Breast cancer has become the leading cause of
cancer-related death among women. A large number of patients become resistant to drug
chemotherapy.
Paclitaxel (
Taxol) is an effective chemotherapeutic agent used to treat
cancer patients.
Taxol has been widely used in human malignancies including
breast cancer because it can stabilize microtubules resulting in cell death by causing an arrest during the G2/M phase of the cell cycle. Pro-apoptotic Bcl-2 antagonist killer 1 (Bak) plays an important role in
Taxol-induced apoptosis in
breast cancer. In our present study, we investigated the expression of the
Bak protein and clinicopathological correlations in a large sample of
breast cancer tissues by immunohistochemistry. We found that the percentage of high scores of Bak expression in
breast cancer was significantly lower than that of the non-cancerous breast control tissue. In addition, lower Bak expression was positively associated with the clinical TNM stage of
breast cancer with a significant decrease in overall survival compared with those with higher Bak expression especially in the
Luminal and HER2 subtypes. Importantly, higher Bak expression predicted a favorable clinical outcome in the cases treated with
Taxol indicated by a higher overall survival than that of patients with lower Bak expression especially in
Luminal and HER2 subtypes. Furthermore, these results were confirmed in vitro since overexpression of Bak sensitized
breast cancer cells to
Taxol by inhibiting proliferation and promoting apoptosis; in contrast, downregulation of Bak through
siRNA transfection inhibited
Taxol induced-apoptosis. Therefore, our results demonstrate that Bak acts as a sensitive biomarker and favorable prognostic factor for
Taxol treatment in
breast cancer. The restoration of Bak expression would be therapeutically beneficial for
Taxol resistant
breast cancer patients.