# Prognostic value of FOXA1 in estrogen receptor-negative breast cancer: A systematic review and meta-analysis

**Authors:** Angela V. Fonseca-Benitez, David Díaz-Báez, James Guevara-Pulido, Milena Rondón-Lagos, Andrés Felipe Aristizábal-Pachón, Nelson Rangel, Yan Xu, Yan Xu, Yan Xu, Yan Xu

PMC · DOI: 10.1371/journal.pone.0332516 · PLOS One · 2025-10-21

## TL;DR

This study finds that higher FOXA1 expression is linked to better survival outcomes in estrogen receptor-negative breast cancer patients.

## Contribution

The paper provides a meta-analysis showing FOXA1's prognostic value in ER-negative breast cancer.

## Key findings

- Higher FOXA1 expression is associated with improved overall survival in ER-negative breast cancer.
- FOXA1 expression correlates with better disease-free survival in ER-negative breast cancer patients.

## Abstract

Breast cancer remains the most common cancer among women worldwide, and recurrence rates stay high despite current treatments, especially for those with negative estrogen receptor status, where therapies are less effective, and prognosis is worse. Identifying molecules with predictive value for therapy response and prognosis is therefore crucial. In this context, FOXA1 could serve as a potential biomarker to predict the progression of ER-negative tumors. A search was conducted to answer the question, “What is the prognostic value of FOXA1 expression in breast cancer, estrogen receptor negative?” using various databases. Controlled vocabulary and Boolean operators were employed. Only studies reporting overall survival and disease-free survival, defined as the time from evaluation to death or relapse, were included. We identified seven articles evaluating FOXA1 and its relationship with disease-free survival (DFS) or overall survival (OS) in patients with ER-negative breast cancer. Our data indicate that higher FOXA1 expression is associated with improved overall survival (HR = 0.61, CI = 0.45–0.83, p < 0.002) and better disease-free survival (HR = 0.69, CI = 0.51–0.93, p < 0.02). These findings suggest that FOXA1 is linked to a favorable prognosis in terms of overall survival and disease-free survival. Further studies are needed to assess the role of FOXA1 in response to chemotherapy. PROSPERO registration number: CRD42024453750

## Linked entities

- **Genes:** FOXA1 (forkhead box A1) [NCBI Gene 3169]
- **Diseases:** breast cancer (MONDO:0004989)

## Full-text entities

- **Genes:** EREG (epiregulin) [NCBI Gene 2069] {aka EPR, ER, Ep}, ESR1 (estrogen receptor 1) [NCBI Gene 2099] {aka ER, ESR, ESRA, ESTRR, Era, NR3A1}, FOXA1 (forkhead box A1) [NCBI Gene 3169] {aka HNF3A, TCF3A}
- **Diseases:** Breast cancer (MESH:D001943), cancer (MESH:D009369), death (MESH:D003643)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12539746/full.md

## References

28 references — full list in the complete paper: https://tomesphere.com/paper/PMC12539746/full.md

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Source: https://tomesphere.com/paper/PMC12539746