Predictive Analysis of Breast Cancer Response to Neoadjuvant Chemotherapy through Plasma Metabolomics

Abstract

Abstract Purpose Preoperative chemotherapy is a critical component of breast cancer management, yet its effectiveness is not uniform. Moreover, the adverse effects associated with chemotherapy necessitate the identification of a patient subgroup that would derive the maximum benefit from this treatment. This study aimed to establish a method for predicting the response to preoperative chemotherapy in breast cancer patients utilizing metabolomics. Methods Plasma samples were obtained from 87 breast cancer patients undergoing preoperative chemotherapy at our facility, collected both prior to the commencement of the treatment and before the second treatment cycle. Metabolite analysis was conducted using capillary electrophoresis-mass spectrometry (CE-MS) and liquid chromatography-mass spectrometry (LC-MS). We performed comparative profiling of metabolite concentrations by assessing the metabolite profiles of patients who achieved a pathological complete response (pCR) against those who did not, both in initial and subsequent treatment cycles. Results Significant variances were observed in the metabolite profiles between pCR and non-pCR cases, both at the onset of preoperative chemotherapy and before the second cycle. Noteworthy distinctions were also evident between the metabolite profiles from the initial and the second preoperative chemotherapy courses. Furthermore, metabolite profiles exhibited variations associated with intrinsic subtypes at all assessed time points. Conclusion The application of plasma metabolomics, utilizing CE-MS and LC-MS, has proven to be an effective approach for predicting the efficacy of preoperative chemotherapy in breast cancer.