DNA 修复特征与三阴性乳腺癌患者对蒽环类药物的反应相关。
DNA repair signature is associated with anthracycline response in triple negative breast cancer patients.
机构信息
Dan L Duncan Cancer Center, Baylor College of Medicine, 1 Baylor Plaza BCM 600, Houston, TX 77030, USA.
出版信息
Breast Cancer Res Treat. 2010 Aug;123(1):189-96. doi: 10.1007/s10549-010-0983-z. Epub 2010 Jun 26.
We hypothesized that a subset of sporadic triple negative (TN) breast cancer patients whose tumors have defective DNA repair similar to BRCA1-associated tumors are more likely to exhibit up-regulation of DNA repair-related genes, anthracycline-sensitivity, and taxane-resistance. We derived a defective DNA repair gene expression signature of 334 genes by applying a previously published BRCA1-associated expression pattern to three datasets of sporadic TN breast cancers. We confirmed a subset of 69 of the most differentially expressed genes by quantitative RT-PCR, using a low density custom array (LDA). Next, we tested the association of this DNA repair microarray signature expression with pathologic response in neoadjuvant anthracycline trials of FEC (n = 50) and AC (n = 16), or taxane-based TET chemotherapy (n = 39). Finally, we collected paraffin-fixed, formalin-embedded biopsies from TN patients who had received neoadjuvant AC (n = 28), and tested the utility of the LDA to discriminate response. Correlation between RNA expression measured by the microarrays and 69-gene LDA was ascertained. This defective DNA repair microarray gene expression pattern was significantly associated with anthracycline response and taxane resistance, with the area under the ordinary receiver operating characteristic curve (AUC) of 0.61 (95% CI = 0.45-0.77), and 0.65 (95% CI = 0.46-0.85), respectively. From the FFPE samples, the 69-gene LDA could discriminate AC responders, with AUC of 0.79 (95% CI = 0.59-0.98). In conclusion, a promising defective DNA repair gene expression signature appears to differentiate TN breast cancers that are sensitive to anthracyclines and resistant to taxane-based chemotherapy, and should be tested in clinical trials with other DNA-damaging agents and PARP-1 inhibitors.
我们假设,一小部分散发性三阴性(TN)乳腺癌患者的肿瘤具有类似于 BRCA1 相关肿瘤的缺陷 DNA 修复,这些患者更有可能表现出 DNA 修复相关基因的上调、蒽环类药物敏感性和紫杉烷类药物耐药性。我们通过将先前发表的 BRCA1 相关表达模式应用于三个散发性 TN 乳腺癌数据集,得出了一个由 334 个基因组成的缺陷 DNA 修复基因表达特征。我们通过使用低密度定制阵列(LDA)对定量 RT-PCR 验证了 69 个差异表达基因中的一小部分。接下来,我们测试了这种 DNA 修复微阵列特征表达与新辅助蒽环类试验 FEC(n=50)和 AC(n=16)或基于紫杉烷的 TET 化疗(n=39)的病理反应之间的关联。最后,我们从接受新辅助 AC(n=28)的 TN 患者中收集了石蜡固定、福尔马林固定的活检,并测试了 LDA 区分反应的能力。通过微阵列测量的 RNA 表达与 69 基因 LDA 之间的相关性得到了证实。这种缺陷 DNA 修复微阵列基因表达模式与蒽环类药物反应和紫杉烷类药物耐药性显著相关,普通接收器操作特征曲线(ROC)下的面积(AUC)分别为 0.61(95%CI=0.45-0.77)和 0.65(95%CI=0.46-0.85)。从 FFPE 样本中,69 基因 LDA 可以区分 AC 反应者,AUC 为 0.79(95%CI=0.59-0.98)。总之,一种有前途的缺陷 DNA 修复基因表达特征似乎可以区分对蒽环类药物敏感且对基于紫杉烷的化疗耐药的 TN 乳腺癌,并且应该在临床试验中与其他 DNA 损伤剂和 PARP-1 抑制剂一起进行测试。