Review Survivin expression and targeting in breast cancer Kumkum Jha a , Mridula Shukla b , Manoj Pandey a, * a Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221 005, India b Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221 005, India article info Article history: Accepted 8 January 2011 Keywords: Apoptosis Inhibitors Survivin EGFR HER2 abstract Introduction: Survivin a multifunctional protein that controls cell division, inhibition of apoptosis and promotion of angiogenesis. It is expressed in most human neoplasm, but is absent in normal and differ- entiated tissues. The purpose of this article is to overview the expression of survivin, effect of its expression in response to treatment, correlation with other markers and newer advancement in targeting survivin. Methods: A detailed search of Medline was carried out using the following search strategy: “((survivin) OR ((apoptosis) AND (inhibitor OR inhibitors))) AND ((breast) AND (neoplasm OR neoplasms OR tumor OR tumor OR cancer OR carcinoma))”. Abstract of all articles thus identified were reviewed to identify the relevant studies, full articles of studies thus identified were then obtained and reviewed. All relevant data was extracted and tabulated. Results: Survivin expression by Immunohistochemistry was identified in 65.3% (55.2e90.0%) of the breast cancer patients among the identified studies while survivin mRNA by RT-PCR was identified in 93.6% (90e97%). Survivin expression has been reported to be associated with over expression of HER 2, vascular endothelial growth factor (VEGF), urokinase plasminogen activator (uPA)/PAI-1. Conclusion: Survivin is over expressed in majority of breast cancers. The over expression of survivin is found to correlate with HER 2 and EGFR expression. Survivin expression has been found to confer resistance to chemotherapy and radiation. Targeting survivin in experimental models improves survival. More studies are needed on the role of survivin in multi drug resistance (MDR) in the presence of Pgp/ uPA/PAI-1 and the impact of survivin over expression in triple negative breast cancer. Ó 2011 Elsevier Ltd. All rights reserved. Contents Introduction ........................................................................................................................ 126 Survivin and cell-cycle .......................................................................................................... 126 Localization of survivin .......................................................................................................... 126 Survivin expression ............................................................................................................. 126 Survivin and its splice variants .................................................................................................... 128 Survivin in body fluids .......................................................................................................... 128 Survivin and response to treatment ............................................................................................... 128 Chemotherapy/hormone therapy .................................................................................................. 128 Survivin: correlation with other marker ................................................. .......................................... 128 Targeting survivin ............................................................................................................... 129 Survivin: antisense oligonucleotide ................................................ ......................................... 129 Survivin:Ribozyme ........................................................ ................................................ 129 Survivin: RNA interference ................................................................................................. 129 Survivin: cancer vaccine ................................................................................................... 129 Recent therapeutic targets ............................................................................................................ 129 * Corresponding author. Tel.: þ91 542 2368769; fax: þ91 542 2361014. E-mail address: manojpandey@wjso.com (M. Pandey). Contents lists available at ScienceDirect Surgical Oncology journal homepage: www.elsevier.com/locate/suronc 0960-7404/$ e see front matter Ó 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.suronc.2011.01.001 Surgical Oncology 21 (2012) 125e131