Abstract

Purpose: TNBC with germline BRCA1/2 mutation (gBRCAm) have higher sensitivity to DNA damaging agents including platinum-based chemotherapy and PARP inhibitors. But the treatment of TNBC without gBRCAm remains challenging. This study aimed to develop a long non-coding RNA (lncRNA) signature of TNBC patients without gBRCAm to improve risk stratification and optimize individualized treatment. Methods: 98 TNBC patients without gBRCAm were acquired from The Cancer Genome Atlas database. The univariable Cox regression analysis and LASSO Cox regression model were applied to establish an lncRNA signature in the training cohort. Then Kaplan–Meier survival curve and time-dependent ROC curve were used to validate the prognostic ability of the signature. The qPCR assay was performed to confirm the expressions and clinicopathological correlations of two potential lncRNAs HAGLROS and TONSL-AS1 in 30 paired clinical triple-negative breast cancer samples without gBRCAm. Results: We developed an 8-lncRNA signature in the training cohort including HAGLROS, AL139002.1, AL391244.2, AP000696.1, AL391056.1, AL513304.1, TONSL-AS1 and AL031008.1. Patients with higher risk scores showed significantly worse overall survival compared to those with lower risk scores (P=0.00018 and P =0.0068 respectively). 30 paired specimens of TNBC without gBRCAm in our center showed that two potential lncRNAs HAGLROS and TONSL-AS1 were found frequently overexpressed, and significantly associated with tumor grade and invasion. Conclusion: We constructed a novel 8-lncRNA signature which significantly associated with the overall survival of TNBC patients without gBRCAm. Among those 8 lncRNAs, HAGLROS and TONSL-AS1 may be potential therapeutic targets which function needed further exploration.

Highlights

  • Breast cancer (BC) Breast cancer (BC) is the most common cancer and the leading cause of cancer-related death among women worldwide [1, 2]

  • We constructed a novel 8-long non-coding RNA (lncRNA) signature which significantly associated with the overall survival of Triple-negative breast cancer (TNBC) patients without germline BRCA1/2 mutation (gBRCAm)

  • Several targeted therapies have been approved for TNBC, including the poly (ADP-ribose) polymerase(PARP) inhibitors olaparib[3] and talazoparib[4] for TNBC with germline BRCA1/2 mutation(gBRCAm) and the checkpoint inhibitor, atezolizumab[5] in combination with nabpaclitaxel for programmed death-ligand 1 (PD-L1) positive advanced TNBC

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Summary

Introduction

Breast cancer (BC) Breast cancer (BC) is the most common cancer and the leading cause of cancer-related death among women worldwide [1, 2]. Triple-negative breast cancer (TNBC) is a particular aggressive type of BC, defining as the lack of estrogen receptor (ER) and progesterone receptor (PR) expression as well as human epidermal growth factor receptor 2 (HER2) amplification, accounting for approximately 15-20% of all breast cancers. The treatment of TNBC mainly relies on a combination of surgery, radiotherapy, and chemotherapy. Several targeted therapies have been approved for TNBC, including the poly (ADP-ribose) polymerase(PARP) inhibitors olaparib[3] and talazoparib[4] for TNBC with germline BRCA1/2 mutation(gBRCAm) and the checkpoint inhibitor, atezolizumab[5] in combination with nabpaclitaxel for programmed death-ligand 1 (PD-L1) positive advanced TNBC. The TNBC is still characterized by poorer prognosis compared with other types of breast cancers [6,7,8]

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