Neoadjuvant Chemotherapy Efficacy In Breast Cancer Research Articles

Integrated single-cell and bulk RNA sequencing analysis identifies a neoadjuvant chemotherapy-related gene signature for predicting survival and therapy in breast cancer

Neoadjuvant chemotherapy (NAC) is a well-established treatment modality for locally advanced breast cancer (BC). However, it can also result in severe toxicities while controlling tumors. Therefore, reliable predictive biomarkers are urgently needed to objectively and accurately predict NAC response. In this study, we integrated single-cell and bulk RNA-seq data to identify nine genes associated with the prognostic response to NAC: NDRG1, CXCL14, HOXB2, NAT1, EVL, FBP1, MAGED2, AR and CIRBP. Furthermore, we constructed a prognostic risk model specifically linked to NAC. The clinical independence and generalizability of this model were effectively demonstrated. Additionally, we explore the underlying cancer hallmarks and microenvironment features of this NAC response-related risk score, and further assess the potential impact of risk score on drug response. In summary, our study constructed and validated a nine-gene signature associated with NAC prognosis, which was accomplished through the integration of single-cell and bulk RNA data. The results of our study are of crucial significance in the prediction of the efficacy of NAC in BC, and may have implications for the clinical management of this disease.

Prognostic significance of platelet-to-lymphocyte ratio (PLR) in patients with breast cancer treated with neoadjuvant chemotherapy: a meta-analysis

ObjectivePlatelet-to-lymphocyte ratio (PLR), known as a key systemic inflammatory parameter, has been proved to be associated with response to neoadjuvant therapy in breast cancer (BC); however, the results remain controversial....

Tumor immune microenvironment components and the other markers can predict the efficacy of neoadjuvant chemotherapy for breast cancer.

Breast cancer is an epithelial malignant tumor that occurs in the terminal ducts of the breast. Neoadjuvant chemotherapy (NACT) is an important part of breast cancer treatment. Its purpose is to use systemic treatment for some locally advanced breast cancer patients, to decrease the tumor size and clinical stage so that non-operable breast cancer patients can have a chance to access surgical treatment, or patients who are not suitable for breast-conserving surgery can get the opportunity of breast-conserving. However, some patients who do not respond to NACT will lead deterioration in their condition. Therefore, prediction of NACT efficacy in breast cancer is vital for precision therapy. The tumor microenvironment (TME) has a crucial role in the carcinogenesis and therapeutic response of breast cancer. In this review, we summarized the immune cells, immune checkpoints, and other biomarkers in the TME that can evaluate the efficacy of NACT in treating breast cancer. We believe that the detection and evaluation of the TME components in breast cancer are helpful to predict the efficacy of NACT, and the prediction methods are in the prospect. In addition, we also summarized other predictive factors of NACT, such as imaging examination, biochemical markers, and multigene/multiprotein profiling.

Is there a correlation between miR-301a expression and neoadjuvant chemotherapy efficacy in breast cancer tissue?

Neoadjuvant chemotherapy (NAC) is the standard therapeutic regimen for locally advanced breast cancer. However, clinical physical examination and imaging results fail to accurately assess the treatment response, and postoperative pathological examination has a time lag in response to therapeutic effect which is not conducive to the timely adjustment of treatment strategies. A previous study has shown that miR-301a was associated with invasion and metastasis in breast cancer, and was found to be involved in endocrine therapy resistance; however, evidence regarding the correlation between miR-301a expression and NAC efficacy remains scarce. In this study, 101 patients with locally advanced breast cancer were included. All patients received anthracycline based chemotherapy. The expression level of miR-301a in pretreatment core needle biopsy tissues was determined by real-time polymerase chain reaction analysis. Relevant clinicopathological data were collected, and the correlation between miR-301a expression and NAC efficacy was assessed. Based on our data, miR-301a cannot be used to identify whether breast cancer benefits from NAC, and no correlation was observed between miR-301a expression and clinicopathological characteristics. In conclusion, miR-301a may not be a potential prognostic biomarker of NAC efficacy in breast cancer.

Comedications influence immune infiltration and pathological response to neoadjuvant chemotherapy in breast cancer

ABSTRACT Immunosurveillance plays an important role in breast cancer (BC) prognosis and progression, and can be geared by immunogenic chemotherapy. In a cohort of 1023 BC patients treated with neoadjuvant chemotherapy (NAC), 40% of the individuals took comedications mostly linked to aging and comorbidities. We systematically analyzed the off-target effects of 1178 concurrent comedications (classified according to the Anatomical Therapeutic Chemical (ATC) Classification System) on the density of tumor-infiltrating lymphocytes (TILs) and pathological complete responses (pCR). At level 1 of the ATC system, the main anatomical classes of drugs were those targeting the nervous system (class N, 39.1%), cardiovascular disorders (class C, 26.6%), alimentary and metabolism (class A, 16.9%), or hormonal preparations (class H, 6.5%). At level 2, the most frequent therapeutic classes were psycholeptics (N05), analgesics (N02), and psychoanaleptics (N06). Pre-NAC TIL density in triple-negative BC (TNBC) was influenced by medications from class H, N, and A, while TIL density in HER2+ BC was associated with the use of class C. Psycholeptics (N05) and agents acting on the renin-angiotensin system (C09) were independently associated with pCR in the whole population of BC or TNBC, and in HER2-positive BC, respectively. Importantly, level 3 hypnotics (N05C) alone were able to reduce tumor growth in BC bearing mice and increased the anti-cancer activity of cyclophosphamide in a T cell-dependent manner. These findings prompt for further exploration of drugs interactions in cancer, and for prospective drug-repositioning strategies to improve the efficacy of NAC in BC.

EXOSOMAL MICRO-RNA - POTENTIAL PREDICTIVE MARKER OF BREAST CANCER NEOADJUVANT THERAPY EFFECT

Neoadjuvant systemic treatment of patients with breast cancer (BC) may include neoadjuvant chemotherapy (NHT), neoadjuvant hormone therapy (NGT), neoadjuvant targeted therapy. The type of systemic therapy is determined by the level of expression of estrogen/progesterone receptors, HER2, i.e. immunohistochemical characteristic of the disease. In this article, we evaluated the predictive value of the profile of plasma exosomal microRNA, assessing the immediate efficacy of NHT, which included taxanes. Obtained results revealed a correlation between the level of concentration of several miRNA molecules in circulating exosomes and the effect of NHT. Furthermore, the index calculated as the ratio of miR-34a and miR-451 concentrations, allowеd to predict the effect of taxanecontaining NHT. The results confirm the assumption on the predictive significance of exosomal miRNA. Further research is needed to confirm the validity of a new method of prediction of the NHT efficacy in breast cancer.

Prediction of clinical efficacy of breast cancer neoadjuvant chemotherapy using shear wave elastography

Objective To investigate the value of shear wave elastography (SWE) to early predict clinical efficacy of breast cancer neoadjuvant chemotherapy(NAC). Methods Fifty-three patients (55 lesions) with breast cancer who underwent NAC were enrolled in this study. SWE was performed at baseline and after the end of 2, 4, 6 cycles of NAC. According to the postoperative pathological results, the lesions were divided into major pathologic response group and minor pathologic response group. The maximum diameter of the lesions between the baseline and the end of the last cycle of the two groups were measured and the maximum diameter changes (ΔDmax) of the two groups were compared. The maximum elastic modulus (Emax) and the maximum elastic modulus changes (ΔEmax) of the two groups were measured and compared at baseline and after the end of 2, 4, 6 cycles of NAC. The ROC curves of ΔEmax at the end of 2 and 4 cycles were used to evaluate the predictive value of NAC response. Results The ΔDmax of the major pathologic response group [(64.82±21.06)%] was higher than that of the minor pathologic response group [(26.49±26.11)%, P<0.001]. With the prolongation of NAC, the values of Emax were significantly decreased in the two groups, but the decreasing degrees were different.The Emax was significantly decreased at the end of 2 cycles in the major pathologic response group (P<0.05), however, at the end of 4 cycles in minor pathologic response group (P<0.05). The value of ΔEmax in the major pathologic response group was higher than that in the minor pathologic response group in every cycle significantly (all P<0.05). The ΔEmax threshold of the 2 cycles for predicting the NAC response was 26.1% (81.8% of sensitivity, 75% of specificity), while the threshold of the 4 cycles was 35.5% (87.9% of sensitivity, 83.3% of specificity), there was no significant difference between the areas under the two curves (P=0.264). Conclusions The value of ΔEmax in breast cancer lesions can predict the efficacy of NAC early.SWE can provide a valuable complement for two-dimensional ultrasound in the evaluation of NAC efficacy in breast cancer. Key words: Elasticity imaging techniques; Breast neoplasms; Neoadjuvant chemotherapy; Curative effect