Estrogen Receptor Alpha Gene Amplification Is an Independent Predictor of Long-Term Outcome in Postmenopausal Patients with Endocrine-Responsive Early Breast Cancer.


Journal

Clinical cancer research : an official journal of the American Association for Cancer Research
ISSN: 1557-3265
Titre abrégé: Clin Cancer Res
Pays: United States
ID NLM: 9502500

Informations de publication

Date de publication:
15 09 2022
Historique:
received: 28 12 2021
revised: 07 03 2022
accepted: 08 07 2022
pubmed: 4 8 2022
medline: 17 9 2022
entrez: 3 8 2022
Statut: ppublish

Résumé

Estrogen receptor (ER) expression is a prognostic parameter in breast cancer, and a prerequisite for the use of endocrine therapy. In ER+ early breast cancer, however, no receptor-associated biomarker exists that identifies patients with a particularly favorable outcome. We have investigated the value of ESR1 amplification in predicting the long-term clinical outcome in tamoxifen-treated postmenopausal women with endocrine-responsive breast cancer. 394 patients who had been randomized into the tamoxifen-only arm of the prospective randomized ABCSG-06 trial of adjuvant endocrine therapy with available formalin-fixed, paraffin-embedded tumor tissue were included in this analysis. IHC ERα expression was evaluated both locally and in a central lab using the Allred score, while ESR1 gene amplification was evaluated by FISH analysis using the ESR1/CEP6 ratio indicating focal copy number alterations. Focal ESR1 copy-number elevations (amplifications) were detected in 187 of 394 (47%) tumor specimens, and were associated with a favorable outcome: After a median follow-up of 10 years, women with intratumoral focal ESR1 amplification had a significantly longer distant recurrence-free survival [adjusted HR, 0.48; 95% confidence interval (CI), 0.26-0.91; P = 0.02] and breast cancer-specific survival (adjusted HR 0.47; 95% CI, 0.27-0.80; P = 0.01) as compared with women without ESR1 amplification. IHC ERα protein expression, evaluated by Allred score, correlated significantly with focal ESR1 amplification (P < 0.0001; χ2 test), but was not prognostic by itself. Focal ESR1 amplification is an independent and powerful predictor for long-term distant recurrence-free and breast cancer-specific survival in postmenopausal women with endocrine-responsive early-stage breast cancer who received tamoxifen for 5 years.

Identifiants

pubmed: 35920686
pii: 707422
doi: 10.1158/1078-0432.CCR-21-4328
pmc: PMC9475247
doi:

Substances chimiques

Antineoplastic Agents, Hormonal 0
Estrogen Receptor alpha 0
Tamoxifen 094ZI81Y45

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

4112-4120

Informations de copyright

©2022 The Authors; Published by the American Association for Cancer Research.

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Auteurs

Christian F Singer (CF)

Department of OB/GYN, Medical University of Vienna, Vienna, Austria.

Frederik Holst (F)

Department of OB/GYN, Medical University of Vienna, Vienna, Austria.
Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Stefan Steurer (S)

Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Eike C Burandt (EC)

Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Sigurd F Lax (SF)

Department of Pathology, Medical University of Graz, Graz, Austria.
Hospital Graz II, Graz, Austria.
Johannes Kepler University, School of Medicine, Graz, Austria.

Raimund Jakesz (R)

Department of Surgery, Medical University of Vienna, Vienna, Austria.

Margaretha Rudas (M)

Department of Pathology, Medical University of Vienna, Vienna, Austria.

Herbert Stöger (H)

Department of Medicine, Medical University of Graz, Graz, Austria.

Richard Greil (R)

Salzburg Cancer Research Institute - Center for Clinical and Immunology Trials and Cancer Cluster Salzburg; IIIrd Medical Department, Paracelsus Medical University Salzburg, Salzburg, Austria.

Guido Sauter (G)

Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Martin Filipits (M)

Center for Cancer Research, Medical University of Vienna, Vienna, Austria.

Ronald Simon (R)

Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Michael Gnant (M)

Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

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