation of organoid culture technology for growing IBC patient samples, with the goal of generating a model of IBC that more faithfully recapitulates the key features of the disease.
Methods: Tumor samples (taken from lumpectomy, mastectomy, PDX, or core biopsy samples), were digested to the organoid level using collagenase, and were grown in three dimensional cultures using a basement membrane extract and a fully-defined organoid medium, as described (Sachs et al. Cell 2018). First, we surveyed non-IBC metastatic breast cancer samples to determine the efficiency of growth of multiple breast cancer subtypes under these conditions. Then, we assessed the efficiency of growth of IBC samples taken after treatment, at the time of mastectomy. Co-culture experiments in which IBC organoids were grown in the presence of human endothelial cells were performed in three dimensional culture using a mixture of type I collagen and basement membrane extract.
Results: Our success rate for establishing organoid cultures from breast cancer samples in general was 75% (33 out of 44 samples), and for triple-negative breast cancers, the success rate for establishment of organoid cultures was 100% (14 out of 14 samples). Expansion of ER+ tumor organoids (16 of 26 samples) was primarily restricted by a slow growth rate in culture, as compared to triple-negative tumor organoids. We were able to establish 12 breast cancer organoids from core biopsies of multiple metastatic sites, including brain, liver, bone, breast, and skin. We subsequently were able to establish organoid cultures from five out of five IBC tumor samples. Our IBC organoids preserved histopathologic features of the original tumor, and expressed key markers, such as E-cadherin, that are known to be associated with IBC. In addition, our IBC organoids interacted with human endothelial cells under co-culture conditions designed to model lymphovascular invasion, an essential feature of IBC.
Conclusion: We have shown that organoid cultures can be established to propagate IBC tumors with high efficiency, preserve key pathologic features of IBC in vitro, and model interactions between tumor cells and the microenvironment. Thus, organoids are useful complements to existing IBC models, and can be used to identify potential therapeutic vulnerabilities associated with this particularly aggressive breast cancer subtype.
Citation Format: Rosenbluth JM, Zervantonakis I, Boedicker M, Wagle N, Dillon D, Nakhlis F, Brugge JS, Overmoyer B. Patient-derived organoid models of inflammatory breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-17-01.