A 41-gene signature derived from breast cancer stem cells as a predictor of survival

Abstract

PurposeThe aim of this study was to evaluate the ability of a 41-gene signature derived from breast cancer stem cells (BCSCs) to estimate the risk of metastasis and survival in breast cancer patients.MethodsThe centroid expression of the 41-gene signature derived from BCSCs was applied as the threshold to classify patients into two separate groups—patients with high expression (high-EL) of the prognostic signature and patients with low expression (low-EL). The predictive ability of the 41-gene signature was evaluated by Cox regression model and was compared against other popular tests, such as Oncotype and MammaPrint.ResultsOur results showed that the 41-gene prognostic signature was significantly associated with age (P = .0351) and ER status (P = .0095). The analysis indicated that patients in the high-EL group had a worse prognosis than those in the low-EL group in terms of both overall survival (OS: HR, 2.05, P = .009) and distant metastasis-free survival (DMFS: HR, 2.24, P = .002). Additionally, the 41-gene signature was an independent risk factor and separates patients based on estrogen receptor status. While comparable to Oncotype, the analysis demonstrated that the 41-gene signature had a better prognostic value in predicting DMFS and OS than AOL, NPI, St. Gallen, Veridex, and MammaPrint.ConclusionsThis study confirms the utility of the 41-gene signature and adds to the growing evidence that gene expression signatures of BCSCs have clinical potential to predict patient outcome and aid in treatment choice.

Targeting Cancer Stemness in the Clinic: From Hype to Hope

“…Likewise, increased expression and activity of the enzyme ALDH1, which is one of the proposed CSC markers, significantly associated with poor outcomes in a cohort of 439 patients with serous ovarian cancer (Deng et al, 2010). Another study investigated the utility of a 41-gene signature derived from breast CSCs in a cohort of 198 patients and reported that patients with high CSC score had worse OS (Yin et al, 2014). This CSC signature was comparable to the commonly used Oncotype test and superior to MammaPrint for risk stratifying breast cancer patients.…”

A four-long non-coding RNA signature in predicting breast cancer survival

“…One of the examples is a 21-gene classifer (Oncotype DX) ,which classifies breast tumors into low-,intermediate- and high-risk groups as to the advisability of adjuvant chemotherapy for patients in high-risk group [ 12 , 13 ]. The utility of such gene signature might have clinical potential to predict patient outcome and aid in treatment choice [ 14 ].…”

An ER-associated miRNA signature predicts prognosis in ER-positive breast cancer

“…Breast cancer is a heterogeneous disease that comprises a range of subgroups with diverse clinical behaviors and responses to treatment [1]. Many breast-cancer-related genes have been investigated to explore the molecular mechanism of carcinogenesis and diverse clinical outcome of the disease [2][3][4][5][6]. Among them, some specific genes such as estrogen receptor (ER) [7], progesterone receptor (PR) [8] and human epidermal growth factor receptor 2 (HER2) [9] have been used to identify different subgroups and indicate different prognostic results with different treatment modalities in the clinical.…”