Low-dose anti-inflammatory combinatorial therapy reduced cancer stem cell formation in patient-derived preclinical models for tumour relapse prevention

Bee Luan Khoo, Gianluca Grenci, Joey Sze Yun Lim, Yan Ping Lim, July Fong, Wei Hseun Yeap, Su Bin Lim, Song Lin Chua, Siew Cheng Wong, Yoon Sim Yap, Soo Chin Lee, Chwee Teck Lim, Jongyoon Han

Research output: Journal article publicationJournal articleAcademic researchpeer-review

19 Citations (Scopus)


Background: Emergence of drug-resistant cancer phenotypes is a challenge for anti-cancer therapy. Cancer stem cells are identified as one of the ways by which chemoresistance develops. Method: We investigated the anti-inflammatory combinatorial treatment (DA) of doxorubicin and aspirin using a preclinical microfluidic model on cancer cell lines and patient-derived circulating tumour cell clusters. The model had been previously demonstrated to predict patient overall prognosis. Results: We demonstrated that low-dose aspirin with a sub-optimal dose of doxorubicin for 72 h could generate higher killing efficacy and enhanced apoptosis. Seven days of DA treatment significantly reduced the proportion of cancer stem cells and colony-forming ability. DA treatment delayed the inhibition of interleukin-6 secretion, which is mediated by both COX-dependent and independent pathways. The response of patients varied due to clinical heterogeneity, with 62.5% and 64.7% of samples demonstrating higher killing efficacy or reduction in cancer stem cell (CSC) proportions after DA treatment, respectively. These results highlight the importance of using patient-derived models for drug discovery. Conclusions: This preclinical proof of concept seeks to reduce the onset of CSCs generated post treatment by stressful stimuli. Our study will promote a better understanding of anti-inflammatory treatments for cancer and reduce the risk of relapse in patients.

Original languageEnglish
Pages (from-to)407-423
Number of pages17
JournalBritish Journal of Cancer
Issue number4
Publication statusPublished - 19 Feb 2019
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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