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Prognostic significance of autophagy related genes in estrogen receptor positive tamoxifen treated breast cancer



Alok Mishra1, Ankit Pateriya1, Anand Kumar Mishra2, Ashutosh Shrivastava1*



1Center for Advance Research, Faculty of Medicine, King George’s Medical University, Lucknow, Uttar Pradesh, India, 226003; 2Department of Endocrine Surgery, Faculty of Medicine, King George’s Medical University, Lucknow, Uttar Pradesh, India, 226003



*Address correspondence to Ashutosh Shrivastava, ashutoshshrivastava@kgmcindia.edu


Article Type

Research Article



Submitted on August 15, 2020; Revision August 11, 2020; Accepted August 11, 2020; Published September 30, 2020



Resistance to Tamoxifen constitutes a major therapeutic challenge in treating hormone sensitive breast cancer. The induction of autophagy has been shown to be involved as one of the mechanism responsible for Tamoxifen resistance. Autophagy related gene (ATG) members are the regulators and effectors of Macroautophagy process in the cellular systems. In this study, we evaluated the prognostic significance of ATGs in Tamoxifen treated breast cancer. The “Kaplan- Meier plotter” database was utilized to analyze the relevance and significance of ATGs mRNA expression to Relapse Free Survival in breast cancer patients. We used the data of patients who are Estrogen receptor positive and are treated with Tamoxifen. Hazard ratio and log-rank p-value were calculated using KM survival plots for various ATGs. Overexpressed ATG3, ATG 5, ATG 8B and PIK3R4 resulted in a poor prognosis. A gene signature of these ATGs predicts deteriorated RFS (p-value=8.3e-05 and HR=1.84 (1.35-2.51) and Distant Metastasis Free Survival (p value 0.0027 and HR=2.03 (1.27-3.26). We report the distinct prognostic values of ATGs in patients of breast cancer treated with Tamoxifen. Thus, better understandings of the induction of autophagy pathway may potentially form the basis for use of autophagy inhibitors in the Tamoxifen resistant breast cancer.



Breast Cancer, Estrogen Receptor, Tamoxifen resistance, Autophagy, Autophagy related genes, Kaplan-Meier Plot



Mishra et al. Bioinformation 16(9): 710-718 (2020)


Edited by

P Kangueane






Biomedical Informatics



This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.