Association between changes in androgen receptor expression before and after neoadjuvant chemotherapy and treatment response in breast cancer

XIE Jiahui; MAO Dahua; XU Shun'en

doi:10.3969/j.issn.1009-0460.2025.07.007

Abstract：Objective To investigate the correlation between androgen receptor(AR)expression before and after neoadjuvant chemotherapy(NAC)and clinicopathological characteristics as well as treatment response in breast cancer patients at different clinical stages.Methods From January 2021 to December 2022,104 patients with stage Ⅱ and Ⅲ breast cancer(52 cases each)who received NAC at the Affiliated Hospital of Guizhou Medical University were enrolled.AR expression levels were measured before and after NAC to analyze their association with clinicopathological characteristics.After completing 4 cycles of NAC,treatment response was evaluated according to Response Evaluation Criteria in Solid Tumors version 1.1.Patients achieving complete response or partial response were classified as the response group,while those with stable disease or progressive disease were assigned to the progression group.A generalized linear mixed-effects model was used to assess the impact of AR expression on treatment efficacy,aiming to explore the potential clinical value of AR as a predictive biomarker for NAC response.Results In this cohort of 104 breast cancer patients,AR positivity was observed in 70.19％(73/104)of cases,with the AR-positive group demonstrating significantly higher rates of maximum tumor diameter≥5 cm(69.86％vs.41.94％,P=0.007),poor differentiation(56.16％vs.22.58％,P=0.002),lymph node metastasis(75.34％vs.38.71％,P<0.001),TNM stage Ⅱ(57.53％vs.32.26％,P=0.018),and estrogen receptor positivity(50.68％vs.22.58％,P=0.008)compared to AR-negative patients.Stratified regression identified TNM stage,nodal status,differentiation grade and estrogen receptor expression as independent predictors of AR expression(all P<0.05).Notably,stage Ⅲ patients exhibited a significant increase in AR positivity following NAC(59.62％to 78.85％,P=0.034),while AR-negative status was associated with superior treatment response(74.19％vs.49.32％,P=0.019)and confirmed as an independent predictor of therapeutic efficacy(OR=5.450,95％CI:2.980-12.552,P<0.001).Interaction analysis revealed significant antagonistic effects between AR expression and TNM staging(P=0.003).Conclusion AR expression correlates with tumor size,differentiation grade,and lymph node metastasis in breast cancer.AR-negative patients demonstrate potentially greater sensitivity to NAC,with observed antagonistic effects against TNM staging,suggesting AR's potential utility as a predictive biomarker for NAC efficacy.