SPARC MRNA Predicts The Efficacy Of Nab-Paclitaxel In The Treatment Of Malignant Tumors

Objective:To explore the relationship between the secreted protein acidic and rich in cysteine(SPARC)m RNA and the efficacy of nanoparticle albumin bound paclitaxel(nab-PTX),and to clarify whether the expression can be used as a predictor of the chemotherapy efficacy of the nab-PTX.Methods:1.Venous blood was collected before and after two cycles nab-PTX chemotherapy for patients who met the inclusion criteria and exclusion criteria,and then RNA of precipitated cells was extracted with Trizol reagent after centrifugation.SPARC m RNA was assayed by real-time quantitative reverse transcription polymerase chain reaction.The data were analyzed using Graph Pad Prism 9.0 and SPSS 26.0 statistical software.2.To search relevant clinical trials in Pub Med,EMBASE,CNKI and other databases.The levels of SPARC expression(regardless of detection methods or detection materials)in patients receiving nab-PTX therapy were screened,and the relationship between SPARC expression level and progression free survival(PFS)and/or overall survival(OS)was assessed.The clinical study of the relationship between SPARC expression level and pathologic complete response(p CR)after neoadjuvant chemotherapy of breast cancer was evaluated.The basic characteristics of the included studies were extracted,the quality of the included studies was evaluated by Newcastle Ottawa scale,the publication bias of the included studies was detected by funnel chart,the heterogeneity was measured by I~2 test,and analyzed by reviewer manager 5.3.Results:1.A total of 27 patients were statistically analyzed in this study.The paired Wilcoxon nonparametric rank sum test showed that there was no significant difference in SPARC m RNA expression before and after nab-PTX(P>0.05);The logistic regression analysis showed that the expression of SPARC m RNA had no correlation with the efficacy of nab-PTX in malignant tumors(P>0.05)and the expression of SPARC m RNA was not significantly correlated with p CR in breast cancer patients after neoadjuvant chemotherapy(P>0.05).2.The relationship between SPARC expression level and therapeutic efficacy of nab-PTX:a meta-analysis.Finally,five related literatures were included in the study.The HR of PFS between SPARC high expression and low expression groups was 1.25(95%CI:0.72-2.14,P=0.43,tumor cells)and 1.51(95%CI:0.93-2.46,P=0.10,stromal cells).The HR of OS between SPARC high expression and low expression groups was 1.07(95%CI:0.57-2.03,P=0.83,tumor cells)and 1.34(95%CI:0.74-2.43,P=0.33,stromal cells).It indicates that the expression level of SPARC in tumor cells or stromal cells is not related to PFS and OS of patients treated with nab-PTX.3.The predictive effect of SPARC on p CR in breast cancer patients after neoadjuvant chemotherapy with nab-PTX:a meta-analysis.Finally,four related literatures were included in the study.The OR of PCR between SPARC high and low expression groups was 0.58(95%CI:0.18-1.89),P=0.37.There was no significant correlation between SPARC and p CR after neoadjuvant chemotherapy with nab-PTX in breast cancer patients.Conclusion:1.In the 27 patients enrolled in this study,there was no significant difference in the expression of SPARC m RNA before and after the application of nab-PTX.2.SPARC m RNA expression may not be used as a predictor of the efficacy of nab-PTX.3.The expression of SPARC m RNA may not predict p CR after nab-PTX neoadjuvant chemotherapy in breast cancer patients.