Abstract
Background: Androgen receptor (AR) is widely expressed in breast cancer (BC) but its role in estrogen receptor (ER)-positive tumors is still controversial. The AR/ER ratio has been reported to impact prognosis and response to antiestrogen endocrine therapy (ET). Methods: We assessed whether AR in primary tumors and/or matched metastases is a predictor of efficacy of first-line ET in advanced BC. Patients who had received first-line ET (2002-2011) were recruited, while those given concomitant chemotherapy or trastuzumab or pretreated with > 2 lines of chemotherapy were excluded. ER, progesterone receptor (PgR), Ki67 and AR expression were assessed by immunohistochemistry, and HER2 mainly by fluorescent in-situ hybridization. Cut-offs of 1 and 10% immunostained cells were used to categorize AR expression. Results: Among 102 evaluable patients, biomarkers were assessed in primary tumors in 70 cases and in metastases in 49, with 17 patients having both determinations. The overall concordance rate between primary tumors and metastases was 64.7% (95% CI 42%-87.4%) for AR status. AR status did not affect TTP significantly, whereas PgR and Ki67 status did. AR/PgR ≥0.96 was associated with a significantly shorter TTP (HR = 1.65, 95% CI 1.05-2.61, p = 0.028). AR status in primary tumors or metastases was not associated with progressive disease (PD) as best response. In contrast, Ki67 ≥ 20% and PgR < 10% showed a statistically significant association with PD as best response. Conclusions: AR expression does not appear to be useful to predict the efficacy of ET in advanced BC, whereas Ki67 and PgR exert a greater impact on its efficacy.
| Original language | English |
|---|---|
| Article number | 348 |
| Journal | BMC Cancer |
| Volume | 18 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Mar 27 2018 |
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Keywords
- Advanced breast cancer
- Androgen receptor
- Anti-estrogen therapy
- AR/ER ratio
- Endocrine therapy
ASJC Scopus subject areas
- Oncology
- Genetics
- Cancer Research
Cite this
Androgen receptor in advanced breast cancer : Is it useful to predict the efficacy of anti-estrogen therapy? / Bronte, Giuseppe; Rocca, Andrea; Ravaioli, Sara; Puccetti, Maurizio; Tumedei, Maria Maddalena; Scarpi, Emanuela; Andreis, Daniele; Maltoni, Roberta; Sarti, Samanta; Cecconetto, Lorenzo; Fedeli, Anna; Pietri, Elisabetta; De Simone, Valeria; Asioli, Silvia; Bravaccini, Sara; Amadori, Dino.
In: BMC Cancer, Vol. 18, No. 1, 348, 27.03.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Androgen receptor in advanced breast cancer
T2 - Is it useful to predict the efficacy of anti-estrogen therapy?
AU - Bronte, Giuseppe
AU - Rocca, Andrea
AU - Ravaioli, Sara
AU - Puccetti, Maurizio
AU - Tumedei, Maria Maddalena
AU - Scarpi, Emanuela
AU - Andreis, Daniele
AU - Maltoni, Roberta
AU - Sarti, Samanta
AU - Cecconetto, Lorenzo
AU - Fedeli, Anna
AU - Pietri, Elisabetta
AU - De Simone, Valeria
AU - Asioli, Silvia
AU - Bravaccini, Sara
AU - Amadori, Dino
PY - 2018/3/27
Y1 - 2018/3/27
N2 - Background: Androgen receptor (AR) is widely expressed in breast cancer (BC) but its role in estrogen receptor (ER)-positive tumors is still controversial. The AR/ER ratio has been reported to impact prognosis and response to antiestrogen endocrine therapy (ET). Methods: We assessed whether AR in primary tumors and/or matched metastases is a predictor of efficacy of first-line ET in advanced BC. Patients who had received first-line ET (2002-2011) were recruited, while those given concomitant chemotherapy or trastuzumab or pretreated with > 2 lines of chemotherapy were excluded. ER, progesterone receptor (PgR), Ki67 and AR expression were assessed by immunohistochemistry, and HER2 mainly by fluorescent in-situ hybridization. Cut-offs of 1 and 10% immunostained cells were used to categorize AR expression. Results: Among 102 evaluable patients, biomarkers were assessed in primary tumors in 70 cases and in metastases in 49, with 17 patients having both determinations. The overall concordance rate between primary tumors and metastases was 64.7% (95% CI 42%-87.4%) for AR status. AR status did not affect TTP significantly, whereas PgR and Ki67 status did. AR/PgR ≥0.96 was associated with a significantly shorter TTP (HR = 1.65, 95% CI 1.05-2.61, p = 0.028). AR status in primary tumors or metastases was not associated with progressive disease (PD) as best response. In contrast, Ki67 ≥ 20% and PgR < 10% showed a statistically significant association with PD as best response. Conclusions: AR expression does not appear to be useful to predict the efficacy of ET in advanced BC, whereas Ki67 and PgR exert a greater impact on its efficacy.
AB - Background: Androgen receptor (AR) is widely expressed in breast cancer (BC) but its role in estrogen receptor (ER)-positive tumors is still controversial. The AR/ER ratio has been reported to impact prognosis and response to antiestrogen endocrine therapy (ET). Methods: We assessed whether AR in primary tumors and/or matched metastases is a predictor of efficacy of first-line ET in advanced BC. Patients who had received first-line ET (2002-2011) were recruited, while those given concomitant chemotherapy or trastuzumab or pretreated with > 2 lines of chemotherapy were excluded. ER, progesterone receptor (PgR), Ki67 and AR expression were assessed by immunohistochemistry, and HER2 mainly by fluorescent in-situ hybridization. Cut-offs of 1 and 10% immunostained cells were used to categorize AR expression. Results: Among 102 evaluable patients, biomarkers were assessed in primary tumors in 70 cases and in metastases in 49, with 17 patients having both determinations. The overall concordance rate between primary tumors and metastases was 64.7% (95% CI 42%-87.4%) for AR status. AR status did not affect TTP significantly, whereas PgR and Ki67 status did. AR/PgR ≥0.96 was associated with a significantly shorter TTP (HR = 1.65, 95% CI 1.05-2.61, p = 0.028). AR status in primary tumors or metastases was not associated with progressive disease (PD) as best response. In contrast, Ki67 ≥ 20% and PgR < 10% showed a statistically significant association with PD as best response. Conclusions: AR expression does not appear to be useful to predict the efficacy of ET in advanced BC, whereas Ki67 and PgR exert a greater impact on its efficacy.
KW - Advanced breast cancer
KW - Androgen receptor
KW - Anti-estrogen therapy
KW - AR/ER ratio
KW - Endocrine therapy
UR - http://www.scopus.com/inward/record.url?scp=85044507804&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044507804&partnerID=8YFLogxK
U2 - 10.1186/s12885-018-4239-3
DO - 10.1186/s12885-018-4239-3
M3 - Article
C2 - 29587674
AN - SCOPUS:85044507804
VL - 18
JO - BMC Cancer
JF - BMC Cancer
SN - 1471-2407
IS - 1
M1 - 348
ER -