Predictive value of serum anti-p53 antibodies, carcino-embryonic antigen, carbohydrate antigen 15-3, estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 in taxane-based and anthracycline-based neoadjuvant chemotherapy in locally advanced breast cancer patients

Efficacy and safety of pyrotinib combined with albumin-bound paclitaxel as first-line treatment for HER2-positive metastatic breast cancer in patients previously treated with adjuvant and/or neoadjuvant trastuzumab therapy: The stage 1 results of a single-arm, phase 2 prospective clinical trial

OBJECTIVE

It has been observed that the prognosis of patients with HER2-positive metastatic breast cancer has improved significantly with HER2-targeted agents. However, there is still a lack of evidence regarding first-line anti-HER2 treatment options for patients who have received adjuvant and/or neoadjuvant trastuzumab for HER2-positive metastatic breast cancer. Besides, there are no reliable markers that can predict the efficacy of anti-HER2 treatment in these patients.

METHODS

Patients who have received adjuvant and/or neoadjuvant trastuzumab for HER2-positive metastatic breast cancer were enrolled. Pyrotinib plus albumin-bound paclitaxel were used as first-line treatment. The primary endpoint was the objective response rate (ORR). The safety profile was also assessed. In order to explore predictive biomarkers using Olink technology, blood samples were collected dynamically.

RESULTS

From December 2019 to August 2023, the first stage of the study involved 27 eligible patients. It has not yet reached the median PFS despite the median follow-up being 17.8 months. Efficacy evaluation showed that the ORR was 92.6%, and the DCR was 100%. Adverse events of grade 3 or higher included diarrhoea (29.6%), leukopenia (11.1%), neutropenia (25.9%), oral mucositis (3.7%), and hand-foot syndrome (3.7%). Toll-like receptor 3 (TLR3) and Proto-oncogene tyrosine-protein kinase receptor (RET) were proteins with significant relevance to PFS in these patients.

CONCLUSIONS

This study demonstrates that pyrotinib plus albumin-bound paclitaxel as a first-line treatment regimen shows good efficacy and manageable safety for patients who have received adjuvant and/or neoadjuvant trastuzumab for HER2-positive metastatic breast cancer. Besides, a significant association was identified between the expression levels of TLR3 and RET and the PFS in patients.

The Potential Role of CDH1 as an Oncogene Combined With Related miRNAs and Their Diagnostic Value in Breast Cancer

BACKGROUND

Breast cancer (BC) is the leading cause of cancer-related mortality in females and the most common malignancy with high morbidity worldwide. It is imperative to develop new biomarkers and therapeutic targets for early diagnosis and effective treatment in BC.

METHODS

We revealed the oncogene function of cadherin 1 (CDH1) via bioinformatic analysis in BC. Moreover, miRNA database was utilized to predict miRNAs upstream of CDH1. Expression of CDH1-related miRNAs in BC and their values in BC stemness and prognosis were analyzed through TCGA-BRCA datasets. In addition, Gene Ontology (GO) and Gene Set Enrichment Analysis (GSEA) were performed to explore the potential functions and signaling pathways of CDH1 in combination with CDH1-related miRNAs in BC progression. Finally, the differential expressions of soluble E-cadherin (sE-cad), which is formed by the secretion of CDH1-encoded E-cadherin into serum, analyzed by enzyme-linked immunosorbent assay (ELISA). Reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) was used to detect the expression level of CDH1-related miRNAs in serum samples.

RESULTS

The mRNA and protein expressions of CDH1 were elevated in BC tissues compared with normal counterparts. Moreover, CDH1 overexpression was positively correlated with BC stage, metastatic, stemness characteristics, and poor prognosis among patients. In predictive analysis, miR-340, miR-185, and miR-20a target CDH1 and are highly expressed in BC. miR-20a overexpression alone was strongly associated with high stemness characteristics and poor prognosis of BC. Additionally, GO, KEGG, and hallmark effect gene set analysis demonstrated that CDH1 in combination with overexpression of miR-340, miR-185, or miR-20a participated in multiple biological processes and underly signaling pathways involving in tumorigenesis and development of BC. Finally, we provide experimental evidence that the combined determination of serum sE-cad and miR-20a in BC has highly diagnostic efficiency.

CONCLUSIONS

This study provides evidence for CDH1 as an oncogene in BC and suggests that miR-20a may regulate the stemness characteristics of BC to exert a pro-oncogenic effect by regulating CDH1. Moreover, sE-cad and miR-20a in serum can both be used as valid noninvasive markers for BC diagnosis.

DNA origami-based aptasensors

Traditional analytical techniques face many limitations such as time-consuming process, complicated sample preparation, high consumption of reagents and need for expensive equipment. So, it is important that simple, rapid and sensitive detection methods are introduced. Nucleic acids-based assays, particularly aptamers, have a great impact on modern life sciences for biological analysis and target detection. Aptamer-based biosensors with unique recognition properties including high specificity and affinity, rapid response and simple fabrication have attracted much attention. It is believed that two- and three-dimensional structures, sometimes referred to as DNA origami, using DNA aptamers can show more selective binding affinity and better stability over other nucleic acids forms. In this review, we will focus on recent advances in the development and uses of electrochemical and optical DNA origami-based aptasensors to supply readers with a comprehensive understanding of their improvements. Also, the challenges and awards of these approaches are discussed.

Measurement of Carcinoembryonic Antigen in Clinical Serum Samples Using a Centrifugal Microfluidic Device

Carcinoembryonic antigen (CEA) is a broad-spectrum tumor marker used in clinical applications. The primarily clinical method for measuring CEA is based on chemiluminescence in serum during enzyme-linked immunosorbent assays (ELISA) in 96-well plates. However, this multi-step process requires large and expensive instruments, and takes a long time. In this study, a high-throughput centrifugal microfluidic device was developed for detecting CEA in serum without the need for cumbersome washing steps normally used in immunoreactions. This centrifugal microdevice contains 14 identical pencil-like units, and the CEA molecules are separated from the bulk serum for subsequent immunofluorescence detection using density gradient centrifugation in each unit simultaneously. To determine the optimal conditions for CEA detection in serum, the effects of the density of the medium, rotation speed, and spin duration were investigated. The measured values from 34 clinical serum samples using this high-throughput centrifugal microfluidic device showed good agreement with the known values (average relative error = 9.22%). These results indicate that the high-throughput centrifugal microfluidic device could provide an alternative approach for replacing the classical method for CEA detection in clinical serum samples.

Further evidence to demonstrate the significance of serum appearance of anti-p53 antibody as a marker for progressive potential in invasive ductal carcinoma of the breast

BACKGROUND

Serum appearance of anti-p53 antibody (p53Ab) has been reported as an indicator for progressive potential of human tumor tumors including breast cancer. But its significance in breast cancer has not been discussed fully.

METHODS

Relationship between serum appearance of p53Abs and representative data accounting for progressive potential in breast cancer, nuclear grade (NG), triple negative cancer, and the cumulative score based on these two data (TGS) was investigated among 129 women with invasive ductal carcinoma (IDC) of the breast, who had been treated with surgical resection.

RESULTS

There was a significant correlation between appearance of p53Abs and recurrence of the tumors (P = 0.035). Significant correlation of serum appearance of p53Abs with negative expression of ER (P = 0.011), the proportion of TNBC (P = 0.013), NG (P = 0.017), and TGS (P = 0.0005).

CONCLUSIONS

Preoperative serum appearance of p53Abs can be correlated with pathological nuclear grade, incidence of triple negative breast cancer, and TGS. These results might demonstrate more powerful significance of serum appearance of p53Abs as an indicator of progressive potential in IDC of the breast. J. Med. Invest. 64: 241-244, August, 2017.

The BMP inhibitor DAND5 in serum predicts poor survival in breast cancer

Background & Aims

Breast cancer (BC) is prevalent worldwide malignant cancer. Improvements in timely and effective diagnosis and prediction are needed. As reported, secreted DAND5 is contributed to BC metastasis. We aim to assess whether DAND5 in peripheral blood serum could determine BC-specific mortality.

Methods

We used immunohistochemistry staining to detect DAND5 expression in our BC tissue array including 250 samples. Angiogenesis assay and xenograft mice model were used to examine the secreted DAND5 function in BC progression. Serum concentration of DAND5 was examined by ELISA in 1730 BC patients. Kaplan-Meier and adjusted Cox proportional hazards models were utilized to analyze the prognosis and survival of BC patients.

Results

Tissue array results showed that positive DAND5 staining cases displayed a higher likelihood of occurrence of disease events (HR=5.494; 95% CI: 1.008-2.353; P=0.048) in univariate analysis and remained the same trend in multivariate analysis (HR=2.537; 95% CI: 1.056-6.096; P=0.037). DAND5 positive patients exerted generally poor DFS (P=0.041) in the Kaplan-Meier survival analysis. Furthermore, secreted DAND5 promoted tumor growth and angiogenesis in vitro and in vivo. In addition, positive DAND5 in BC patients serum was associated with increased risk of disease events occurrence (univariate: HR=1.58; 95% CI: 1.206-2.070; P=0.001; multivariate: HR=1.4; 95% CI: 1.003-1.954; P=0.048) in univariate and multivariate survival analysis. In the Kaplan-Meier analysis, serum DAND5 positively correlated with poor DFS (P=0.001) and DDFS (P=0.002).

Conclusions

DAND5 was correlated with poor survival and could serve as an easily detectable serum biomarker to predict the survival of breast cancer.

Elevation of serum CEA and CA15-3 levels during antitumor therapy predicts poor therapeutic response in advanced breast cancer patients

The aim of the present study was to assess the correlation between therapeutic response and carcinoembryonic antigen (CEA) and carbohydrate antigen 15-3 (CA15-3) levels in advanced breast cancer patients with non-assessable lesions or stable disease (SD) according to the Response Evaluation Criteria in Solid Tumors. A total of 232 female patients with recurrent tumors following radical mastectomy were recruited, including 76 patients with non-assessable lesions and 60 patients with SD. The correlation between CEA and CA15-3 changes, progression-free survival (PFS) and therapeutic response were analyzed in the non-assessable and SD patient groups. For all subjects, the association between the patients' serum tumor markers levels and the clinical presentation of the tumor, as well as the correlation between initial tumor marker levels and PFS, were analyzed. An increase in CEA (an increment of >2 ng/ml) or CA15-3 levels (an increase of >15 U/ml) following the second cycle of treatment correlated with shorter PFS in both non-assessable and SD patients, and with poor clinical outcome in SD patients. High CA15-3 levels correlated with hormone receptor-positive tumors, multiple metastases and liver metastases. Bone metastases correlated with high levels of both CEA and CA15-3. Relatively low CEA and CA15-3 concentrations were associated with triple-negative and locally invasive tumors. High CEA and CA15-3 levels at the beginning of relapse correlated with shorter PFS. The present study illustrates that CEA and CA15-3 levels correlate with several factors in recurrent breast cancer patients. Elevated levels of CEA and CA15-3 at the beginning of relapse may predict shorter PFS. Furthermore, elevation of CEA and CA15-3 levels following the second therapeutic cycle predict poor therapeutic response in patients with non-assessable lesions and SD. Our findings suggest that alterations in CEA and CA15-3 levels can predict therapeutic response in advanced breast cancer patients.

Prognostic Value of Pre- and Postoperative Anti-p53 Antibody Levels in Colorectal Cancer Patients: A Retrospective Study

OBJECTIVE

To determine the utility of the post-/preoperative anti-p53 antibody (p53 Ab) ratio as a prognostic factor for colorectal cancer (CRC) recurrence.

METHODS

A total of 737 nonmetastatic CRC patients who had undergone R0 resection were retrospectively analyzed. p53 Ab levels were measured within 1 month prior to and at least every 3 months after surgery. Post-/preoperative p53 Ab ratios were calculated, and the optimal ratio cutoff values for predicting recurrence were determined using the Kaplan-Meier method and the log-rank test.

RESULTS

Preoperative p53 Ab elevation was observed in 194 patients (pre-p53 high). Preoperative p53 Ab levels correlated with TNM stage. Re-elevation of p53 Ab levels occurred on recurrence in the pre-p53 high group, but not in the pre-p53 low group (n = 543). In the pre-p53 high group, patients who experienced tumor recurrence exhibited a slow postoperative reduction of p53 Ab levels, and a post-/preoperative p53 Ab ratio >0.4 at postoperative 3 months predicted relapse-free survival. In other words, a p53 Ab level remaining higher than 40% of the preoperative level was an independent and strong risk factor for recurrence in multivariate analyses.

CONCLUSION

In CRC patients with preoperative p53 Ab elevation, the rate of p53 Ab reduction in the early postsurgical period is a promising prognostic factor for recurrence.

Avaliação imunoistoquímica dos receptores de estrogênio e progesterona no câncer de mama, pré e pós-quimioterapia neoadjuvante

OBJETIVO: Avaliar a imunoexpressão dos receptores de estrogênio e progesterona em biópsias e peças cirúrgicas de pacientes com câncer de mama pré e pós-quimioterapia neoadjuvante e correlacionar suas alterações com o padrão de resposta à quimioterapia e diagnóstico de menopausa. MÉTODOS: Selecionaram-se 47 pacientes com diagnóstico histopatológico de carcinoma primário de mama localmente avançado. Para cada paciente existiam dois blocos: o espécime da biópsia e o da ressecção cirúrgica. A partir destes blocos foi avaliada a expressão dos receptores hormonais por imunoistoquímica com a técnica da streptoavidina-biotina-imunoperoxidase e anticorpos primários anti-RE e anti-RP. A análise estatística utilizou o teste paramétrico t de Student e o não-paramétrico exato de Fisher, com nível de significância de 5%. RESULTADOS: Das 47 pacientes, 30 apresentavam imunoexpressão positiva dos receptores hormonais. Observou-se redução significativa tanto nos níveis de receptor de estrogênio e progesterona quanto em sua imunoexpressão. Em 53,3% observaram-se mudanças nos níveis expressos de receptor de estrogênio, 56,6% em receptor de progesterona, 26,6% na imunoexpressão do receptor de estrogênio e 33,3% na imunoexpressão do receptor de progesterona. Não foi encontrada significância estatística ao correlacionar-se a influência da resposta à quimioterapia e do diagnóstico de menopausa nas pacientes com a variação na expressão dos receptores hormonais. CONCLUSÃO: A quimioterapia neoadjuvante alterou significativamente a imunoexpressão dos receptores hormonais nas pacientes da amostra, reduzindo sua positividade nas células tumorais.

Serum appearance of anti-p53 antibody in triple negative breast cancer

BACKGROUND

Significance of serum appearance of anti-p53 antibody in breast cancer has not been discussed fully.

METHODS

The relationship between serum appearance of anti-p53 antibody and the clinicopathological features was investigated on the basis of the data of 42 women with breast cancer who had been treated with surgical resection.

RESULTS

The proportion of tumors with histological grade 3 was significantly higher among tumors with serum appearance of anti-p53 antibody (P = 0.020). The proportion of triple negative tumors was also significantly higher among tumors with serum appearance of anti-p53 antibody (P = 0.003).

CONCLUSIONS

Preoperative appearance of anti-p53 antibody in sera can be correlated with the incidence of triple negative breast cancer and could therefore help identify tumors with aggressive potential.

Anti-p53 antibodies in serum: relationship to tumor biology and prognosis of breast cancer patients

The aim of this study was to analyze the concentration of anti-p53 antibodies in the serum of breast cancer patients and to correlate these results with various clinical, pathological and biochemical parameters. We also wanted to assess the prognostic significance of these antibodies in our patients. Sera from 61 patients with breast cancer and 20 individuals without malignancies were analyzed using enzyme-linked immunoadsorbent assay. High levels of anti-p53 antibodies were detected in twenty-one (35%) breast cancer patients and one control (5%). The difference was statistically significant. We observed an inverse relationship between the anti-p53 antibodies and the age of the patients. We found significant association of anti-p53 antibodies with tumor size, histological grade of the tumors and the number of axillary lymph nodes involved. The levels of anti-p53 antibodies were higher in patients with negative estrogen and progesterone receptors in comparison with patients with positive steroid receptors, but the difference was not statistically significant. No relation was observed between anti-p53 antibodies neither with the Cathepsin D levels in the cytosol nor with the HER-2/neu extracellular domain in the serum. Patients with primary tumors and higher levels of anti-p53 antibodies had shorter 5-year survival than patients with lower levels of anti-p53 antibodies. Our results support the role of anti-p53 antibodies as a biomarker of less favorable phenotype as well as a prognostic factor for patients with breast cancer.