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Correlation between androgen receptor expression and pathological response rate in pre-operative HER2-positive breast cancer patients

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Abstract

Purpose

In this study, we aimed to explore the potential significance of AR expression in HER2-positive breast cancer patients who underwent neoadjuvant targeted therapy. Specifically, we investigated the correlation between AR expression levels and pathological complete response (pCR) rates. Our objective was to determine whether there were significant differences in pCR rates among HER2-positive breast cancer patients with different levels of AR expression.

Methods

We conducted a retrospective analysis of 258 HER-2 positive breast cancer patients who underwent neoadjuvant dual-blocked standard therapy (following the NCCN Guideline 2021) at three breast cancer centers in southwest China. We analyzed the clinicopathological features and pCR rates of these patients. The cut-off value for AR expression level was calculated as the median value of 70%. We used the chi-square test to investigate the correlation between AR expression level and pCR rate, as well as other clinicopathological features.

Results

Out of the 258 patients analyzed, 154 (59.69%) achieved pCR. Based on the cut-off value of 70%, AR expression level was classified as low (AR ≤ 70%) or high (AR > 70%) expression. Our analysis revealed a significant correlation between AR expression level and pCR rate in HER2-positive breast cancer patients (P = 0.031). We also found a significant association between pCR rate and clinical stage (P = 0.033) and chemotherapy regimen (P = 0.034).

Furthermore, subgroup analyses showed that the pCR rate was higher in patients with high AR expression levels compared to those with low AR expression levels. Additionally, we observed that patients with an ER/AR ratio of less than 1 had a higher pCR rate than those with an ER/AR ratio greater than 1 (P = 0.038).

Conclusion

Our study findings suggest that HER2-positive breast cancer patients with high AR expression levels may achieve higher pCR rates when treated with neoadjuvant dual-blocked therapy. Overall, our results support the idea that AR expression levels have a significant correlation with pCR rates in HER2-positive breast cancer patients receiving this particular form of treatment.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was supported by the National Natural Science Foundation of China (grant numbers 82060538 and 82060543), the Training Plan of Medical Academic Leaders of Yunnan Provincial Health and Health Committee (grant number D-2018002), the Kunming-Medical Joint Project-Surface Project (grant number 202001AY070001-079), and the Young and Middle-Aged Academic and Technical Leaders Reserve Talent Project (grant number 202205AC160008). We gratefully acknowledge the support provided by these funding agencies.

Author information

Author notes

  1. Na Li, Jingxuan Wu , and Xiaowei Qi have made equal contributions to this study and should be acknowledged as co-first authors. Furthermore, Wenlin Chen and Fei Ge are designated as co-corresponding authors.

Authors and Affiliations

  1. Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming, 650118, Yunnan, China

    Na Li, Ruimin Liu, Yang Yang, Chenxi Li, Mingqing Huang, Mengping Lin, Chenxi Wang, Zhuocen Cha, Xiaochen Hou, Lin Luo & Wenlin Chen

  2. Department of Breast Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China

    Jingxuan Wu & Fei Ge

  3. Department of Breast and Thyroid Surgery, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China

    Xiaowei Qi

  4. First Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming, 650118, Yunnan, China

    Qianxi Yang

Authors
  1. Na Li
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Contributions

All authors contributed to the study conception and design. WC and FG conceptualized this study and generated the population. Data collection were performed by NL, JW, XQ and RL. CL, MH, ML and CW performed the date analysis with advice from QY. YY completed the drawing of the manuscript image. ZC, XH and LL completed the references search for this manuscript. Finally, the first draft of the manuscript was written by NL, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Fei Ge or Wenlin Chen.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

This is an observational study. The Yunnan Cancer hospital Ethics Committee has confirmed that no ethical approval is required.

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Informed consent was obtained from all individual participants included in the study.

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The authors affirm that human research participants provided informed consent for publication of the information in Tables 1, 2, 3 and 4.

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Li, N., Wu, J., Qi, X. et al. Correlation between androgen receptor expression and pathological response rate in pre-operative HER2-positive breast cancer patients. J Cancer Res Clin Oncol 149, 10109–10117 (2023). https://doi.org/10.1007/s00432-023-04904-x

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  • DOI: https://doi.org/10.1007/s00432-023-04904-x

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