• AKAP4: a potential early biomarker in the diagnosis of breast cancer and immunotherapy target
  • Maryam Jafari,1,* Maryam Najafi,2
    1. Student research committee, Anzali International Medical Campus, Guilan University of Medical Sciences, Guilan, Iran
    2. Student research committee, Anzali International Medical Campus, Guilan University of Medical Sciences, Guilan, Iran


  • Introduction: Breast cancer is one of the most common cancer, especially in women related to death and early diagnosis is significant to manage it better and prevent the major problem and improve overall survival in patients. Screen tests are so important to detect breast cancer as soon as possible to increase the success rate of treatment. A-kinase anchoring protein 4 (AKAP4) is a scaffolding protein and it's binding to the regulatory subunit of protein kinase A (PKA). AKAP4 is known as Cancer testis (CT) antigens: a group of antigens used as early biomarkers. It's participated in the intracellular signaling of protein kinase–A. AKAP4 high expression in germ cells and cancer than normal cells. The present study aims to investigate the AKAP4 as an early detection of breast cancer and immunotherapy target for treatment.
  • Methods: In this study, a review was conducted to obtain relevant studies from the online databases Pubmed, Web of Science, and Scopus with "Breast cancer" and "AKAP4" as keywords from 2013 to September 2022 and only English studies was included. We reviewed all studies that considered AKAP4 as an early biomarker or immunotherapy target.
  • Results: Totally 5 related articles were reviewed. The data revealed that AKAP4 was expressed in various histotypes of breast cancer and it was detected in most patients with breast cancer. AKAP4 was detectable in all 4 stages of breast cancer (I-IV) in both tumor and peripheral blood. However, the expression of AKAP4 was significantly higher in stage IV, nodal involvement, and distant metastasis in peripheral blood. The studies demonstrated that anti-AKAP4 antibodies are present in patients' sera too and it can provide a better method of diagnosis. Due to the minimally invasive association with this method AKAP4 can consider a primary screen test. According to the presence of AKAP4 in all these stages, we can predict that it may consider as a tumorigenic factor; so some studies showed that AKAP4 can consider as an immunotherapy target and showed that knockdown of AKAP4 inhibited proliferation of breast cancer cells in vivo and in vitro. However, studies showed different result and we need more study to confirm this hypothesis.
  • Conclusion: AKAP4 is exclusively found in testicular tissue and It's not found in any other normal tissue. When AKAP4 is detected in other tissue or serum it can be considered as an early biomarker for cancer and malignant cells. Evaluation of AKAP4 was recently recognized as an early biomarker in breast cancer and it can help to more successful treatment and it can consider as immunotherapy target. However, more studies are needed to clear gray areas of the Role of AKA4P for breast cancer early diagnosis and treatment.
  • Keywords: Keywords: Breast cancer, AKAP4, Biomarker, Immunotherapy target