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Fuso P, Di Salvatore M, Santonocito C, Guarino D, Autilio C, Mulè A, Arciuolo D, Rinninella A, Mignone F, Ramundo M, Di Stefano B, Orlandi A, Capoluongo E, Nicolotti N, Franceschini G, Sanchez AM, Tortora G, Scambia G, Barone C, Cassano A. Let-7a-5p, miR-100-5p, miR-101-3p, and miR-199a-3p Hyperexpression as Potential Predictive Biomarkers in Early Breast Cancer Patients. J Pers Med 2021; 11:816. [PMID: 34442460 PMCID: PMC8400663 DOI: 10.3390/jpm11080816] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/06/2021] [Accepted: 08/14/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The aim of this study is to identify miRNAs able to predict the outcomes in breast cancer patients after neoadjuvant chemotherapy (NAC). PATIENTS AND METHODS We retrospectively analyzed 24 patients receiving NAC and not reaching pathologic complete response (pCR). miRNAs were analyzed using an Illumina Next-Generation-Sequencing (NGS) system. RESULTS Event-free survival (EFS) and overall survival (OS) were significantly higher in patients with up-regulation of let-7a-5p (EFS p = 0.006; OS p = 0.0001), mirR-100-5p (EFS s p = 0.01; OS p = 0.03), miR-101-3p (EFS p = 0.05; OS p = 0.01), and miR-199a-3p (EFS p = 0.02; OS p = 0.01) in post-NAC samples, independently from breast cancer subtypes. At multivariate analysis, only let-7a-5p was significantly associated with EFS (p = 0.009) and OS (p = 0.0008). CONCLUSION Up-regulation of the above miRNAs could represent biomarkers in breast cancer.
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Affiliation(s)
- Paola Fuso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (P.F.); (A.M.); (D.A.); (G.S.)
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
| | - Mariantonietta Di Salvatore
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
- Comprehensive Cancer Center, Medical Oncology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Concetta Santonocito
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
- Laboratory of Clinical Molecular Biology, Department of Biochemistry and Clinical Biochemistry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Donatella Guarino
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
- Laboratory of Clinical Molecular Biology, Department of Biochemistry and Clinical Biochemistry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Chiara Autilio
- Department of Biochemistry and Molecular Biology, Faculty of Biology and Research Institute, Universidad Complutense, Av. Sèneca, 2, 28040 Madrid, Spain;
| | - Antonino Mulè
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (P.F.); (A.M.); (D.A.); (G.S.)
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
- Department of Pathologic Anatomy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Damiano Arciuolo
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (P.F.); (A.M.); (D.A.); (G.S.)
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
- Department of Pathologic Anatomy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Antonina Rinninella
- Department of Science and Innovation Technology, University of Piemonte Orientale, V.le Teresa Michel 11, 15121 Alessandria, Italy; (A.R.); (F.M.)
| | - Flavio Mignone
- Department of Science and Innovation Technology, University of Piemonte Orientale, V.le Teresa Michel 11, 15121 Alessandria, Italy; (A.R.); (F.M.)
| | - Matteo Ramundo
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
- Comprehensive Cancer Center, Medical Oncology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Brunella Di Stefano
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
- Comprehensive Cancer Center, Medical Oncology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Armando Orlandi
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
- Comprehensive Cancer Center, Medical Oncology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Ettore Capoluongo
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
- Biotecnologie Avanzate, Università Federico II-CEINGE, Corso Umberto I 40, 80138 Naples, Italy
| | - Nicola Nicolotti
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
- Medical Management, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Gianluca Franceschini
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
- Multidisciplinary Breast Center, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Alejandro Martin Sanchez
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
- Multidisciplinary Breast Center, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Giampaolo Tortora
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
- Comprehensive Cancer Center, Medical Oncology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Giovanni Scambia
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (P.F.); (A.M.); (D.A.); (G.S.)
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
| | - Carlo Barone
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
| | - Alessandra Cassano
- Faculty of Medicine and Surgery, Università Cattolica Del Sacro Cuore, Largo F. Vito 8, 00168 Rome, Italy; (C.S.); (D.G.); (M.R.); (B.D.S.); (A.O.); (E.C.); (N.N.); (G.F.); (A.M.S.); (G.T.); (C.B.); (A.C.)
- Comprehensive Cancer Center, Medical Oncology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
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Trabulsi NH, Shabkah AA, Ujaimi R, Iskanderani O, Kadi MS, Aljabri N, Sharbatly L, AlOtaibi MN, Farsi AH, Nassif MO, Saleem AM, Akeel NY, Malibary NH, Samkari AA. Locally Advanced Breast Cancer: Treatment Patterns and Predictors of Survival in a Saudi Tertiary Center. Cureus 2021; 13:e15526. [PMID: 34277162 PMCID: PMC8269977 DOI: 10.7759/cureus.15526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 11/11/2022] Open
Abstract
Background Breast cancer (BC) is the most common cancer in the Kingdom of Saudi Arabia (KSA) and the second leading cause of cancer-related mortality. About 40% of BC in KSA is locally advanced BC (LABC), which has been associated with poorer survival compared with early diagnosed BC. Objective To review the presentation and outcomes of LABC, including the characteristics of the disease, different treatment modalities, overall survival (OS), disease-free survival (DFS), and local recurrence in relation to different radiotherapy (RT) techniques. Methods We retrospectively reviewed the medical records of 153 female patients with pathologically proven LABC diagnosed at King Abdulaziz University Hospital, Jeddah, KSA, between 2009 and 2017. We obtained data on patient demographics, stage of cancer at diagnosis, tumor characteristics (subtype and receptor status), type of surgery, systemic treatments received (hormonal, targeted therapy, and chemotherapy), RT variables, and recurrence and death dates. Data were analyzed to assess OS and DFS by using Kaplan-Meier analyses and the log-rank test. Univariate and multivariate Cox proportional hazard regression analyses were used to explore and identify factors associated with survival. Results The median survival time in the study population was 9.16 years. Older age (65+ years) was associated with worse OS and DFS than was younger age (<65 years) (hazard ratio (HR) 3.20, 95% CI 1.48-6.90, P = 0.003 and HR 2.21, 95% CI 1.12-4.36, P = 0.022, respectively). Regarding the type of surgery, having a mastectomy was associated with worse OS and DFS than was having a lumpectomy (HR 2.44, 95% CI 0.97-6.12, P = 0.05 and HR 2.41, 95% CI 1.13-5.14, P = 0.023, respectively). Positive estrogen and progesterone receptor status was associated with better OS and DFS than was a negative estrogen or progesterone receptor status (HR 0.13, 95% CI 0.05-0.30, P < 0.001 and HR 0.21, 95% CI 0.11-0.41, P < 0.001, respectively). Patients who received RT had a lower risk of recurrence than did those who did not receive RT (P = 0.011). Moreover, three-dimensional conformal RT was associated with lower local recurrence than intensity-modulated RT or volumetric-modulated arc therapy (P = 0.003). Conclusion Multiple factors can affect the OS and DFS in LABC. Younger patients, having hormone-positive disease, and undergoing lumpectomy were associated with better outcomes. Adjuvant RT may improve local control and the use of three-dimensional conformal RT was superior for local control. Prospective studies with larger sample sizes are needed to further highlight these findings and to assess the role of chemotherapy and targeted therapy in patients with LABC.
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Affiliation(s)
- Nora H Trabulsi
- Department of Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Alaa A Shabkah
- Department of Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Reem Ujaimi
- Department of Radiation Oncology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Omar Iskanderani
- Department of Radiation Oncology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Mai S Kadi
- Department of Community Medicine, King Abdulaziz University, Jeddah, SAU
| | - Nuran Aljabri
- Department of Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Liane Sharbatly
- Department of Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Manal N AlOtaibi
- Department of Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Ali H Farsi
- Department of Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Mohammed O Nassif
- Department of Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Abdulaziz M Saleem
- Department of Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Nouf Y Akeel
- Department of Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Nadim H Malibary
- Department of Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Ali A Samkari
- Department of Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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Arjunan R, Ramamani TA, Ramachandra C, Swamyvelu K, Chunduri S, Althaf S, Usha A, Namrata R. Sentinel Lymph Node Biopsy in Locally Advanced Breast Cancer After Neoadjuvant Chemotherapy-an Indian Perspective. Indian J Surg Oncol 2020; 11:242-247. [PMID: 32523270 DOI: 10.1007/s13193-020-01035-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 01/03/2020] [Indexed: 02/06/2023] Open
Abstract
Sentinel lymph node biopsy (SLNB) alone in early breast cancer is an established standard of care. However, the same results have not been replicated in locally advanced breast cancer (LABC) after neoadjuvant chemotherapy (NACT). We aim to examine the feasibility of SLNB in LABC patients post NACT to determine identification rates (IR) and false negative rates (FNR). This was a single tertiary cancer center-based prospective study from February 2017 to November 2018. Forty-four patients with LABC (T3, T4 with N0 or N1) were studied and response after NACT was assessed. Only those patients who were N0 or who converted from N1 to N0 after NACT were included. Those patients who remained node positive after NACT directly proceeded with axillary dissection without SLNB and were excluded from the study. Demographic and clinical data is expressed in ratios and percentage and presented in table format. The median age at the time of study was 45.18 years. Most of the patients had T3 and above (97.7%) and N1 (86.3%) disease at the start of neoadjuvant therapy. The mean number of axillary lymph nodes dissected was 13.97. Dual method of sentinel lymph node mapping (methylene blue dye and radiolabeled colloid) was used in 26 (59.1%) patients. At least 1 SLN was identified in 86.4% patients with 100% identification in those patients in whom the dual method of SLN mapping was used. Median of 2 SLN was removed. Overall, false negative rate was 21.4%. FNR was high with the single method of SLN mapping (50% and 33.3% with methylene blue and radioactive colloid respectively) while it was considerably low when both were used simultaneously (11%). An average of 2 (range 0-4) SLN were identified and FNR were zero when 2 or more SLN were identified. Our study shows that SLNB in patients with LABC post NACT though viable cannot be recommended at present due to unacceptable high FNR. However, this should not dissuade us from exploring recurrence-free survival and overall survival associated with such IR and FNR albeit strictly under a clinical trial setting.
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Affiliation(s)
- Ravi Arjunan
- Department of Surgical Oncology, Kidwai Cancer Institute, Bangalore, India
| | | | | | | | - Srinivas Chunduri
- Department of Surgical Oncology, Kidwai Cancer Institute, Bangalore, India
| | - Syed Althaf
- Department of Surgical Oncology, Kidwai Cancer Institute, Bangalore, India
| | - Amirtham Usha
- Department of Pathology, Kidwai Cancer Institute, Bangalore, India
| | - Ranganath Namrata
- Department of Anaesthesia and Pain Relief, Kidwai Cancer Institute, Bangalore, India
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Allis S, Reali A, Mortellaro G, Arcadipane F, Bartoncini S, Grazia Ruo Redda M. Should Radiotherapy after Primary Systemic Therapy be Administered with the Same Recommendations Made for Operable Breast Cancer Patients who Receive Surgery as first Treatment? A Critical Review. TUMORI JOURNAL 2018; 98:543-9. [DOI: 10.1177/030089161209800502] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Primary systemic therapy is not only used in patients with locally advanced inoperable non-metastatic breast cancer but also for operable stage II and III cancer aimed at breast conservation. The indications for local-regional radiotherapy for patients who receive primary systemic therapy are still evolving. The purpose of this article is to provide a comprehensive discussion of how primary systemic therapy in operable breast cancer patients could affect the indications of radiotherapy to optimize local-regional treatment. An overview of available literature data regarding neoadjuvant treatment and radiotherapy is analyzed and discussed. Considering the variability of data on this issue, an appropriate approach could still be to tailor treatment decision to the individual clinical case.
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Affiliation(s)
- Simona Allis
- Department of Clinical and Biological Sciences, Radiation Oncology Unit, University of Turin, S. Luigi Hospital, Orbassano
| | - Alessia Reali
- Department of Clinical and Biological Sciences, Radiation Oncology Unit, University of Turin, S. Luigi Hospital, Orbassano
| | - Gianluca Mortellaro
- Department of Clinical and Biological Sciences, Radiation Oncology Unit, University of Turin, S. Luigi Hospital, Orbassano
| | - Francesca Arcadipane
- Department of Medical and Surgical Sciences, Radiation Oncology Unit, University of Turin, S Giovanni Battista Hospital, Turin, Italy
| | - Sara Bartoncini
- Department of Medical and Surgical Sciences, Radiation Oncology Unit, University of Turin, S Giovanni Battista Hospital, Turin, Italy
| | - Maria Grazia Ruo Redda
- Department of Clinical and Biological Sciences, Radiation Oncology Unit, University of Turin, S. Luigi Hospital, Orbassano
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miR-668 enhances the radioresistance of human breast cancer cell by targeting IκBα. Breast Cancer 2017; 24:673-682. [PMID: 28138801 DOI: 10.1007/s12282-017-0756-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 01/18/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND A large proportion of breast cancer patients are resistant to radiotherapy, which is a mainstay treatment for this malignancy, but the mechanisms of radioresistance remain unclear. METHODS AND MATERIALS To evaluate the role of miRNAs in radioresistance, we established two radioresistant breast cancer cell lines MCF-7R and T-47DR derived from parental MCF-7 and T-47D. Moreover, miRNA microarray, quantitative RT-PCR analysis, luciferase reporter assay and western blotting were used. RESULTS We found that miR-668 was most abundantly expressed in radioresistant cells MCF-7R and T-47DR. miR-668 knockdown reversed radioresistance of MCF-7R and T-47DR, miR-668 overexpression enhanced radioresistance of MCF-7 and T-47D cells. Mechanically, bioinformatics analysis combined with experimental analysis demonstrated IκBα, a tumor-suppressor as well as an NF-κB inhibitor, was a direct target of miR-668. Further, miR-668 overexpression inhibited IκBα expression, activated NF-κB, thus, increased radioresistance of MCF-7 and T-47D cells. Conversely, miR-668 knockdown restored IκBα expression, suppressed NF-κB, increased radiosensitivity of MCF-7R and T-47DR cells. CONCLUSION Our findings suggest miR-668 is involved in the radioresistance of breast cancer cells and miR-668-IκBα-NF-κB axis may be a novel candidate for developing rational therapeutic strategies for human breast cancer treatment.
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