Manginstar Christian, Islam Andi Asadul, Sampepajung Daniel, Hamdani William, Bukhari Agussalim, Syamsu Salman Ardy, Smaradania Nilam, Faruk Muhammad
Division of Oncology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
Department of Neurosurgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
Ann Med Surg (Lond). 2021 Feb 10;63:102164. doi: 10.1016/j.amsu.2021.02.010. eCollection 2021 Mar.
Neoadjuvant chemotherapy has become the standard form of treatment for locally advanced breast cancer. Chemoresistence is a problem that limits the effectiveness of chemotherapy. Therefore, predictive biomarkers are needed to choose the appropriate chemotherapy to the right patient. The role of NF-кb expression as a predictive biomarker of neoadjuvant chemotherapy response needs to be investigated in patients with locally advanced breast cancer who are treated with a regimen of cyclophosphamide-doxorubicin-5FU (CAF).
This observational study used the prospective cohort method to examine 62 samples. CAF was administered at 3-week intervals for 3 cycles of chemotherapy. The data utilized in this study include the positive and negative expression of NF-κB, ER, and HER2 overexpression. The cases were divided into groups that were responsive and non-responsive to the neoadjuvant chemotherapy.
The average age in the youngest group was 26 years, and that in the oldest was 66 years. The highest age group was subjects in their 50s, which had 26 cases (41.9%). The majority of the cases were moderate grade with 38 cases (61.3%). The percentage of responsive subjects was higher in the groups with negative NF-κB expression (82.5%), positive HER2 status (85.7%), and negative ER status (71.9%). It was found that 37 cases (59.7%) were responsive to CAF, while 25 cases (40.3%) were non-responsive. There was a significant relationship between NF-κB expression and chemotherapy response (p < 0.05), and the percentage of responsive subjects was higher among those with negative NF-κB expression (82.5%) than positive NF-κB expression (18.2%).
NF-κB expression, ER status, and HER2 have a significant relationship with the response to anthracycline-based neoadjuvant chemotherapy for local advanced breast cancer, and NF-κB expression has the most significant relationship with the chemotherapy response. Therefore, NF-κB expression should be considered as a predictive biomarker for the response to CAF regimens.
新辅助化疗已成为局部晚期乳腺癌的标准治疗方式。化疗耐药是一个限制化疗效果的问题。因此，需要预测性生物标志物来为合适的患者选择恰当的化疗方案。在接受环磷酰胺-阿霉素-5-氟尿嘧啶（CAF）方案治疗的局部晚期乳腺癌患者中，需要研究NF-κB表达作为新辅助化疗反应预测性生物标志物的作用。
本观察性研究采用前瞻性队列研究方法，检测62个样本。CAF每3周给药一次，共进行3个周期的化疗。本研究使用的数据包括NF-κB、雌激素受体（ER）的阳性和阴性表达以及人表皮生长因子受体2（HER2）过表达情况。病例被分为对新辅助化疗有反应和无反应两组。
最年轻组的平均年龄为26岁，最年长组为66岁。年龄最大的组是50多岁的受试者，有26例（41.9%）。大多数病例为中度分级，有38例（61.3%）。NF-κB表达阴性组（82.5%）、HER2状态阳性组（85.7%）和ER状态阴性组（71.9%）中有反应受试者的比例更高。发现37例（59.7%）对CAF有反应，而25例（40.3%）无反应。NF-κB表达与化疗反应之间存在显著关系（p<0.05），NF-κB表达阴性者中有反应受试者的比例（82.5%）高于NF-κB表达阳性者（18.2%）。
NF-κB表达、ER状态和HER2与局部晚期乳腺癌基于蒽环类药物的新辅助化疗反应有显著关系，且NF-κB表达与化疗反应的关系最为显著。因此，NF-κB表达应被视为CAF方案反应的预测性生物标志物。
