The following is a summary of “BIRC5 expression by race, age and clinical factors in breast cancer patients,” published in the March 2024 issue of Oncology by Hamilton et al.
The purpose of this study was to investigate the expression of survivin/BIRC5, a proliferation marker associated with poor prognosis in breast cancer and a promising therapeutic target, particularly among racially diverse populations where aggressive breast cancers prevail. The researchers conducted a comprehensive analysis of BIRC5 expression in correlation with clinical and demographic variables, as well as its predictive value for recurrence, using data from the Carolina Breast Cancer Study (CBCS) comprising 2,174 participants, including a substantial representation of Black (n = 1,113) and younger (<50 years; n = 1,137) individuals with breast cancer. For comparative analysis, similar investigations were undertaken using The Cancer Genome Atlas (TCGA) dataset, encompassing 1094 participants, including Black (n = 183) and younger (n = 295) individuals. BIRC5 expression was evaluated as a continuous and categorical variable (highest quartile vs. lower three quartiles).
The findings revealed that univariate, continuous BIRC5 expression was notably elevated in breast tumors from Black women compared to non-Black women across estrogen receptor (ER)-positive and ER-negative tumors, even when stratified by stage. Within both CBCS and TCGA cohorts, BIRC5-high status was significantly associated with younger age (<50 years), Black race, hormone receptor-negative tumors, non-Luminal A PAM50 subtypes, advanced stage, and larger tumor size (>2 cm). Importantly, BIRC5-high tumors exhibited a significantly poorer 5-year recurrence-free survival (RFS) among ER-positive tumors, even after adjustment for age and stage. However, this association was not evident among ER-negative tumors.
In conclusion, the study underscores the heightened burden of BIRC5-high tumors among Black and younger women with breast cancer, highlighting the potential relevance of emerging anti-survivin treatment strategies in ensuring equitable breast cancer outcomes. These findings underscore the importance of considering racial and age disparities in breast cancer management and the potential implications for tailored therapeutic interventions.
Source: breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-024-01792-y