Association of SMAD4 loss with drug resistance in clinical cancer patients: A systematic meta-analysis

Drug resistance frequently led to the failure of chemotherapy for malignant cancers, hence causing cancer relapse. Thus, understanding mechanism of drug resistance in cancer is vital to improve the treatment efficacy. Here, we aim to evaluate the association between SMAD4 expression and the drug res...

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Bibliographic Details
Published in:PloS one 2021-05, Vol.16 (5), p.e0250634-e0250634
Main Authors: Xu, Wei, Lee, Sau Har, Qiu, Fengjun, Zhou, Li, Wang, Xiaoling, Ye, Tingjie, Hu, Xudong
Format: Article
Language:English
Subjects:
Antibodies
Cancer
Cancer patients
Cancer therapies
Chemotherapy
Chinese medicine
Cisplatin
Criteria
Dilution
Drafting software
Drug resistance
Drug therapy
Editing
Genetic aspects
Head & neck cancer
Health aspects
Herbal medicine
Inactivation
Information technology
Medical ethics
Medical prognosis
Medical science
Medicine and Health Sciences
Meta-analysis
Metastasis
Multivariate analysis
Mutation
Pancreatic cancer
Patients
Physical Sciences
Prostate cancer
Research and Analysis Methods
Smad proteins
Smad4 protein
Statistical analysis
Survival
Traditional Chinese medicine
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Summary:Drug resistance frequently led to the failure of chemotherapy for malignant cancers, hence causing cancer relapse. Thus, understanding mechanism of drug resistance in cancer is vital to improve the treatment efficacy. Here, we aim to evaluate the association between SMAD4 expression and the drug resistance in cancers by performing a meta-analysis. Relevant studies detecting SMAD4 expression in cancer patients treated with chemo-drugs up till December 2020 were systematically searched in four common scientific databases using selected keywords. The pooled hazard ratio (HR) was the ratio of hazard rate between SMAD4.sup.neg population vs SMAD4.sup.pos population. The HRs and risk ratios (RRs) with 95% confidence intervals (CIs) were used to explore the association between SMAD4 expression losses with drug resistance in cancers. After an initial screening according to the inclusion and exclusion criteria, eleven studies were included in the meta-analysis. There were a total of 2092 patients from all the included studies in this analysis. Results obtained indicated that loss of SMAD4 expression was significantly correlated with drug resistance with pooled HRs (95% CI) of 1.23 (1.01-1.45), metastasis with pooled RRs (95% CI) of 1.10 (0.97-1.25) and recurrence with pooled RRs (95% CI) of 1.32 (1.06-1.64). In the subgroup analysis, cancer type, drug type, sample size and antibody brand did not affect the significance of association between loss of SMAD4 expression and drug resistance. In addition, there was no evidence of publication bias as suggested by Begg's test.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0250634