The prognostic value of NRF2 in breast cancer patients: a systematic review with meta-analysis

Purpose Nuclear factor E2-related factor 2 (NRF2) is a transcription factor that plays a major role in the regulation of intracellular antioxidant response. The effect of NRF2 overexpression in many malignancies is still unclear and recent meta-analysis correlated NRF2 overexpression with poor progn...

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Bibliographic Details
Published in:Breast cancer research and treatment 2020-02, Vol.179 (3), p.523-532
Main Authors: Almeida, Micaela, Soares, Mafalda, Ramalhinho, Ana Cristina, Moutinho, José Fonseca, Breitenfeld, Luiza, Pereira, Luísa
Format: Article
Language:English
Subjects:
Analysis
Antioxidants
Breast cancer
Cancer patients
Cancer research
Care and treatment
Database searching
Immunohistochemistry
Internet/Web search services
Medical prognosis
Medicine
Medicine & Public Health
Meta-analysis
Oncology
Online searching
Patients
Prognosis
Review
RNA
Survival
Systematic review
Tumors
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Summary:Purpose Nuclear factor E2-related factor 2 (NRF2) is a transcription factor that plays a major role in the regulation of intracellular antioxidant response. The effect of NRF2 overexpression in many malignancies is still unclear and recent meta-analysis correlated NRF2 overexpression with poor prognosis in a variety of human cancers. However, the effect of NRF2 overexpression in breast cancer is still unclear. Thus, the main goal of this work was to clarify the role of NRF2 expression in survival and relapse of breast cancer patients by performing a systematic review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement, followed by a meta-analysis. Methods The electronic search was conducted in PubMed, Scopus, SciELO, Web of Science and Embase between November of 2017 and September of 2018. To be included, studies should evaluate NRF2 expression in breast cancer tissue, through immunohistochemistry and/or mRNA and had to report one or more of the following outcomes: overall survival (OS), disease-free survival (DFS), mean survival and median survival. Results For the meta-analysis, seven studies were included and NRF2 expression was correlated with OS and DFS. It was observed that compared to patients with low NRF2 expression, patients with NRF2 overexpression had poorer OS with a hazard ratio of 1.82 (95% CI 1.32–2.50; p value 
ISSN:0167-6806
1573-7217
DOI:10.1007/s10549-019-05494-4