A stroma-related gene signature predicts resistance to neoadjuvant chemotherapy in breast cancer

Pierre Farmer, Hervé Bonnefoi, Pascale Anderle, David Cameron, Pratyaksha Wirapati, Pratyakasha Wirapati, Véronique Becette, Sylvie André, Martine Piccart, Mario Campone, Etienne Brain, Gaëtan Macgrogan, Thierry Petit, Jacek Jassem, Frédéric Bibeau, Emmanuel Blot, Jan Bogaerts, Michel Aguet, Jonas Bergh, Richard IggoMauro Delorenzi

Research output: Contribution to journalArticlepeer-review


To better understand the relationship between tumor-host interactions and the efficacy of chemotherapy, we have developed an analytical approach to quantify several biological processes observed in gene expression data sets. We tested the approach on tumor biopsies from individuals with estrogen receptor-negative breast cancer treated with chemotherapy. We report that increased stromal gene expression predicts resistance to preoperative chemotherapy with 5-fluorouracil, epirubicin and cyclophosphamide (FEC) in subjects in the EORTC 10994/BIG 00-01 trial. The predictive value of the stromal signature was successfully validated in two independent cohorts of subjects who received chemotherapy but not in an untreated control group, indicating that the signature is predictive rather than prognostic. The genes in the signature are expressed in reactive stroma, according to reanalysis of data from microdissected breast tumor samples. These findings identify a previously undescribed resistance mechanism to FEC treatment and suggest that antistromal agents may offer new ways to overcome resistance to chemotherapy.
Original languageEnglish
Pages (from-to)68-74
Number of pages7
JournalNature Medicine
Issue number1
Publication statusPublished - Jan 2009


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