Prognostic Interplay of Caveolin1 and FOXC1 in Early Nonmetastatic Triple Negative Breast Cancer Undergoing Neoadjuvant Chemotherapy

Triple-negative breast cancer (TNBC) lacks specific molecular targets. This highlights an obvious need to identify specific prognostic biomarkers to stratify patients and guide treatment decisions. We designed this study to evaluate CAV1 and FOXC1 immunohistochemical expression and their correlation to survival outcomes and response to neoadjuvant chemotherapy (NAC). CAV1 and FOXC1 expressions were analyzed in 50 cases of TNBC. Clinical data on overall survival (OS), progression-free survival (PFS), and NAC response were collected and statistically evaluated. The predominant histologic subtype was invasive carcinoma of no special type (78%), with most cases being grade II (56%). CAV1 positivity was observed in 24% of cases, while FOXC1 was expressed in 74%. FOXC1 was significantly associated with higher tumor grade (P=0.02), advanced stage (P<0.001), and nodal involvement (P=0.002). It also correlated with poor NAC response and worse OS and PFS (P=0.001 and 0.01, respectively). There was a significant association of CAV1 with grade (P=0.002), lymph node involvement (P=0.003), stage (P=0.01), unfavorable clinical and pathologic response to NAC (P<0.001, P=0.01), and poor OS and PFS (P<0.001 for each). Conclusions: Both CAV1 and FOXC1 may serve as adverse prognostic indicators in TNBC. Their overexpression suggests a potential lack of benefit from NAC, indicating that targeted therapies against these markers might be more effective.