Format

Send to

Choose Destination
Breast Cancer. 2019 Mar 29. doi: 10.1007/s12282-019-00967-2. [Epub ahead of print]

Diabetes as a prognostic factor in HER-2 positive breast cancer patients treated with targeted therapy.

Author information

1
Department of Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.
2
Department of Radiation Oncology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
3
Department of Biological Sciences, School of Life Sciences, Ulsan National Institutes of Science and Technology, Ulsan, South Korea.
4
Department of Radiation Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.
5
Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.
6
Department of Pathology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
7
Department of Biological Sciences, School of Life Sciences, Ulsan National Institutes of Science and Technology, Ulsan, South Korea. jpark@unist.ac.kr.
8
Department of Radiation Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea. rtyoon@gmail.com.

Abstract

PURPOSE:

Recent studies revealed that metabolic stress influences the outcomes of breast cancer treatment. We sought to evaluate the prognostic effect of type 2 diabetes and find the molecular mechanism of relapses in postoperative HER-2+ breast cancer patients treated with HER-2 targeted therapy.

MATERIALS AND METHODS:

We evaluated 190 HER-2+ breast cancer patients (pT1-4N0-2M0) who were treated with surgical resection and trastuzumab (HER-2 targeted therapy) between 2006 and 2015. Survival outcomes and failure patterns were compared between such patients with (n = 12) and without (n = 178) type 2 diabetes.

RESULTS:

The median follow-up period was 42.4 months (range 12.0-124.7 months). Twenty-one patients (11.1%) showed relapse (including nine patients with locoregional failure), and three patients (1.6%) died as a result of cancer relapse. One-third of the patients with diabetes experienced relapse (4/12, 33.3%). The 3-year disease-free survival (DFS) and overall survival (OS) rates were 90.7% and 98.6%, respectively. Diabetic patients showed shorter DFS compared with non-diabetic patients (p = 0.006, 74.1% vs. 91.9%). OS was also shorter in diabetic patients compared with non-diabetic patients (p = 0.017, 91.7% vs. 99.1%). Of our interest, the levels of HER-3 and its ligand neuregulin-1 were significantly increased in the tumor specimen in HER-2+ breast cancer patients suffering with type 2 diabetes than that in the euglycemic control group.

CONCLUSIONS:

Type 2 diabetes was associated with detrimental effects on survival in postoperative HER-2+ breast cancer patients who were treated with trastuzumab. The poor prognostic effect of diabetes in HER-2+ breast cancer patients could be associated with the high levels of HER-3 and neuregulin 1, thus it should be considered and evaluated more.

KEYWORDS:

Diabetes; HER-2 positive breast cancer; Prognostic factor; Survival; Trastuzumab

PMID:
30927244
DOI:
10.1007/s12282-019-00967-2

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center