Abstract

Neoadjuvant chemotherapy (NAC) is intensively used for the treatment of primary breast cancer. In our previous studies, we reported that clinical tumor response to NAC is associated with the change of multidrug resistance (MDR) gene expression in tumors after chemotherapy. In this study we performed a combined analysis of MDR gene locus deletions in tumor DNA, MDR gene expression and clinical response to NAC in 73 BC patients. Copy number variations (CNVs) in biopsy specimens were tested using high-density microarray platform CytoScanTM HD Array (Affymetrix, USA). 75%–100% persons having deletions of MDR gene loci demonstrated the down-regulation of MDR gene expression. Expression of MDR genes was 2–8 times lower in patients with deletion than in patients having no deletion only in post-NAC tumors samples but not in tumor tissue before chemotherapy. All patients with deletions of ABCB1 ABCB 3 ABCC5 gene loci – 7q21.1, 6p21.32, 3q27 correspondingly, and most patients having deletions in ABCC1 (16p13.1), ABCC2 (10q24), ABCG1 (21q22.3), ABCG2 (4q22.1), responded favorably to NAC. The analysis of all CNVs, including both amplification and deletion showed that the frequency of 13q14.2 deletion was 85% among patients bearing tumor with the deletion at least in one MDR gene locus versus 9% in patients with no deletions. Differences in the frequency of 13q14.2 deletions between the two groups were statistically significant (p = 2.03 ×10−11, Fisher test, Bonferroni-adjusted p = 1.73 × 10−8). In conclusion, our study for the first time demonstrates that deletion MDR gene loci can be used as predictive marker for tumor response to NAC.

Highlights

  • ATP-binding cassette (ABC) transporters are known to modulate the transport and metabolism of endogenous and exogenous substrates

  • We reported that the clinical tumor response to Neoadjuvant chemotherapy (NAC) appeared to be associated with changes in the expression of the multidrug resistance (MDR) gene in tumors after chemotherapy

  • In our previous study we have demonstrated NAC induced up-regulated expression of MDR genes in breast cancer patients

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Summary

Introduction

ATP-binding cassette (ABC) transporters are known to modulate the transport and metabolism of endogenous and exogenous substrates. They exercise protective physiological roles by removing potentially harmful molecules and can cause the efflux of common chemotherapeutic agents, which provide the mechanisms for multidrug resistance (MDR) to hormonal, targeted and cytostatic therapy in many cancer types, including breast cancer (BC) [1,2,3,4]. We reported that the clinical tumor response to NAC appeared to be associated with changes in the expression of the MDR gene in tumors after chemotherapy. Poor clinical response to NAC appeared to be related to the increase in MDR gene expression in tumor tissue after NAC and poor disease prognosis [7]

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