Predictive and prognostic value of EPIC1 in patients with breast cancer receiving neoadjuvant chemotherapy

Abstract

Background: EPIC1 is an oncogenic long non-coding ribonucleic acid (RNA) that promotes cell growth and cell-cycle progression and inhibits apoptosis in several cancer cell lines. However, clinical studies on EPIC1 in breast cancer, specifically in the neoadjuvant setting, are relatively few. Methods: Patients treated with weekly paclitaxel–cisplatin-based neoadjuvant chemotherapy after core-needle biopsy were included in the study. Real-time quantitative polymerase chain reaction assays were performed to detect EPIC1 expression. Results: Among all patients included in this study ( n = 111), higher EPIC1 expression was associated with estrogen receptor negativity, human epidermal growth factor receptor 2 positivity, higher Ki67 index, and higher histologic grade. Multivariate analysis suggested that EPIC1 expression was an independent predictive factor for pathological complete response, with a significant interaction between EPIC1 expression and age. The Kaplan–Meier Plotter dataset suggested that the EPIC1 high-expression group showed a worse 10-year distant metastasis-free survival and post-progression survival when compared with the EPIC1 low-expression group. The Cancer Genome Atlas dataset suggested that the overall survival in the EPIC1 high-expression group was inferior to that in the EPIC1 low-expression group, specifically in hormone receptor (HorR)-positive patients and patients aged <50 years. Pathway analysis revealed the top pathways that indicated the potential mechanisms of EPIC1 in chemoresistance, including the daunorubicin and doxorubicin metabolic processes. Conclusions: Our study suggests that EPIC1 may be a promising biomarker for both neoadjuvant chemosensitivity and long-term clinical outcomes in breast cancer, specifically in the HorR-positive premenopausal subgroup. It may also help identify candidate responders and determine treatment strategies.

Diffusion-weighted MRI for predicting pathologic response to neoadjuvant chemotherapy in breast cancer: evaluation with mono-, bi-, and stretched-exponential models

“…The treatment protocols have been previously described [ 25 ]. Each patient received intravenous administration of paclitaxel at 80 mg/m 2 body surface area and cisplatin at 25 mg/m 2 body surface area for four cycles lasting 16 weeks in duration.…”

Exploring the effectiveness of molecular subtypes, biomarkers, and genetic variations as first-line treatment predictors in Asian breast cancer patients: A systematic review and meta-analysis

“…3 (see Additional File 7). In the crude analysis of ER + vs ER-pooling ve studies [42,54,73,76,107], ER was not associated with pCR outcome (OR: 0.39; 95% CI: 0.13-1.15; p = 0.09). The reported moderate heterogeneity between the studies was perhaps due to the difference in favoured outcomes in one study [73] compared to the rest.…”

“…3D). Although all three and seven studies pooled in the two analyses were performed in the Chinese population, the primary outcome assessed in Li et al [45] and Xu et al [42] focused on the contribution of genetic mutations or long non-coding RNAs (lncRNAs) as a predictor of pCR status in the recruited population. Consequently, pooled analysis excluding Li et al eliminates the heterogeneity in the rst analysis revealing signi cant association (OR: 2.30; 95% CI: 1.66-3.19; p < 0.00001), while pooled analysis excluding Li et al and Xu et al in the second analysis decreased the heterogeneity, and maintaining the signi cant association (OR: 3.80; 95% CI: 2.02-7.13; p < 0.0001).…”

“…Our study investigated ve biomarkers comprising ER, PR, HR, HER2, and Ki-67 on their effect on pCR outcome in Asian breast cancer patients treated with NAC TP. Five studies [42,64,97,104,107] and two studies [100,102] were pooled to evaluate the association of ER and PR, and HR, respectively. pCR outcome was signi cantly associated with ER-(OR: 4.91; 95% CI: 3.20-7.53; p < 0.00001; Fig.…”

“…Ki-67 was evaluated by analysing ve pooled studies [42,45,64,100,107], showing that pCR outcome was not signi cantly associated with either high Ki-67 or low Ki-67 (OR: 2.20; 95% CI: 0.74-6.59; p = 0.16; Fig. 6E).…”