title: Survivin expression and targeting in breast cancer.
abstract: BACKGROUND
  Survivin a multifunctional protein that controls cell division, inhibition of apoptosis and promotion of angiogenesis. It is expressed in most human neoplasm, but is absent in normal and differentiated tissues. The purpose of this article is to overview the expression of survivin, effect of its expression in response to treatment, correlation with other markers and newer advancement in targeting survivin.
  
  
  METHODS
  A detailed search of Medline was carried out using the following search strategy: "((survivin) OR ((apoptosis) AND (inhibitor OR inhibitors))) AND ((breast) AND (neoplasm OR neoplasms OR tumor OR tumor OR cancer OR carcinoma))". Abstract of all articles thus identified were reviewed to identify the relevant studies, full articles of studies thus identified were then obtained and reviewed. All relevant data was extracted and tabulated.
  
  
  RESULTS
  Survivin expression by Immunohistochemistry was identified in 65.3% (55.2-90.0%) of the breast cancer patients among the identified studies while survivin mRNA by RT-PCR was identified in 93.6% (90-97%). Survivin expression has been reported to be associated with over expression of HER 2, vascular endothelial growth factor (VEGF), urokinase plasminogen activator (uPA)/PAI-1.
  
  
  CONCLUSIONS
  Survivin is over expressed in majority of breast cancers. The over expression of survivin is found to correlate with HER 2 and EGFR expression. Survivin expression has been found to confer resistance to chemotherapy and radiation. Targeting survivin in experimental models improves survival. More studies are needed on the role of survivin in multi drug resistance (MDR) in the presence of Pgp/uPA/PAI-1 and the impact of survivin over expression in triple negative breast cancer.
authors.affiliation: Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: Kumkum
authors.initials: K
authors.lastname: Jha
authors.forename: Mridula
authors.initials: M
authors.lastname: Shukla
authors.forename: Manoj
authors.initials: M
authors.lastname: Pandey
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy; D019496:Cancer Vaccines; D002453:Cell Cycle / Q000502:physiology; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000037:antagonists & inhibitors / Q000378:metabolism*; D009363:Neoplasm Proteins / Q000037:antagonists & inhibitors / Q000378:metabolism*; D016376:Oligonucleotides, Antisense / Q000627:therapeutic use; D020033:Protein Isoforms / Q000378:metabolism; D034622:RNA Interference / Q000502:physiology; D016337:RNA, Catalytic / Q000627:therapeutic use; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D019496:Cancer Vaccines; D051034:Inhibitor of Apoptosis Proteins; D009363:Neoplasm Proteins; D016376:Oligonucleotides, Antisense; D020033:Protein Isoforms; D016337:RNA, Catalytic; D000077022:Survivin