ArticleAnnals of surgical oncology2026
High Expression of Aurora Kinase A (AURKA) is Associated with Aggressive Tumor Biology and Therapeutic Response in ER+/HER2- Breast Cancer.
Article in Annals of surgical 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
backgroundAurora kinase A (AURKA) is a serine/threonine kinase that regulates mitotic entry, spindle assembly, and chromosomal segregation. AURKA overexpression has been linked to multiple malignancies. The biological and clinical significance of AURKA expression within estrogen receptor-positive, human epidermal growth factor receptor 2-negative (ER+/HER2-) breast cancer has yet to be fully elucidated.
methodsA total of 8896 patients were analyzed across bulk transcriptomic datasets. Single-cell RNA sequencing datasets were also analyzed. ER+/HER2- tumors were divided into AURKA-high or -low groups according to the median AURKA expression within each cohort.
resultsAURKA expression was associated with Nottingham histological grade and Ki-67 expression (p < 0.001) and enrichment of cell cycle-related pathways across The Cancer Genome Atlas, Molecular Taxonomy of Breast Cancer International Consortium, and Sweden Cancerome Analysis Network-Breast datasets (all false discovery rate <0.01; normalized enrichment score >2). AURKA expression was associated with genomic instability, increased mutational burden and enhanced DNA repair-related genes (all p < 0.001) and with increased infiltration of type 1 and 2 T-helper cells, M1-like macrophages, and total macrophages (all p < 0.001). Conversely, AURKA-low tumors were enriched for epithelial mesenchymal transition, myogenesis, coagulation, angiogenesis, and transforming growth factor-β signaling pathways (most false discovery rate <0.01) and higher cancer stem cells score (all p < 0.001). Clinically, higher AURKA expression was associated with pathological complete response after neoadjuvant chemotherapy in three of nine ER+/HER2- cohorts and with worse survival outcomes. AURKA expression also decreased after neoadjuvant chemotherapy in all three paired cohorts analyzed, regardless of subtype.
conclusionHigh AURKA expression was associated with a highly proliferative, immune-engaged tumor phenotype and with worse survival despite better therapeutic response in ER+/HER2- breast cancer.
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