title: Value of TP53 status for predicting response to neoadjuvant chemotherapy in breast cancer: a meta-analysis.
abstract: BACKGROUND
  Numerous studies have yielded inconclusive results regarding the relationship between tumor suppressor protein TP53 overexpression and/or TP53 gene mutations and the response to neoadjuvant chemotherapy in patients with breast cancer. The purpose of the current study was therefore to evaluate the relationship between TP53 status and response to chemotherapy in breast cancer.
  
  
  RESULTS
  A total of 26 previously published eligible studies including 3,476 cases were identified and included in this meta-analysis. TP53 status (over expression of TP53 protein and/or TP53 gene mutations) was associated with good response in breast cancer patients who received neoadjuvant chemotherapy (total objective response: risk ratio [RR]= 1.20, 95% confidence interval [CI]= 1.09-1.33, p<0.001; pathological objective response: RR = 1.37, 95% CI = 1.20-1.57, p<0.01; total complete response: RR = 1.33, 95% CI = 1.15-1.53, p<0.001; pathological complete response: RR = 1.45, 95% CI = 1.25-1.68, p<0.001). In further stratified analyses, this association also existed among the studies using anthracycline-based neoadjuvant chemotherapy, and the association between response and the presence of gene alterations was stronger than that between response and immunohistochemistry positivity.
  
  
  CONCLUSIONS
  The results of the present meta-analysis suggest that TP53 status is a predictive factor for response in breast cancer patients undergoing neoadjuvant chemotherapy. Further larger and well-designed prospective studies are required to evaluate the predictive role of TP53 status in clinical practice.
authors: Department of Medical Oncology, Kunshan First People's Hospital Affiliated to Jiangsu University, Kunshan, People's Republic of China.
authors: Min-Bin
authors: MB
authors: Chen
authors: Ya-Qun
authors: YQ
authors: Zhu
authors: Jun-Ying
authors: JY
authors: Xu
authors: Li-Qiang
authors: LQ
authors: Wang
authors: Chao-Ying
authors: CY
authors: Liu
authors: Zhang-Yi
authors: ZY
authors: Ji
authors: Pei-Hua
authors: PH
authors: Lu
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics*; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy; D017594:Publication Bias; D012307:Risk Factors; D016896:Treatment Outcome; D016159:Tumor Suppressor Protein p53 / Q000235:genetics*
chemical_list: D000970:Antineoplastic Agents; D016159:Tumor Suppressor Protein p53