ArticleDiscover oncology2026
SMARCA4 mutations drive metastatic progression and predict poor survival in breast cancer based on a real-world cohort study.
Article in Discover oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
To investigate the incidence, clinicopathological characteristics, and prognostic impact of SMARCA4 mutations in breast cancer, we conducted a retrospective cohort study using the MSK-CHORD database, enrolling 4,032 patients categorized into SMARCA4 mutant (1.22%, 49/4032) and wild-type groups. We analyzed overall survival (OS) via the Kaplan-Meier method and log-rank test, performed subgroup analyses by HER2/hormone receptor (HR) status, and explored associations with tumor mutational burden (TMB), microsatellite instability (MSI), and co-mutations. Results showed the mutant group had significantly higher rates of bone (75.5% vs. 55.3%, p = 0.005) and lymph node metastasis (81.6% vs. 60.9%, p = 0.003), shorter OS (p = 0.0087), and attenuated prognostic advantages of HER2-positive (p = 0.25) and HR-positive (p = 0.72) status. Additionally, the mutant group exhibited higher TMB (p < 0.05), poorer prognosis in high-MSI patients (p = 0.04), and frequent co-mutations in TP53 and PIK3CA. SMARCA4 mutation is an independent adverse prognostic factor in breast cancer (HR = 1.6, p = 0.02), linked to enhanced metastasis, altered HER2/HR prognostic value, and genomic instability, with potential as a prognostic biomarker.
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