Title |
Serial expression analysis of breast tumors during neoadjuvant chemotherapy reveals changes in cell cycle and immune pathways associated with recurrence and response
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Published in |
Breast Cancer Research, May 2015
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DOI | 10.1186/s13058-015-0582-3 |
Pubmed ID | |
Authors |
Mark Jesus M. Magbanua, Denise M. Wolf, Christina Yau, Sarah E. Davis, Julia Crothers, Alfred Au, Christopher M. Haqq, Chad Livasy, Hope S. Rugo, I-SPY 1 TRIAL Investigators, Laura Esserman, John W. Park, Laura J. van ’t Veer |
Abstract |
The molecular biology involving neoadjuvant chemotherapy (NAC) response is poorly understood. To elucidate the impact of NAC on breast cancer transcriptome and its association with clinical outcome, we analyzed gene expression data from serial tumor samples of breast cancer patients who received NAC in the I-SPY 1 TRIAL. Expression data were collected before treatment (T1), 24-96 h after initiation of chemotherapy (T2) and at surgery (TS). Expression between T1vsT2 (N = 36) and T1vsTS (N = 39) were compared. Subtype was assigned using PAM50. Differences in early gene expression changes (T2-T1) between responders and non-responders as defined by residual cancer burden (RCB) were evaluated. Cox proportional hazards modeling was used to identify genes in residual tumors associated with recurrence-free survival (RFS). Pathway analysis was performed with Ingenuity® software. Comparing expression profiles at T1vsT2 and T1vsTS detected significantly altered expression of 150 and 59 transcripts, respectively. We observed notable down-regulation of proliferation and immune-related genes at T2. Lower concordance in subtype assignment was observed between T1vsTS (62 %) as compared to T1vsT2 (75 %). Analysis of early gene expression changes (T2-T1) revealed that decreased expression of cell cycle inhibitors was associated with poor response. Increased interferon signaling (TS-T1) and high expression of cell proliferation genes in residual tumors (TS) were associated with reduced RFS. Serial gene expression analysis revealed candidate immune and proliferation pathways associated with response and recurrence. Larger studies incorporating the approach described here are warranted to identify predictive and prognostic biomarkers in the NAC setting for specific targeted therapies. The I-SPY 1 TRIAL was registered on April 9, 2002 as NCT00033397 . |
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Unknown | 2 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 1 | 50% |
Practitioners (doctors, other healthcare professionals) | 1 | 50% |
Mendeley readers
Geographical breakdown
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United Kingdom | 1 | 1% |
Chile | 1 | 1% |
United States | 1 | 1% |
Unknown | 86 | 97% |
Demographic breakdown
Readers by professional status | Count | As % |
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Researcher | 24 | 27% |
Student > Ph. D. Student | 19 | 21% |
Student > Master | 7 | 8% |
Student > Bachelor | 7 | 8% |
Student > Postgraduate | 5 | 6% |
Other | 14 | 16% |
Unknown | 13 | 15% |
Readers by discipline | Count | As % |
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Agricultural and Biological Sciences | 21 | 24% |
Biochemistry, Genetics and Molecular Biology | 8 | 9% |
Immunology and Microbiology | 4 | 4% |
Engineering | 3 | 3% |
Other | 11 | 12% |
Unknown | 15 | 17% |