CDK9 Expression Shows Role as a Potential Prognostic Biomarker in Breast Cancer Patients Who Fail to Achieve Pathologic Complete Response after Neoadjuvant Chemotherapy

Failure to achieve pathologic complete response is associated with poor prognosis in breast cancer patients following neoadjuvant chemotherapy (NACT). However, prognostic biomarkers for clinical outcome are unclear in this patient population. Cyclin-dependent kinase 9 (CDK9) is often dysregulated in...

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Main Authors: Ashley J. Schlafstein, Allison E. Withers, Soumon Rudra, Diana Danelia, Jeffrey M. Switchenko, Donna Mister, Saul Harari, Hui Zhang, Waaqo Daddacha, Shahrzad Ehdaivand, Xiaoxian Li, Mylin A. Torres, David S. Yu
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:International Journal of Breast Cancer
Online Access:http://dx.doi.org/10.1155/2018/6945129
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author Ashley J. Schlafstein
Allison E. Withers
Soumon Rudra
Diana Danelia
Jeffrey M. Switchenko
Donna Mister
Saul Harari
Hui Zhang
Waaqo Daddacha
Shahrzad Ehdaivand
Xiaoxian Li
Mylin A. Torres
David S. Yu
author_facet Ashley J. Schlafstein
Allison E. Withers
Soumon Rudra
Diana Danelia
Jeffrey M. Switchenko
Donna Mister
Saul Harari
Hui Zhang
Waaqo Daddacha
Shahrzad Ehdaivand
Xiaoxian Li
Mylin A. Torres
David S. Yu
author_sort Ashley J. Schlafstein
collection DOAJ
description Failure to achieve pathologic complete response is associated with poor prognosis in breast cancer patients following neoadjuvant chemotherapy (NACT). However, prognostic biomarkers for clinical outcome are unclear in this patient population. Cyclin-dependent kinase 9 (CDK9) is often dysregulated in breast cancer, and its deficiency results in genomic instability. We reviewed the records of 84 breast cancer patients from Emory University’s Winship Cancer Institute who had undergone surgical resection after NACT and had tissue available for tissue microarray analysis (TMA). Data recorded included disease presentation, treatment, pathologic response, overall survival (OS), locoregional recurrence free survival (LRRFS), distant-failure free survival (DFFS), recurrence-free survival (RFS), and event-free survival (EFS). Immunohistochemistry was performed on patient samples to determine CDK9 expression levels after NACT. Protein expression was linked with clinical data to determine significance. In a Cox proportional hazards model, using a time-dependent covariate to evaluate the risk of death between groups beyond 3 years, high CDK9 expression was significantly associated with an increase in OS (HR: 0.26, 95% CI: 0.07-0.98, p=0.046). However, Kaplan-Meier curves for OS, LRRFS, DFFS, RFS, and EFS did not reach statistical significance. The results of this study indicate that CDK9 may have a potential role as a prognostic biomarker in patients with breast cancer following NACT. However, further validation studies with increased sample sizes are needed to help elucidate the prognostic role for CDK9 in the management of these patients.
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spelling doaj-art-33a4a2a95b42440e8020da2048abadae2025-02-03T05:50:48ZengWileyInternational Journal of Breast Cancer2090-31702090-31892018-01-01201810.1155/2018/69451296945129CDK9 Expression Shows Role as a Potential Prognostic Biomarker in Breast Cancer Patients Who Fail to Achieve Pathologic Complete Response after Neoadjuvant ChemotherapyAshley J. Schlafstein0Allison E. Withers1Soumon Rudra2Diana Danelia3Jeffrey M. Switchenko4Donna Mister5Saul Harari6Hui Zhang7Waaqo Daddacha8Shahrzad Ehdaivand9Xiaoxian Li10Mylin A. Torres11David S. Yu12Department of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Biostatistics and Bioinformatics, Rollins School of Public Health and Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Pathology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Pathology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Pathology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USAFailure to achieve pathologic complete response is associated with poor prognosis in breast cancer patients following neoadjuvant chemotherapy (NACT). However, prognostic biomarkers for clinical outcome are unclear in this patient population. Cyclin-dependent kinase 9 (CDK9) is often dysregulated in breast cancer, and its deficiency results in genomic instability. We reviewed the records of 84 breast cancer patients from Emory University’s Winship Cancer Institute who had undergone surgical resection after NACT and had tissue available for tissue microarray analysis (TMA). Data recorded included disease presentation, treatment, pathologic response, overall survival (OS), locoregional recurrence free survival (LRRFS), distant-failure free survival (DFFS), recurrence-free survival (RFS), and event-free survival (EFS). Immunohistochemistry was performed on patient samples to determine CDK9 expression levels after NACT. Protein expression was linked with clinical data to determine significance. In a Cox proportional hazards model, using a time-dependent covariate to evaluate the risk of death between groups beyond 3 years, high CDK9 expression was significantly associated with an increase in OS (HR: 0.26, 95% CI: 0.07-0.98, p=0.046). However, Kaplan-Meier curves for OS, LRRFS, DFFS, RFS, and EFS did not reach statistical significance. The results of this study indicate that CDK9 may have a potential role as a prognostic biomarker in patients with breast cancer following NACT. However, further validation studies with increased sample sizes are needed to help elucidate the prognostic role for CDK9 in the management of these patients.http://dx.doi.org/10.1155/2018/6945129
spellingShingle Ashley J. Schlafstein
Allison E. Withers
Soumon Rudra
Diana Danelia
Jeffrey M. Switchenko
Donna Mister
Saul Harari
Hui Zhang
Waaqo Daddacha
Shahrzad Ehdaivand
Xiaoxian Li
Mylin A. Torres
David S. Yu
CDK9 Expression Shows Role as a Potential Prognostic Biomarker in Breast Cancer Patients Who Fail to Achieve Pathologic Complete Response after Neoadjuvant Chemotherapy
International Journal of Breast Cancer
title CDK9 Expression Shows Role as a Potential Prognostic Biomarker in Breast Cancer Patients Who Fail to Achieve Pathologic Complete Response after Neoadjuvant Chemotherapy
title_full CDK9 Expression Shows Role as a Potential Prognostic Biomarker in Breast Cancer Patients Who Fail to Achieve Pathologic Complete Response after Neoadjuvant Chemotherapy
title_fullStr CDK9 Expression Shows Role as a Potential Prognostic Biomarker in Breast Cancer Patients Who Fail to Achieve Pathologic Complete Response after Neoadjuvant Chemotherapy
title_full_unstemmed CDK9 Expression Shows Role as a Potential Prognostic Biomarker in Breast Cancer Patients Who Fail to Achieve Pathologic Complete Response after Neoadjuvant Chemotherapy
title_short CDK9 Expression Shows Role as a Potential Prognostic Biomarker in Breast Cancer Patients Who Fail to Achieve Pathologic Complete Response after Neoadjuvant Chemotherapy
title_sort cdk9 expression shows role as a potential prognostic biomarker in breast cancer patients who fail to achieve pathologic complete response after neoadjuvant chemotherapy
url http://dx.doi.org/10.1155/2018/6945129
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