Persistent EGFR/K-RAS/SIAH pathway activation drives chemo-resistance and early tumor relapse in triple-negative breast cancer.
| Autor: | Tang AH; Department of Microbiology and Molecular Cell Biology, Leroy T. Canoles Jr. Cancer Research Center, Eastern Virginia Medical School, Norfolk, VA 23507, USA., Hoefer RA; School of Systems Biology, George Mason University, Manassas, VA 20110, USA.; Sentara Cancer Network, Sentara Healthcare, Norfolk, VA 23507, USA., Guye ML; Sentara Cancer Network, Sentara Healthcare, Norfolk, VA 23507, USA.; Sentara Surgery Specialists, Surgical Oncology, Sentara CarePlex Hospital, Newport News, VA 23606, USA., Bear HD; Division of Surgical Oncology, Departments of Surgery and Microbiology and Immunology, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23298-0011, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cancer drug resistance (Alhambra, Calif.) [Cancer Drug Resist] 2022 Jun 22; Vol. 5 (3), pp. 691-702. Date of Electronic Publication: 2022 Jun 22 (Print Publication: 2022). |
| DOI: | 10.20517/cdr.2022.31 |
| Abstrakt: | Triple-negative breast cancer (TNBC) is the most aggressive breast cancer subtype. It disproportionately affects BRCA mutation carriers and young women, especially African American (AA) women. Chemoresistant TNBC is a heterogeneous and molecularly unstable disease that challenges our ability to apply personalized therapies. With the approval of immune checkpoint blockade (ICB) for TNBC, the addition of pembrolizumab to systemic chemotherapy has become standard of care (SOC) in neoadjuvant systemic therapy (NST) for high-risk early-stage TNBC. Pembrolizumab plus chemotherapy significantly increased the pathologic complete response (pCR) and improved event-free survival in TNBC. However, clinical uncertainties remain because similarly treated TNBC partial responders with comparable tumor responses to neoadjuvant therapy often experience disparate clinical outcomes. Current methods fall short in accurately predicting which high-risk patients will develop chemo-resistance and tumor relapse. Therefore, novel treatment strategies and innovative new research initiatives are needed. We propose that the EGFR-K-RAS-SIAH pathway activation is a major tumor driver in chemoresistant TNBC. Persistent high expression of SIAH in residual tumors following NACT/NST reflects that the EGFR/K-RAS pathway remains activated (ON), indicating an ineffective response to treatment. These chemoresistant tumor clones persist in expressing SIAH (SIAH High/ON ) and are linked to early tumor relapse and poorer prognosis. Conversely, the loss of SIAH expression (SIAH Low/OFF ) in residual tumors post-NACT/NST reflects EGFR/K-RAS pathway inactivation (OFF), indicating effective therapy and chemo-sensitive tumor cells. SIAH Low/OFF signal is linked to tumor remission and better prognosis post-NACT/NST. Therefore, SIAH is well-positioned to become a novel tumor-specific, therapy-responsive, and prognostic biomarker. Potentially, this new biomarker (SIAH High/ON ) could be used to quantify therapy response, predict chemo-resistance, and identify those patients at the highest risk for tumor relapse and poor survival in TNBC. Competing Interests: All authors declared that there are no conflicts of interest. (© The Author(s) 2022.) |
| Databáze: | MEDLINE |
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