Androgen receptor, EGFR, and BRCA1 as biomarkers in triple-negative breast cancer: a meta-analysis

Li Zhang, Cheng Fang, Xianqun Xu, Anling Li, Qing Cai, Xinghua Long, Li Zhang, Cheng Fang, Xianqun Xu, Anling Li, Qing Cai, Xinghua Long

Abstract

Objective: More and more evidences demonstrate that androgen receptor (AR), epidermal growth factor receptor (EGFR), and breast cancer susceptibility gene 1 (BRCA1) have unique clinical implications for targeted therapy or prognosis in triple-negative breast cancer (TNBC). Therefore, we conducted a meta-analysis to summarize the possible associations.

Methods: We retrieved published articles about AR, EGFR, and BRCA1 in TNBC from PubMed and EMBASE. The analysis was performed with Rev-Man 5.2 software.

Results: A total of 38 articles were eligible for the meta-analysis. Our study showed that the expression level of EGFR (OR = 6.88, P < 0.00001) and the prevalence of BRCA1 mutation (RR = 5.26, P < 0.00001) were higher in TNBC than non-TNBC. In contrast, the expression level of AR was lower in TNBC than non-TNBC (OR = 0.07, P < 0.00001). In the subgroup related to EGFR expression, the level of EGFR expression was significantly increased in Asians (OR = 9.60) compared with Caucasians (OR = 5.53) for TNBC patients. Additionally, the prevalence of BRCA1 mutation in Asians (RR = 5.43, P < 0.00001) was higher than that in Caucasians (RR = 5.16, P < 0.00001).

Conclusions: The distinct expression of AR and EGFR and the prevalence of BRCA1 mutation indicated that AR, EGFR, and BRCA1 might be unique biomarkers for targeted therapy and prognosis in TNBC.

Figures

Figure 1
Figure 1
Flow diagram of the study.
Figure 2
Figure 2
Forest plot of studies evaluating OR of AR expression in TNBC compared with non-TNBC. The events of TNBC and the events of non-TNBC refer to the number of TNBC patients with positive expression of AR and the number of non-TNBC patients with positive expression of AR, respectively. The squares and horizontal lines correspond to the specific OR and 95% CI for every study. The area of the squares reflects the study specific weight. The diamond stands for the pooled OR and 95% CI.
Figure 3
Figure 3
Forest plot of studies evaluating OR of EGFR expression in TNBC compared with non-TNBC. The events of TNBC and the events of non-TNBC refer to the number of TNBC patients with positive expression of EGFR and the number of non-TNBC patients with positive expression of EGFR, respectively. The squares and horizontal lines correspond to the specific OR and 95% CI for every study. The area of the squares reflects the study specific weight. The diamond stands for the pooled OR and 95% CI.
Figure 4
Figure 4
Forest plot of subgroup related to antibody source evaluating EGFR expression in TNBC compared with non-TNBC.
Figure 5
Figure 5
Forest plot of studies evaluating RR of BRCA1 mutation in TNBC compared with non-TNBC. The events of TNBC and the events of non-TNBC refer to the number of TNBC patients with BRCA1 mutation and the number of non-TNBC patients with BRCA1 mutation, respectively. The squares and horizontal lines correspond to the specific RR and 95% CI for every study. The area of the squares reflects the study specific weight. The diamond stands for the pooled RR and 95% CI.
Figure 6
Figure 6
Forest plot of the subgroup related to race evaluating RR of BRCA1 mutation in TNBC compared with non-TNBC.
Figure 7
Figure 7
Funnel plots for evaluating publication bias for the eligible articles about AR (a), EGFR (b), and BRCA1 (c). As shown in the figures, the funnel plots were almost symmetric and no evidence of publication bias was observed in this analysis.

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