TP53 gene polymorphism at codon 72 as a response predictor for neoadjuvant chemotherapy

Abstract

Introduction: Breast cancer is one of the most prevalent cancers in women worldwide and neoadjuvant chemotherapy is a favored method for achieving pathologic complete response (pCR). The TP53 gene is involved in inducing the response to chemotherapy drugs. Objectives: The present study sought to correlate polymorphism variants at codon 72 with pathologic complete response to neoadjuvant chemotherapy. Casuistry and Methods: The study was conducted in the state of Sergipe, in Northeastern Brazil. A total of 206 patients with a histopathological diagnosis of breast cancer who underwent neoadjuvant chemotherapy from 2019 to 2022 were included. DNA samples were collected for the evaluation of TP53 polymorphism at codon 72. A prospective evaluation of the cases was conducted to verify the surgical pathologic response after chemotherapy; the response evaluation criteria in solid tumors were used (RECIST). The study was approved by the University of São Paulo Ethics and Research Committee. Results: Of the 168 patients, 44.6% were Arg72Arg, 17.3% Pro72Pro, and 38.0% Arg72Pro; pCR was achieved in 21.4% of the patients; 10.1% had progressive disease, 13.7% stable disease, and 54.2% had a partial pathologic response. The only predictor of pCR in multivariate regression was immunohistochemistry (p < 0.001). In the multivariate analysis, Arg72Pro and Pro72Pro increased the odds of the patient evolve with stable disease.This study was innovative in demonstrating a predictor of stable disease in response to neoadjuvant chemotherapy Conclusion: TP53 polymorphism at codon 72 is not a predictor of pathologic complete response, but it can be a predictor of stable disease.