Potential clinically useful prognostic biomarkers in triple-negative breast cancer: preliminary results of a retrospective analysis
Received 1 June 2018
Accepted for publication 16 October 2018
Published 23 November 2018 Volume 2018:10 Pages 177—194
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Pranela Rameshwar
Silvia Mihaela Ilie,1 Xenia Elena Bacinschi,1,2 Inga Botnariuc,2 Rodica Maricela Anghel1,2
1University of Medicine and Pharmacy “Carol Davila,” Bucharest, Romania; 2Department of Oncology-Radiotherapy, Institute of Oncology “Prof Dr Alexandru Trestioreanu,” Bucharest, Romania
Background: Triple-negative breast cancer (TNBC) has a poor prognosis, even in its early stages. In the absence of postoperative targeted treatments, intensive adjuvant chemotherapy regimens are proposed. For those favorable histologies, such as apocrine and adenoid cystic carcinoma, which frequently belong to TNBC, aggressive treatments are unnecessary.
Patients and methods: We retrospectively analyzed 631 cases of breast cancer, primary operated curatively, and followed up at our institution for at least 36 months to identify the biomarkers assessable by immunohistochemistry, to be proposed as prognostic score for tailoring adjuvant treatment to TNBC patients.
Results: The triple-negative phenotype was found in 85 patients (13.5%). Over a mean follow-up of 55.7 months, relapses occurred in 106 patients (16.8%), of which 18 (2.8%) were TNBC. Recurrence was directly correlated with Ki67 and cytokeratin 5/6 (CK5/6) immunoreactivity in all breast cancer patients (P=0.005), but only marginally with CK5/6 and epithelial cadherin (E-cad) expression in TNBC patients (P=0.07). Mean event-free survival (EFS) in TNBC patients was 85.52 months compared with 100.4 months in non-TNBC patients (P=0.228). The EFS of CK5/6-negative triple-negative patients was 68.84 months compared with 98.84 months in those who were CK5/6 positive (HR =5.08; P=0.038). EFS differed among patients identified as double-positive for E-cad and CK5/6 (83.87 months), those expressing E-cad or CK5/6 (64.23 months), and those negative for both biomarkers (39.64 months).
Conclusion: These preliminary results suggest that CK5/6 and E-cad are possible core biomarkers for a cost-effective prognostic evaluation of primary operable TNBC patients.
Keywords: prognosis, immunohistochemical biomarkers, triple-negative breast cancer, CK5/6, E-cadherin
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