A novel ferroptosis-related gene signature associated with cuproptosis for predicting overall survival in breast cancer patients.

Purpose Ferroptosis and cuproptosis are both metal-dependent regulated cell death that play an important role in cancer. However, the expression patterns and the prognostic values of ferroptosis-related genes (FRGs) associated with cuproptosis in breast cancer (BC) are largely unknown. This study aims to explore the prognostic value of cuproptosis-related FRGs and their relationship with tumor microenvironments in BC. Methods The clinical and RNA sequencing data of BC patients from TCGA, METABRIC and GEO databases were analyzed. The least absolute shrinkage and selection operator regression analysis was used to establish prognostic signatures based on cuproptosis-related FRGs. The overall survival between risk subgroups was assessed by Kaplan-Meier analysis. The changes in risk score during neoadjuvant chemotherapy, and differences in immune cells, immune checkpoints, and drug sensitivity between risk subgroups were also analyzed in this study. Results A successful development of a prognostic signature based on cuproptosis-related FRGs in the TCGA cohort was achieved and it was validated in the METABRIC cohort. Gene set enrichment analysis results revealed the enrichment of steroid biosynthesis and ABC transporters in the high-risk group. Moreover, the signature was also found to be associated with immune cells and immune checkpoints. Lower risk score in patients after neoadjuvant chemotherapy and higher sensitivity of the high-risk group to AKT inhibitor VIII and cisplatin was also observed. Conclusion Cuproptosis-related FRGs can be used as a novel prognostic signature for predicting the overall survival of BC patients. This can provide meaningful insights into the selection of immunotherapy and antitumor drugs for BC.