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Activation of a cGAS-STING-mediated immune response predicts response to neoadjuvant chemotherapy in early breast cancer

Title: Activation of a cGAS-STING-mediated immune response predicts response to neoadjuvant chemotherapy in early breast cancer
Authors: Parkes, EE; Savage, KI; Lioe, T; Boyd, C; Halliday, S; Walker, SM; Lowry, K; Knight, L; Buckley, NE; Grogan, A; Logan, GE; Clayton, A; Hurwitz, J; Kirk, SJ; Xu, J; Sidi, FA; Humphries, MP; Bingham, V; James, JA; James, CR; Paul Harkin, D; Kennedy, RD; McIntosh, SA
Publisher Information: Springer Nature [academic journals on nature.com]
Publication Year: 2026
Collection: Oxford University Research Archive (ORA)
Description: BACKGROUND: The DNA-damage immune-response (DDIR) signature is an immune-driven gene expression signature retrospectively validated as predicting response to anthracycline-based therapy. This feasibility study prospectively evaluates the use of this assay to predict neoadjuvant chemotherapy response in early breast cancer. METHODS: This feasibility study assessed the integration of a novel biomarker into clinical workflows. Tumour samples were collected from patients receiving standard of care neoadjuvant chemotherapy (FEC + /-taxane and anti-HER2 therapy as appropriate) at baseline, mid- and post-chemotherapy. Baseline DDIR signature scores were correlated with pathological treatment response. RNA sequencing was used to assess chemotherapy/response-related changes in biologically linked gene signatures. RESULTS: DDIR signature reports were available within 14 days for 97.8% of 46 patients (13 TNBC, 16 HER2 + ve, 27 ER + HER2-ve). Positive scores predicted response to treatment (odds ratio 4.67 for RCB 0-1 disease (95% CI 1.13-15.09, P = 0.032)). DDIR positivity correlated with immune infiltration and upregulated immune-checkpoint gene expression. CONCLUSIONS: This study validates the DDIR signature as predictive of response to neoadjuvant chemotherapy which can be integrated into clinical workflows, potentially identifying a subgroup with high sensitivity to anthracycline chemotherapy. Transcriptomic data suggest induction with anthracycline-containing regimens in immune restricted, "cold" tumours may be effective for immune priming. TRIAL REGISTRATION: Not applicable (non-interventional study). CRUK Internal Database Number 14232
Document Type: article in journal/newspaper
Language: English
DOI: 10.1038/s41416-021-01599-0
Availability: https://doi.org/10.1038/s41416-021-01599-0; https://ora.ox.ac.uk/objects/uuid:395b9580-b17a-4ccf-a2ec-78577880f8c2
Rights: info:eu-repo/semantics/openAccess ; CC Attribution (CC BY)
Accession Number: edsbas.F6D191A9
Database: BASE