Immunohistochemical prediction of lapatinib efficacy in advanced HER2-positive breast cancer patients
2016
// Renata Duchnowska 1 , Piotr J. Wysocki 2 , Konstanty Korski 3 , Bogumila Czartoryska-Arlukowicz 4 , Anna Niwinska 5 , Marlena Orlikowska 6 , Barbara Radecka 7 , Maciej Studzinski 8 , Regina Demlova 9 , Barbara Ziolkowska 10 , Monika Merdalska 11 , Łukasz Hajac 12 , Paulina Myśliwiec 13 , Dorota Zuziak 14 , Sylwia Debska-Szmich 15 , Istvan Lang 16 , Malgorzata Foszczynska-Kloda 2 , Bozenna Karczmarek-Borowska 17 , Anton Żawrocki 18 , Anna Kowalczyk 18 , Wojciech Biernat 18 , Jacek Jassem 18 , for the Central and East European
OncologyGroup (CEEOG) 1 Military Institute of Medicine,
OncologyDepartment, Warsaw, Poland 2 West
PomeranianCancer Center, Szczecin, Poland 3 Greater Poland Cancer Center, Poznan, Poland 4 Bialystok
OncologyCenter, Bialystok, Poland 5 The Maria Sklodowska-Curie Memorial Cancer Center and Institute of
Oncology, Warsaw, Poland 6 Warmia and Masuria
OncologyCenter, Olsztyn, Poland 7 Opole
OncologyCenter, Poland 8
OncologyCenter, Bydgoszcz, Poland 9 Masaryk Memorial Cancer Institute, Brno, Czech Republic 10 Chemotherapy Department,
Regional Hospital, Wroclaw, Poland 11
OncologyCenter, Kielce, Poland 12
OncologyCenter, Wroclaw, Poland 13
OncologyCenter, Zielona Gora, Poland 14
OncologyCenter, Bielsko-Biala, Poland 15 Medical University of Łodź, Łodź, Poland 16 Department of Medical
Oncology, National Institute of
Oncology, Budapest, Hungary 17 Department of Chemotherapy, Subcarpathian
OncologyCenter, Rzeszow, Poland 18 Medical University of Gdansk, Gdansk, Poland Correspondence to: Renata Duchnowska, e-mail: rdtt@wp.pl Keywords: breast cancer, epidermal growth factor receptor type 2,
lapatinib, mTOR, p-MAPK Received: May 19, 2015 Accepted: November 13, 2015 Published: November 24, 2015 ABSTRACT Molecular mechanisms of
lapatinibresistance in breast cancer are not well understood. The aim of this study was to correlate expression of selected proteins involved in
ErbBfamily signaling pathways with clinical efficacy of
lapatinib. Study group included 270 HER2-positive advanced breast cancer patients treated with
lapatiniband
capecitabine. Immunohistochemical expression of phosphorylated adenosine monophosphate-activated protein (p-AMPK), mitogen-activated protein kinase (p-MAPK), phospho (p)-p70S6K,
cyclin E, phosphatase and
tensinhomolog were analyzed in primary breast cancer samples. The best discriminative value for progression-free survival (PFS) was established for each biomarker and subjected to multivariate analysis. At least one biomarker was determined in 199 patients. Expression of p-p70S6K was independently associated with longer (HR 0.45; 95% CI: 0.25–0.81; p = 0.009), and
cyclin Ewith shorter PFS (HR 1.83; 95% CI: 1.06–3.14; p = 0.029). Expression of p-MAPK (HR 1.61; 95% CI 1.13–2.29; p = 0.009) and
cyclin E(HR 2.99; 95% CI: 1.29–6.94; p = 0.011) was correlated with shorter, and expression of estrogen receptor (HR 0.65; 95% CI 0.43–0.98; p = 0.041) with longer overall survival. Expression of p-AMPK negatively impacted response to treatment (HR 3.31; 95% CI 1.48–7.44; p = 0.004) and disease control (HR 3.07; 95% CI 1.25–7.58; p = 0.015). In conclusion: the efficacy of
lapatinibseems to be associated with the activity of downstream signaling pathways – AMPK/mTOR and Ras/Raf/MAPK. Further research is warranted to assess the clinical utility of these data and to determine a potential role of combining
lapatinibwith MAPK pathway inhibitors.
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