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基于药效基团的分类能更好地预测接受蒽环类和/或紫杉类新辅助化疗的 HER2 阴性乳腺癌患者的结局。

A pharmacophore-based classification better predicts the outcomes of HER2-negative breast cancer patients receiving the anthracycline- and/or taxane-based neoadjuvant chemotherapy.

机构信息

Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Shanghai, China.

Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

出版信息

Cancer Med. 2021 Jul;10(13):4658-4674. doi: 10.1002/cam4.4022. Epub 2021 Jun 2.

Abstract

AIMS

Prognosis of patients for human epidermal growth factor receptor 2 (HER2)-negative breast cancer post neoadjuvant chemotherapy is not well understood. The aim of this study was to develop a novel pharmacophore-based signature to better classify and predict the risk of HER2-negative patients after anthracycline-and/or taxane-based neoadjuvant chemotherapy (NACT).

MAIN METHODS

Anthracycline and taxane pharmacophore-based genes were obtained from PharmMapper. Drug-targeted genes (DTG) related clinical and bioinformatic analyses were undertaken in four GEO datasets.

KEY FINDINGS

We used 12 genes from the pharmacophore to develop a DTG score (DTG-S). The DTG-S classification exhibited significant prognostic ability with respect to disease free survival (DFS) for HER2-negative patients who receive at least one type of neoadjuvant chemotherapy that included anthracycline and/or taxane. DTG-S associated with a high predictive ability for pathological complete response (pCR) as well as for prognosis of breast cancer. Using the DTG-S classification in other prediction models may improve the reclassification accuracy for DFS. Combining the DTG-S with other clinicopathological factors may further improve its predictive ability of patients' outcomes. Gene ontology and KEGG pathway analysis showed that the biological processes of DTG-S high group were associated with the cell cycle, cell migration, and cell signal transduction pathways. Targeted drug analysis shows that some CDK inhibitors and PI3K-AKT pathway inhibitors may be useful for high DTG-S patients.

SIGNIFICANCE

The DTG-S classification adds prognostic and predictive information to classical parameters for HER2-negative patients who receive anthracycline-and/or taxane-based NACT, which could improve the patients' risk stratification and may help guide adjuvant treatment.

摘要

目的

人表皮生长因子受体 2(HER2)阴性乳腺癌患者接受新辅助化疗后的预后尚不清楚。本研究旨在开发一种基于药效团的新标志物,以更好地分类和预测接受蒽环类和/或紫杉类新辅助化疗(NACT)的 HER2 阴性患者的风险。

方法

从 PharmMapper 获得基于蒽环类和紫杉类药效团的基因。在四个 GEO 数据集进行了与药物靶向基因(DTG)相关的临床和生物信息学分析。

主要发现

我们使用药效团中的 12 个基因开发了一个 DTG 评分(DTG-S)。对于接受至少一种包含蒽环类和/或紫杉类的新辅助化疗的 HER2 阴性患者,DTG-S 分类在无病生存(DFS)方面表现出显著的预后能力。DTG-S 与病理完全缓解(pCR)的预测能力以及乳腺癌的预后相关。在其他预测模型中使用 DTG-S 分类可能会提高 DFS 的重新分类准确性。将 DTG-S 与其他临床病理因素相结合可能会进一步提高其对患者结局的预测能力。基因本体论和 KEGG 通路分析表明,DTG-S 高组的生物学过程与细胞周期、细胞迁移和细胞信号转导途径有关。靶向药物分析表明,一些 CDK 抑制剂和 PI3K-AKT 通路抑制剂可能对 DTG-S 高的患者有用。

意义

DTG-S 分类为接受蒽环类和/或紫杉类 NACT 的 HER2 阴性患者提供了预后和预测信息,可改善患者的风险分层,并可能有助于指导辅助治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f97/8267145/6f20e0245f29/CAM4-10-4658-g004.jpg

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