Effect of Androgen receptors in Triple-Negative Breast Cancer Given Neoadjuvant Therapy: A Systematic Review and Meta-Analysis

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OBJECTIVE: Triple-negative breast cancer (TNBC) is a type of breast cancer that does not express the estrogen receptor (ER), the progesterone receptor (PR), or the human epidermal growth factor receptor 2 (HER2). TNBC has limited treatment targets, including the androgen receptor (AR). However, the therapeutic strategies-based AR expression in TNBC remains uncertain. The aim of this study is to compare the effect of neoadjuvant treatment on TNBC androgen receptor-positive versus receptor-negative patients. METHODS: A systematic search was performed through databases to search for cohort studies that compared the effect of neoadjuvant treatment on TNBC androgen receptor-positive versus TNBC receptor-negative patients. The Mantel-Haenzel and Inverse Variance methods obtained a fixed-effects model of pooled odds or hazard ratios for the primary outcomes. RESULTS: Fifteen cohort studies, including 2,713 patients with TNBC, were assessed. The effect of neoadjuvant chemotherapy is less superior on AR+ patients than AR- (OR = 0.60, p = 0.02). For survival outcomes, the AR+ subtype is associated with better 3-year DFS (HR = 0.93, p = 0.69) and 3-year OS (HR = 0.71, p = 0.20) compared with AR-. The statistical value is insignificant. CONCLUSION: The prognostic value of AR expression in TNBC is not fully understood, which is an inconclusive result.

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