A systematic evaluation of multi-gene predictors for the pathological response of breast cancer patients to chemotherapy

PLoS One. 2012;7(11):e49529. doi: 10.1371/journal.pone.0049529. Epub 2012 Nov 21.

Abstract

Previous studies have reported conflicting assessments of the ability of cell line-derived multi-gene predictors (MGPs) to forecast patient clinical outcomes in cancer patients, thereby warranting an investigation into their suitability for this task. Here, 42 breast cancer cell lines were evaluated by chemoresponse tests after treatment with either TFAC or FEC, two widely used standard combination chemotherapies for breast cancer. We used two different training cell line sets and two independent prediction methods, superPC and COXEN, to develop cell line-based MGPs, which were then validated in five patient cohorts treated with these chemotherapies. This evaluation yielded high prediction performances by these MGPs, regardless of the training set, chemotherapy, or prediction method. The MGPs were also able to predict patient clinical outcomes for the subgroup of estrogen receptor (ER)-negative patients, which has proven difficult in the past. These results demonstrated a potential of using an in vitro-based chemoresponse data as a model system in creating MGPs for stratifying patients' therapeutic responses. Clinical utility and applications of these MGPs will need to be carefully examined with relevant clinical outcome measurements and constraints in practical use.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / pharmacology*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / genetics*
  • Cell Line, Tumor
  • Cohort Studies
  • Cyclophosphamide / therapeutic use
  • Drug Screening Assays, Antitumor / methods*
  • Epirubicin / therapeutic use
  • Female
  • Fluorouracil / therapeutic use
  • Gene Expression Profiling
  • Humans
  • Models, Statistical
  • Pharmacogenetics
  • Prognosis
  • Receptors, Estrogen / metabolism

Substances

  • Antineoplastic Agents
  • Receptors, Estrogen
  • Epirubicin
  • Cyclophosphamide
  • Fluorouracil

Supplementary concepts

  • FEC protocol

Grants and funding

The study was supported in part by the UVA Experimental Therapeutics and Cancer Center grant (GF10725/134430) to JKL. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.