12 research outputs found

    Predictors of Chemosensitivity in Triple Negative Breast Cancer: An Integrated Genomic Analysis

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    Background: Triple negative breast cancer (TNBC) is a highly heterogeneous and aggressive disease, and although no effective targeted therapies are available to date, about one-third of patients with TNBC achieve pathologic complete response (pCR) from standard-of-care anthracycline/taxane (ACT) chemotherapy. The heterogeneity of these tumors, however, has hindered the discovery of effective biomarkers to identify such patients. Methods and Findings: We performed whole exome sequencing on 29 TNBC cases from the MD Anderson Cancer Center (MDACC) selected because they had either pCR (n = 18) or extensive residual disease (n = 11) after neoadjuvant chemotherapy, with cases from The Cancer Genome Atlas (TCGA; n = 144) and METABRIC (n = 278) cohorts serving as validation cohorts. Our analysis revealed that mutations in the AR- and FOXA1-regulated networks, in which BRCA1 plays a key role, are associated with significantly higher sensitivity to ACT chemotherapy in the MDACC cohort (pCR rate of 94.1% compared to 16.6% in tumors without mutations in AR/FOXA1 pathway, adjusted p = 0.02) and significantly better survival outcome in the TCGA TNBC cohort (log-rank test, p = 0.05). Combined analysis of DNA sequencing, DNA methylation, and RNA sequencing identified tumors of a distinct BRCA-deficient (BRCA-D) TNBC subtype characterized by low levels of wild-type BRCA1/2 expression. Patients with functionally BRCA-D tumors had significantly better survival with standard-of-care chemotherapy than patients whose tumors were not BRCA-D (log-rank test, p = 0.021), and they had significantly higher mutation burden (p < 0.001) and presented clonal neoantigens that were associated with increased immune cell activity. A transcriptional signature of BRCA-D TNBC tumors was independently validated to be significantly associated with improved survival in the METABRIC dataset (log-rank test, p = 0.009). As a retrospective study, limitations include the small size and potential selection bias in the discovery cohort. Conclusions: The comprehensive molecular analysis presented in this study directly links BRCA deficiency with increased clonal mutation burden and significantly enhanced chemosensitivity in TNBC and suggests that functional RNA-based BRCA deficiency needs to be further examined in TNBC. © 2016 Jiang et al

    Quality management of inpatient medication administration in Hong Kong public hospitals

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    202011 bcrcVersion of RecordPublishe

    Promotion of appropriate use of electronic devices among Hong Kong adolescents

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    202101 bcrcVersion of RecordPublishe

    Transition of hospital acute-centric to long term care in an ageing population in Hong Kong - Is it an issue of service gap?

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    202012 bcrcVersion of RecordPublishe

    Sport-specific balance ability in Taekwondo practitioners

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    Theme: A Lifespan Approac

    Feasibility and effects of virtual reality motor-cognitive training in community-dwelling older people with cognitive frailty : pilot randomized controlled trial

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    202202 bcvcVersion of RecordOthersThe authors wish to thank Ms Claire Chan and Ms Abigail Kam for their assistance with the intervention implementation. This study would not have been possible without the support of the Innovation and Technology Fund for Better Living (application number ITB/FBL/4015/19/P); School of Nursing, The Hong Kong Polytechnic University for providing financial support; and Pok Oi Hospital for providing logistic and administrative support.Publishe
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