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• W3039592470 abstract "<h3>Importance</h3> There is no proven test that can guide the optimal treatment, either endocrine therapy or chemotherapy, for estrogen receptor–positive breast cancer. <h3>Objective</h3> To investigate the associations of sperm-associated antigen 5 (<i>SPAG5</i>) transcript and SPAG5 protein expressions with treatment response in systemic therapy for estrogen receptor–positive breast cancer. <h3>Design, Settings, and Participants</h3> This retrospective cohort study included patients with estrogen receptor–positive breast cancer who received 5 years of adjuvant endocrine therapy with or without neoadjuvant anthracycline-based combination chemotherapy (NACT) derived from 11 cohorts from December 1, 1986, to November 28, 2019. The associations of<i>SPAG5</i>transcript and SPAG5 protein expression with pathological complete response to NACT were evaluated, as was the association of<i>SPAG5</i>mRNA expression with response to neoadjuvant endocrine therapy. The associations of distal relapse–free survival with<i>SPAG5</i>transcript or SPAG5 protein expressions were analyzed. Data were analyzed from September 9, 2015, to November 28, 2019. <h3>Main Outcomes and Measures</h3> The primary outcomes were breast cancer–specific survival, distal relapse–free survival, pathological complete response, and clinical response. Outcomes were examined using Kaplan-Meier, multivariable logistic, and Cox regression models. <h3>Results</h3> This study included 12 720 women aged 24 to 78 years (mean [SD] age, 58.46 [12.45] years) with estrogen receptor–positive breast cancer, including 1073 women with<i>SPAG5</i>transcript expression and 361 women with SPAG5 protein expression of locally advanced disease stage IIA through IIIC. Women with<i>SPAG5</i>transcript and SPAG5 protein expressions achieved higher pathological complete response compared with those without<i>SPAG5</i>transcript or SPAG5 protein expressions (transcript: odds ratio, 2.45 [95% CI, 1.71-3.51];<i>P</i> < .001; protein: odds ratio, 7.32 [95% CI, 3.33-16.22];<i>P</i> < .001). Adding adjuvant anthracycline chemotherapy to adjuvant endocrine therapy for<i>SPAG5</i>mRNA expression in estrogen receptor–positive breast cancer was associated with prolonged 5-year distal relapse–free survival in patients without lymph node involvement (hazard ratio, 0.34 [95% CI, 0.14-0.87];<i>P</i> = .03) and patients with lymph node involvement (hazard ratio, 0.35 [95% CI, 0.18-0.68];<i>P</i> = .002) compared with receiving 5-year endocrine therapy alone. Mean (SD)<i>SPAG5</i>transcript was found to be downregulated after 2 weeks of neoadjuvant endocrine therapy compared with pretreatment levels in 68 of 92 patients (74%) (0.23 [0.18] vs 0.34 [0.24];<i>P</i> < .001). <h3>Conclusions and Relevance</h3> These findings suggest that<i>SPAG5</i>transcript and SPAG5 protein expressions could be used to guide the optimal therapies for estrogen receptor–positive breast cancer. Retrospective and prospective clinical trials are warranted." @default.
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• W3039592470 date "2020-07-07" @default.
• W3039592470 modified "2023-10-16" @default.
• W3039592470 title "Association of Sperm-Associated Antigen 5 and Treatment Response in Patients With Estrogen Receptor–Positive Breast Cancer" @default.
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• W3039592470 doi "https://doi.org/10.1001/jamanetworkopen.2020.9486" @default.
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