Plasma Extracellular Vesicle Long RNA Profiles in the Diagnosis and Prediction of Treatment Response for Breast Cancer

Abstract

Background: The utility of extracellular vesicle long RNAs (exLRs) as noninvasive biomarkers in breast cancer remains elusive. The purpose of this study was to explore the potential of exLRs as clinically actionable biomarkers for breast cancer diagnosis, classification, and neoadjuvant therapy efficacy prediction. Methods: One hundred and seventy-two participants, including 112 breast cancer patients, 19 benign patients and 41 healthy controls, were enrolled in this case-control study. The exLR profile of the plasma samples was analyzed by exLR sequencing. The d-signature was identified using a support vector machine algorithm with a training cohort (n=120) and was validated using an internal validation cohort (n=52). Treatment efficacy prediction was conducted with 48 patients who received neoadjuvant chemotherapy.Results: We constructed a breast cancer diagnostic signature that showed high accuracy with an area under the curve (AUC) of 0.960 in the training cohort and 0.900 in the validation cohort. The signature was able to identify early stage BC (I/II) with an AUC of 0.940. Integrating the signature could increase the diagnosis accuracy by up to 91.9% for breast cancer patients with the corresponding predictive results based on the Breast Imaging Reporting and Data System classification of 4 or 5. Moreover, the exLRs could provide a strong indication of the breast cancer subtypes, and exMSMO1 is employable as a predictive biomarker in response to neoadjuvant chemotherapy.Conclusions: This study demonstrated the value of exLR profiling to provide potential biomarkers for early detection and treatment efficacy prediction of breast cancer.