Abstract

BackgroundTriple-Negative Breast Cancer (TNBC) is an aggressive and complex subtype of breast cancer. The current biomarkers used in the context of breast cancer treatment are highly dependent on the targeting of oestrogen receptor, progesterone receptor, or HER2, resulting in treatment failure and disease recurrence and creating clinical challenges. Thus, there is still a crucial need for the improvement of TNBC treatment; the discovery of effective biomarkers that can be easily translated to the clinics is essential.MethodsWe report an approach for the discovery of biomarkers that can predict tumour relapse and pathologic complete response (pCR) in TNBC on the basis of mRNA expression quantified using the NanoString nCounter Immunology Panel. To overcome the limited sample size, prediction models based on random Forest were constructed using the differentially expressed genes (DEGs) as selected features. We also evaluated the differences between pre- and post-treatment groups aiming for the combinatorial assessment of pCR and relapse using additive models in edgeR.ResultsWe identify nine and 13 DEGs strongly associated with pCR and relapse, respectively, from 579 immune genes in a small number of samples (n = 55) using edgeR. An additive model for the comparison of pre- and post-treatment groups via the adjustment of the independent subject in the relapse group revealed associations for 41 genes. Comprehensive analysis indicated that our prediction models outperformed those constructed using features extracted from the existing feature selection model Elastic Net in terms of accuracy. The prediction models were assessed using a randomization test to validate the robustness (empirical P for the model of pCR = 0.015 and empirical P for the model of relapse = 0.018). Furthermore, three DEGs (FCER1A, EDNRB, and TGFBI) in the model of relapse showed prognostic significance for predicting the survival of patients with cancer through Cox proportional hazards regression model-based survival analysis.ConclusionGene expression quantified via the NanoString nCounter Immunology Panel can be seamlessly analysed using edgeR, even considering small sample sizes. Our approach provides a scalable framework that can easily be applied for the discovery of biomarkers based on the NanoString nCounter Immunology Panel.Data availabilityThe source code will be available from github at https://github.com/sungheep/nanostring.

Highlights

  • Triple-Negative Breast Cancer (TNBC) is an aggressive and complex subtype of breast cancer

  • We developed an approach for biomarker discovery which predicts relapse and pathological complete responses after neoadjuvant chemotherapy in TNBC as per learning prediction models using random Forest with features selected via the analysing of differential gene expression using edgeR

  • PRE refers to biopsies performed prior to neoadjuvant chemotherapy (n = 55), whereas POST indicates operations performed after neoadjuvant chemotherapy (n = 14, including 6 pathologic complete response (pCR) cases in Additional file 1: Figure S1)

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Summary

Introduction

Triple-Negative Breast Cancer (TNBC) is an aggressive and complex subtype of breast cancer. The current biomarkers used in the context of breast cancer treatment are highly dependent on the targeting of oestrogen receptor, progesterone receptor, or HER2, resulting in treatment failure and disease recurrence and creating clinical challenges. The subtypes of breast cancer have distinct pathological features and clinical implications and primarily include hormone receptor-positive breast cancer, HER2-positive breast cancer, and triple-negative breast cancer (TNBC). Breast cancer therapy involves drugs that target oestrogen, progesterone, and HER2 receptors expressed on hormone receptor-positive and HER2-positive breast cancer cells, respectively [1]. TNBC does not respond to these therapies, including tamoxifen or trastuzumab, as no specific receptors are expressed in TNBC. We aimed to identify prognostic biomarkers for TNBC to facilitate improvements in the current treatment approaches

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