Abstract

Distant metastasis is the principal cause of mortality for breast cancer patients. Targeting specific mutations that have been acquired during the evolution process of advanced breast cancer is a potential means of enhancing the clinical efficacy of treatment strategies. In metastatic breast cancer, ARID1A is the most prevalent mutation of the SWI/SNF complex, which regulates DNA repair, recombination, and gene transcription. The low expression of ARID1A is associated with poor disease-free survival and overall survival of patients with luminal A or HER2-rich breast cancer. In addition, ARID1A plays a prominent role in maintaining luminal characteristics and has an advantage for identifying responses to treatment, including endocrine therapies, HDAC inhibitors and CDK4/6 inhibitors. The therapeutic vulnerabilities initiated by ARID1A alterations encourage us to explore new approaches to cope with ARID1A mutant-related drug resistance or metastasis. In this review, we describe the mutation profiles of ARID1A in metastatic breast cancer and the structure and function of ARID1A and the SWI/SNF complex as well as discuss the potential mechanisms of ARID1A-mediated endocrine resistance and therapeutic potential.

Highlights

  • Breast cancer has become the most frequently occurring malignancy worldwide, with 2.3 million women diagnosed with breast cancer in 2020 [1]

  • These findings indicate that cyclindependent kinase-4 (CDK4)/6 inhibitors are promising therapeutic strategies for AT-rich interactive domain protein 1A (ARID1A)-mutated metastatic breast cancer

  • We summarize newly discovered potential therapeutic targets for metastasis- or endocrine-resistant breast cancer driven by mutated ARID1A (Figure 2) and the treatment approaches being tested in clinical trials involving patients with ARID1A-mutated cancer (Table 1)

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Summary

Frontiers in Oncology

Distant metastasis is the principal cause of mortality for breast cancer patients. Targeting specific mutations that have been acquired during the evolution process of advanced breast cancer is a potential means of enhancing the clinical efficacy of treatment strategies. ARID1A is the most prevalent mutation of the SWI/SNF complex, which regulates DNA repair, recombination, and gene transcription. The low expression of ARID1A is associated with poor disease-free survival and overall survival of patients with luminal A or HER2-rich breast cancer. We describe the mutation profiles of ARID1A in metastatic breast cancer and the structure and function of ARID1A and the SWI/SNF complex as well as discuss the potential mechanisms of ARID1A-mediated endocrine resistance and therapeutic potential

BACKGROUND
PROMISING TREATMENT TARGETS
PARP Niraparib
Others Dasatinib
Not yet recruiting Not yet recruiting Not yet recruiting
Tumor Immunological Microenvironment
Glutathione Metabolic Pathway
Findings
CONCLUSION AND DISCUSSION
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