“BrEXo-Apt” is about non-invasive and accurate diagnosis and treatment of breast cancer (BC). Early screening methods for BC are mainly based on instrumental tests, that may cause in many cases a failure to reach particular categories of patients. This failure could be overcome with the availability of specific and predictive circulating biomarkers allowing non-invasive earliest tumour detection on a larger scale of patients. Recent evidences indicate that the release of a great numbers of exosomes by tumour cells play a key role in tumour progression, drug resistance, immune surveillance escape, angiogenesis, tumour invasion and metastasis. For this reason, cancer-derived exosomes are emerging as very interesting targets for cancer therapy and diagnosis. BC is the most common tumour type and one of the leading causes of cancer mortality in women with more than 450,000 women die annually. The disease stage at diagnosis greatly influences patient survival. Although traditional diagnostic methods, such as mammography, are effective, they are limited by the minimum tumour size required for detection. Therefore, the research of circulating biomarkers is a fundamental challenge that can allow to find out tumours early, when they are non-invasive and most treatable, consequently improving disease outcome and health costs. Aptamers are high affinity ligands of disease-associated proteins and possess many advantages for diagnostic and therapeutic applications including low toxicity, cost-effectiveness, easy synthesis and modification, associated with no immunogenicity. The specific targeting ability of aptamers has ensured their efficient use for biomarker discovery, detection and profiling. In recent years, extracellular endosome-derived vesicles called exosomes are attracting growing interest as promising cancer biomarkers. Exosomes are vesicles of 50–150 nm diameter secreted by cells into circulation and containing nucleic acids and proteins. It has been demonstrated that tumour cells, including BC cells, release excessive amounts of cell specific exosomes that, being stable and easily accessible from body fluids, may be used for cancer specific detection. In addition, cancer exosome involvement in tumour progression and dissemination, drug resistance and immune surveillance. “BrEXo-Apt” took advantage of a novel class of nucleic acid-based molecules named aptamers to specifically identified and inhibit BC exosome and permit early BC detection and early therapeutic treatment. “BrEXo-Apt” used BC aptamers that specifically recognize BC-released exosomes to an early BC diagnosis and treatment. The rationale of our study was that in BC field, non-invasive modality of tumours early diagnosis and target therapy are urgently needed. Aptamers show proprieties that can be easily be applied to this issue. The objective was to develop an innovative, non-invasive approach for early BC detection and its treatment. Towards this question Dr Quintavalle proposed to develop an aptamer-based sandwich assay able to recognize BC-derived exosomes in blood and an aptamer-based affinity plasmapheresis system able to specifically remove BC-derived exosomes.
