Comprehensive evaluation of the relationship between biomarker profiles and neoadjuvant chemotherapy outcomes for breast cancer patients

Abstract Background Accurately predicting the response to neoadjuvant chemotherapy (NAC) in breast cancer patients is crucial for guiding treatment strategies and enhancing clinical outcomes. Current studies have primarily focused on a limited set of biomarkers. More importantly, the results of many...

Full description

Bibliographic Details
Main Authors: Mijia Wang, Zhendong Wei, Jixia Kong, Haidong Zhao
Format: Article
Language:English
Published: BMC 2024-03-01
Series:Diagnostic Pathology
Subjects:
Online Access:https://doi.org/10.1186/s13000-024-01451-y
_version_ 1827310432184958976
author Mijia Wang
Zhendong Wei
Jixia Kong
Haidong Zhao
author_facet Mijia Wang
Zhendong Wei
Jixia Kong
Haidong Zhao
author_sort Mijia Wang
collection DOAJ
description Abstract Background Accurately predicting the response to neoadjuvant chemotherapy (NAC) in breast cancer patients is crucial for guiding treatment strategies and enhancing clinical outcomes. Current studies have primarily focused on a limited set of biomarkers. More importantly, the results of many studies are in conflict. To address this, we conducted a comprehensive evaluation of the predictive value of a diverse range of clinically available molecular biomarkers in breast cancer, including HER2, ER, PR, TOPO II, EGFR, Ki67, CK5/6, AR, and p53. Additionally, we assessed changes in these biomarkers after NAC administration. Methods Our study involved 189 patients with invasive breast cancer who underwent NAC at our institute. We examined biomarker profiles in core-needle biopsies taken before NAC and in surgical specimens obtained after NAC. We examined the association between these biomarkers and NAC outcomes, focusing on two main aspects: the rate of pathological complete response (pCR) and the reduction in tumor size. We used Chi-square and Mann-Whitney U tests to compare biomarker status changes between pCR and non-pCR patients. Linear regression analysis was employed to evaluate the relationship between biomarker status and tumor shrinkage rate. Additionally, we compared the expression status of these biomarkers before and after NAC using Chi-square and Wilcoxon signed-rank tests. Results and conclusions Our results demonstrated significant differences in the expression levels of HER2, ER, PR, TOPO II, EGFR, and Ki67 between pCR and non-pCR patients, underscoring their potential as predictive markers for NAC outcomes. Importantly, our results have shed light on the contentious issue surrounding TOPO II in NAC outcome prediction. We have provided evidence that establishes a significantly positive association between TOPO II expression level and the pCR rate. Notably, tumor size was identified as a relevant predictive factor for achieving pCR. Regarding biomarker profiles, only Ki67 levels and TOPO II status exhibited changes following NAC, resolving previous controversies. While the ER and PR status remained unchanged, their expression values exhibited a slight but significant decrease post-NAC. Our results provide clarity and insights into the value and potential of using these biomarkers to predict NAC responses and prognosis in breast cancer patients.
first_indexed 2024-04-24T19:59:43Z
format Article
id doaj.art-dd0d45340cd04bb0ab2833646efea030
institution Directory Open Access Journal
issn 1746-1596
language English
last_indexed 2024-04-24T19:59:43Z
publishDate 2024-03-01
publisher BMC
record_format Article
series Diagnostic Pathology
spelling doaj.art-dd0d45340cd04bb0ab2833646efea0302024-03-24T12:09:04ZengBMCDiagnostic Pathology1746-15962024-03-0119111010.1186/s13000-024-01451-yComprehensive evaluation of the relationship between biomarker profiles and neoadjuvant chemotherapy outcomes for breast cancer patientsMijia Wang0Zhendong Wei1Jixia Kong2Haidong Zhao3The Second Hospital of Dalian Medical UniversityThe Second Hospital of Dalian Medical UniversityThe Second Hospital of Dalian Medical UniversityThe Second Hospital of Dalian Medical UniversityAbstract Background Accurately predicting the response to neoadjuvant chemotherapy (NAC) in breast cancer patients is crucial for guiding treatment strategies and enhancing clinical outcomes. Current studies have primarily focused on a limited set of biomarkers. More importantly, the results of many studies are in conflict. To address this, we conducted a comprehensive evaluation of the predictive value of a diverse range of clinically available molecular biomarkers in breast cancer, including HER2, ER, PR, TOPO II, EGFR, Ki67, CK5/6, AR, and p53. Additionally, we assessed changes in these biomarkers after NAC administration. Methods Our study involved 189 patients with invasive breast cancer who underwent NAC at our institute. We examined biomarker profiles in core-needle biopsies taken before NAC and in surgical specimens obtained after NAC. We examined the association between these biomarkers and NAC outcomes, focusing on two main aspects: the rate of pathological complete response (pCR) and the reduction in tumor size. We used Chi-square and Mann-Whitney U tests to compare biomarker status changes between pCR and non-pCR patients. Linear regression analysis was employed to evaluate the relationship between biomarker status and tumor shrinkage rate. Additionally, we compared the expression status of these biomarkers before and after NAC using Chi-square and Wilcoxon signed-rank tests. Results and conclusions Our results demonstrated significant differences in the expression levels of HER2, ER, PR, TOPO II, EGFR, and Ki67 between pCR and non-pCR patients, underscoring their potential as predictive markers for NAC outcomes. Importantly, our results have shed light on the contentious issue surrounding TOPO II in NAC outcome prediction. We have provided evidence that establishes a significantly positive association between TOPO II expression level and the pCR rate. Notably, tumor size was identified as a relevant predictive factor for achieving pCR. Regarding biomarker profiles, only Ki67 levels and TOPO II status exhibited changes following NAC, resolving previous controversies. While the ER and PR status remained unchanged, their expression values exhibited a slight but significant decrease post-NAC. Our results provide clarity and insights into the value and potential of using these biomarkers to predict NAC responses and prognosis in breast cancer patients.https://doi.org/10.1186/s13000-024-01451-yBreast cancerNeoadjuvant chemotherapyBiomarkerspCRTumor size change
spellingShingle Mijia Wang
Zhendong Wei
Jixia Kong
Haidong Zhao
Comprehensive evaluation of the relationship between biomarker profiles and neoadjuvant chemotherapy outcomes for breast cancer patients
Diagnostic Pathology
Breast cancer
Neoadjuvant chemotherapy
Biomarkers
pCR
Tumor size change
title Comprehensive evaluation of the relationship between biomarker profiles and neoadjuvant chemotherapy outcomes for breast cancer patients
title_full Comprehensive evaluation of the relationship between biomarker profiles and neoadjuvant chemotherapy outcomes for breast cancer patients
title_fullStr Comprehensive evaluation of the relationship between biomarker profiles and neoadjuvant chemotherapy outcomes for breast cancer patients
title_full_unstemmed Comprehensive evaluation of the relationship between biomarker profiles and neoadjuvant chemotherapy outcomes for breast cancer patients
title_short Comprehensive evaluation of the relationship between biomarker profiles and neoadjuvant chemotherapy outcomes for breast cancer patients
title_sort comprehensive evaluation of the relationship between biomarker profiles and neoadjuvant chemotherapy outcomes for breast cancer patients
topic Breast cancer
Neoadjuvant chemotherapy
Biomarkers
pCR
Tumor size change
url https://doi.org/10.1186/s13000-024-01451-y
work_keys_str_mv AT mijiawang comprehensiveevaluationoftherelationshipbetweenbiomarkerprofilesandneoadjuvantchemotherapyoutcomesforbreastcancerpatients
AT zhendongwei comprehensiveevaluationoftherelationshipbetweenbiomarkerprofilesandneoadjuvantchemotherapyoutcomesforbreastcancerpatients
AT jixiakong comprehensiveevaluationoftherelationshipbetweenbiomarkerprofilesandneoadjuvantchemotherapyoutcomesforbreastcancerpatients
AT haidongzhao comprehensiveevaluationoftherelationshipbetweenbiomarkerprofilesandneoadjuvantchemotherapyoutcomesforbreastcancerpatients