Notch Pathway Deactivation Sensitizes Breast Cancer Stem Cells toward Chemotherapy Using NIR Light-Responsive...

Chemotherapy remains a major therapeutic approach to cancer treatment. However, its effectiveness can be compromised by the heterogeneity of a solid tumor, in which different cancer cell populations display varied responses to chemotherapy. Such an intratumor heterogeneous structure is maintained by the cancer stem-like cells (CSCs) with inherent capacities for self-renewal and differentiation, giving rise to diverse cell populations. To address this, we proposed a combinational strategy in which tumor lesion-targeted Notch signaling regulation was achieved to disrupt CSC-mediated cancer heterogeneity, thereby sensitizing solid tumors toward paclitaxel (PTX). Specifically, gamma-secretase inhibitor LY-411,575 was co-delivered with PTX using a near-infrared (NIR) light-controlled drug delivery system to realize targeted ablation of both differentiated cancer cells and undifferentiated CSCs. By enabling precise regulation of the Notch pathway at the tumor site through NIR light, we observed significantly elevated efficacy of chemotherapy and notable prevention of postsurgical tumor relapse while minimizing systemic side effects. The devised strategy shows promise in addressing the nonspecific inhibition of stemness across various organs, a challenge that hampers the clinical translation of gamma-secretase inhibitors in cancer therapy.