Value of TP53 Status for Predicting Response to Neoadjuvant Chemotherapy in Breast Cancer: A Meta-Analysis

BackgroundNumerous studies have yielded inconclusive results regarding the relationship between tumor suppressor protein TP53 overexpression and/or TP53 gene mutations and the response to neoadjuvant chemotherapy in patients with breast cancer. The purpose of the current study was therefore to evaluate the relationship between TP53 status and response to chemotherapy in breast cancer. Methods and FindingsA total of 26 previously published eligible studies including 3,476 cases were identified and included in this meta-analysis. TP53 status (over expression of TP53 protein and/or TP53 gene mutations) was associated with good response in breast cancer patients who received neoadjuvant chemotherapy (total objective response: risk ratio [RR] = 1.20, 95% confidence interval [CI] = 1.09–1.33, p ConclusionThe results of the present meta-analysis suggest that TP53 status is a predictive factor for response in breast cancer patients undergoing neoadjuvant chemotherapy. Further larger and well-designed prospective studies are required to evaluate the predictive role of TP53 status in clinical practice.背景：目前针对乳腺癌患者中肿瘤抑制蛋白TP53（tumor suppressor protein TP53）过表达和/或TP53基因突变与新辅助化疗（neoadjuvant chemotherapy）疗效之间的关联，已有多项相关研究，但研究结论尚未达成共识。本研究旨在探讨乳腺癌患者TP53状态与化疗疗效之间的关联。 方法与结果：本研究共纳入26项已发表的符合纳入标准的研究，涉及3476例病例，开展荟萃分析（meta-analysis）。结果显示，在接受新辅助化疗的乳腺癌患者中，TP53状态（TP53蛋白过表达和/或TP53基因突变）与良好的化疗应答相关（总客观应答风险比（risk ratio，RR）=1.20，95%置信区间（confidence interval，CI）=1.09~1.33，P值）。 结论：本次荟萃分析结果表明，TP53状态可作为接受新辅助化疗的乳腺癌患者化疗应答的预测因子。未来仍需开展更大样本量、设计严谨的前瞻性研究，以评估TP53状态在临床实践中的预测价值。