Triple-Negative PAM50 Non-Basal Breast Cancer Subtype Predicts Benefit from Extended Adjuvant Capecitabine

Caveolin-1 gene expression provides additional prognostic information combined with PAM50 risk of recurrence (ROR) score in breast cancer

Combining information from the tumor microenvironment (TME) with PAM50 Risk of Recurrence (ROR) score could improve breast cancer prognostication. Caveolin-1 (CAV1) is a marker of an active TME. CAV1 is a membrane protein involved in cell signaling, extracellular matrix organization, and tumor-stroma interactions. We sought to investigate CAV1 gene expression in relation to PAM50 subtypes, ROR score, and their joint prognostic impact. CAV1 expression was compared between PAM50 subtypes and ROR categories in two cohorts (SCAN-B, n = 5326 and METABRIC, n = 1980). CAV1 expression was assessed in relation to clinical outcomes using Cox regression and adjusted for clinicopathological predictors. Effect modifications between CAV1 expression and ROR categories on clinical outcome were investigated using multiplicative and additive two-way interaction analyses. Differential gene expression and gene set enrichment analyses were applied to compare high and low expressing CAV1 tumors. All samples expressed CAV1 with the highest expression in the Normal-like subtype. Gene modules consistent with epithelial-mesenchymal transition (EMT), hypoxia, and stromal activation were associated with high CAV1 expression. CAV1 expression was inversely associated with ROR category. Interactions between CAV1 expression and ROR categories were observed in both cohorts. High expressing CAV1 tumors conferred worse prognosis only within the group classified as ROR high. ROR gave markedly different prognostic information depending on the underlying CAV1 expression. CAV1, a potential mediator between the malignant cells and TME, could be a useful biomarker that enhances and further refines PAM50 ROR risk stratification in patients with ROR high tumors and a potential therapeutic target.

Single-cell combined with bulk-RNA data reveal a pattern related to angiogenesis in breast cancer patients: Individualized medicine

Angiogenesis contributes to tumor progression, aggressive behavior, and metastasis. Although several endothelial dysfunction genes (angiogenesis-related genes [ARGs]) have been identified as diagnostic biomarkers of breast cancer in a few studies, the mixed effects of ARGs have not been thoroughly investigated. The RNA sequencing data and patient survival datasets of breast cancer were obtained for further analysis. MSigDB website includes angiogenesis-related mechanisms. The consensus clustering analysis identifies 1082 breast cancer patients as three clusters. differential expression genes (DEGs) were identified by limma package. GO combined with gene set enrichment analysis (GSEA) to identify cytogenetic functions between two predefined clusters. Then Serpin Family F Member 1 (SERPINF1), angiomotin (AMOT), promyelocytic leukemia (PML), and BTG anti-proliferation factor 1 (BTG) were selected to construct prediction models using random forest survival analysis. External validation was performed using the GSE58812 triple-negative breast cancer cohort as the validation set. The median scoring system was used to discern the high- and low-risk groups, and there was a significant difference in their diagnostic results. Immunological infiltration scores were calculated using single sample gene set enrichment analysis (ssGSEA) and xCell algorithms, and consciousness scores were calculated using the R package "oncoPredict" for drugs in the Genomics of Drug Sensitivity in Cancer (GDSC) database. In addition, the single-cell analysis of seven triple-negative breast cancers using scRNA-seq information from GSE118389 demonstrated the interpretation of SERPINF1, AMOT, PML, and BTG1. In conclusion, this investigation engineered ARG-centric disease paradigms that not only prognosticated prospective therapeutic compounds, but also projected their mechanistic trajectories, thereby facilitating the proposition of tailored treatments within diverse patient cohorts diagnosed with breast cancer.

miR-877-5p as a Potential Link between Triple-Negative Breast Cancer Development and Metabolic Syndrome

Metabolic syndrome (MS) is a risk factor for breast cancer (BC) that increases its aggressiveness and metastasis. The prevalence of MS is higher in triple-negative breast cancer (TNBC), which is the molecular subtype with the worst prognosis. The molecular mechanisms underlying this association have not been fully elucidated. MiRNAs are small, non-coding RNAs that regulate gene expression. Aberrant expression of miRNAs in both tissues and fluids are linked to several pathologies. The aim of this work was to identify circulating miRNAs in patients with alterations associated with MS (AAMS) that also impact on BC. Using microarray technology, we detected 23 miRNAs altered in the plasma of women with AAMS that modulate processes linked to cancer. We found that let-7b-5p and miR-28-3p were decreased in plasma from patients with AAMS and also in BC tumors, while miR-877-5p was increased. Interestingly, miR-877-5p expression was associated with lower patient survival, and its expression was higher in PAM50 basal-like BC tumors compared to the other molecular subtypes. Analyses from public databases revealed that miR-877-5p was also increased in plasma from BC patients compared to plasma from healthy donors. We identified IGF2 and TIMP3 as validated target genes of miR-877-5p whose expression was decreased in BC tissue and moreover, was negatively correlated with the levels of this miRNA in the tumors. Finally, a miRNA inhibitor against miR-877-5p diminished viability and tumor growth of the TNBC model 4T1. These results reveal that miR-877-5p inhibition could be a therapeutic option for the treatment of TNBC. Further studies are needed to investigate the role of this miRNA in TNBC progression.

Capecitabine-based chemotherapy in early-stage triple-negative breast cancer: a meta-analysis

Introduction

The efficacy and safety of adjuvant capecitabine in early-stage triple-negative breast cancer remains undefined. A meta-analysis was conducted to elucidate whether capecitabine-based regimens could improve survival in early-stage triple-negative breast cancer (TNBC).

Methods

The current study searched Medline, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov proceedings up to 2023.9. Disease-free survival (DFS), overall survival (OS), and grade 3-4 adverse events (AEs) were assessed. Extracted or calculated hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were pooled.

Results

The capecitabine-based regimens showed significant advantages in DFS (HR = 0.81, 95% CI: 0.73-0.90; P <.001) and OS (HR = 0.75, 95% CI: 0.65-0.87; P <.001) from 12 randomized controlled trials (RCTs) with 5,390 unselected participants. Subgroup analysis of DFS showed analogous results derived from patients with lymph node negative (HR = 0.68, 95% CI: 0.50-0.92; P = .006) and capecitabine duration no less than six cycles (HR = 0.73; 95% CI: 0.62-0.86; P <.001). Improvement of DFS in the addition group (HR = 0.77, 95% CI: 0.68-0.87; P <.001) and adjuvant setting (HR = 0.79, 95% CI: 0.70-0.89; P <.001) was observed. As to safety profile, capecitabine was associated with more frequent stomatitis (OR = 5.05, 95% CI: 1.45-17.65, P = .011), diarrhea (OR = 6.11, 95% CI: 2.12-17.56; P =.001), and hand-foot syndrome (OR = 31.82, 95% CI: 3.23-313.65, P = .003).

Conclusions

Adjuvant capecitabine-based chemotherapy provided superior DFS and OS to early-stage TNBC. The benefits to DFS in selected patients with lymph node negative and the addition and extended duration of capecitabine were demonstrated.

SIX4, a potential therapeutic target for estrogen receptor-positive breast cancer patients, is associated with low promoter methylation level

Aim: To investigate SIX4 in breast cancer. Methods: Publicly available online tools were used to analyze the expression, methylation and prognostic significance of SIX4 in breast cancer, as well as its immunohistochemistry. Results: High SIX4 levels were associated with low SIX4 promoter methylation, especially in estrogen receptor-positive breast cancer. Increased SIX4 was related to advanced stage and decreased immune infiltration. Gene set enrichment analysis found that the SIX4-correlated genes were enriched in transcriptional processing and immune response. Patients with high SIX4 expression tended to have poor survival, especially those with estrogen receptor-positive breast cancer. Conclusion: High SIX4 expression in breast cancer plays an oncogenic role, promoting the development of malignancies through suppressing the immune response, especially in luminal subtypes, and is associated with a low promoter methylation level.