Value of CDR1-AS as a predictive and prognostic biomarker for patients with breast cancer receiving neoadjuvant chemotherapy in a prospective Chinese cohort

Eur J Med Res. 2024 Sep 11;29(1):454. doi: 10.1186/s40001-024-02015-y.

Abstract

Background: Neoadjuvant chemotherapy (NAC) is an effective treatment for locally advanced breast cancer (BC). However, there are no effective biomarkers for evaluating its efficacy. CDR1-AS, well known for its important role in tumorigenesis, is a famous circular RNA involved in the chemosensitivity of cancers other than BC. However, the predictive role of CDR1-AS in the efficacy and prognosis of NAC for BC has not been fully elucidated. We herein aimed to clarify this role.

Methods: The present study included patients treated with paclitaxel-cisplatin-based NAC. The expression of CDR1-AS was detected by real-time quantitative reverse transcription polymerase chain reaction testing. The predictive value of CDR1-AS expression was examined in pathological complete response (pCR) after NAC using logistic regression analysis. The relationship between CDR1-AS expression and survival was demonstrated using the Kaplan-Meier method, and tested by log-rank test and Cox proportional hazards regression model.

Results: The present study enrolled 106 patients with BC. Multivariate logistic regression analysis revealed that CDR1-AS expression was an independent predictive factor for pCR (odds ratio [OR] = 0.244; 95% confidence interval [CI] 0.081-0.732; p = 0.012). Furthermore, pCR benefits with low CDR1-AS expression were observed across all subgroups. The Kaplan-Meier curves and log-rank test suggested that the CDR1-AS high-expression group showed significantly better disease-free survival (DFS; log-rank p = 0.022) and relapse-free survival (RFS; log-rank p = 0.012) than the CDR1-AS low-expression group. Multivariate analysis revealed that CDR1-AS expression was an independent prognostic factor for DFS (adjusted HR = 0.177; 95% CI 0.034-0.928, p = 0.041), RFS (adjusted HR = 0.061; 95% CI 0.006-0.643, p = 0.020), and distant disease-free survival (adjusted HR = 0.061; 95% CI 0.006-0.972, p = 0.047).

Conclusions: CDR1-AS may be a potential novel predictive biomarker of pCR and survival benefit in patients with locally advanced BC receiving NAC. This may help identify specific chemosensitive individuals and build personalized treatment strategies.

Keywords: Biomarker; Breast cancer; CDR1-AS; Circular RNA; Neoadjuvant chemotherapy.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor* / genetics
  • Biomarkers, Tumor* / metabolism
  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / genetics
  • Breast Neoplasms* / mortality
  • Breast Neoplasms* / pathology
  • China / epidemiology
  • East Asian People
  • Female
  • Humans
  • Middle Aged
  • Neoadjuvant Therapy* / methods
  • Paclitaxel / administration & dosage
  • Paclitaxel / therapeutic use
  • Prognosis
  • Prospective Studies
  • RNA, Circular / genetics

Substances

  • Biomarkers, Tumor
  • RNA, Circular
  • Paclitaxel