Estudio de las alteraciones genéticas asociadas con la resistencia al tratamiento neoadjuvante de deprivación estrogénica en cáncer de mama
Mostra el registre complet de l'element
Visualització
(4.038Mb)
|
|
|
|
|
|
Guerrero Zotano, Angel
Lluch Hernández, Ana (dir.);
Guillem Porta, Vicente (dir.);
López Guerrero, José Antonio (dir.)
Facultat de Medicina i Odontologia
|
|
Aquest document és un/a tesi, creat/da en: 2021
|
|
With current standard of care adjuvant therapy, approximately 25-30% of women with high risk early stage HR+/HER2- breast cancer experience relapse. The preoperative platform offers an opportunity to interrogate mechanisms of drug resistance that, in turn, could inform the choice of adjuvant therapy. We report herein a study where we performed targeted DNA sequencing and whole transcriptome analysis on whole tumor sections from a cohort of 68 operable ER+ breast cancers treated with the aromatase inhibitor letrozole for a median of 7.2 months before surgery, and a with a median follow up of 5 years.
We found that resistant tumors were enriched in clinically actionable mutation and showed an enrichment in expression of genes involved in proliferation. Resistant tumors show a high degree of heterogeneity among them upregulating a variety of transcriptional programs. A common feature among resistant tumors was a co-expression of several genes dependent on the E2F4 transcription factor. We defined an E2F4 activation signature that define ER+ breast cancer with poor prognostic features and is sensitive to treatment with CDK4/6 inhibitors. This signature is of potential use for the identification of patients with ER+ breast cancer candidates for adjuvant therapy with CDK4/6 inhibitors in combination with antiestrogens. Our study also identifies a novel gene, PRR11 (Proline rich 11), as a putative driver of endocrine resistance in ER+ breast cancers and that merits further investigation to understand its mechanisms of action.With current standard of care adjuvant therapy, approximately 25-30% of women with high risk early stage HR+/HER2- breast cancer experience relapse. The preoperative platform offers an opportunity to interrogate mechanisms of drug resistance that, in turn, could inform the choice of adjuvant therapy. We report herein a study where we performed targeted DNA sequencing and whole transcriptome analysis on whole tumor sections from a cohort of 68 operable ER+ breast cancers treated with the aromatase inhibitor letrozole for a median of 7.2 months before surgery, and a with a median follow up of 5 years.
We found that resistant tumors were enriched in clinically actionable mutation and showed an enrichment in expression of genes involved in proliferation. Resistant tumors show a high degree of heterogeneity among them upregulating a variety of transcriptional programs. A common feature among resistant tumors was a co-expression of several genes dependent on the E2F4 transcription factor. We defined an E2F4 activation signature that define ER+ breast cancer with poor prognostic features and is sensitive to treatment with CDK4/6 inhibitors. This signature is of potential use for the identification of patients with ER+ breast cancer candidates for adjuvant therapy with CDK4/6 inhibitors in combination with antiestrogens. Our study also identifies a novel gene, PRR11 (Proline rich 11), as a putative driver of endocrine resistance in ER+ breast cancers and that merits further investigation to understand its mechanisms of action.
|
|
Veure al catàleg Trobes
|
Aquest element apareix en la col·lecció o col·leccions següent(s)
Mostra el registre complet de l'element