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Br J Cancer. 2019 Nov 15. doi: 10.1038/s41416-019-0630-3. [Epub ahead of print]

Androgen receptor expression and response to chemotherapy in breast cancer patients treated in the neoadjuvant TECHNO and PREPARE trial.

Author information

1
Department of Gynecology, University Medical Center, Hamburg, Germany. iwitzel@uke.de.
2
German Breast Group, Neu-Isenburg, Germany.
3
Stratifyer Molecular Oncology GmbH, Cologne, Germany.
4
Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.
5
Institute of Pathology, University Medical Center Charite Berlin, Berlin, Germany.
6
Practice of Gynecologic Oncology Hannover, Hannover, Germany.
7
Department of Gynecology and Obstetrics, University Medical Center Ulm, Ulm, Germany.
8
Department of Gynecology, University Medical Center Frankfurt, Frankfurt, Germany.
9
Department of Gynecology, University Medical Center-UKSH, Kiel, Germany.
10
Department of Gynecology and Obstetrics, University Medical Center Heidelberg, Heidelberg, Germany.
11
Mammazentrum, Krankenhaus Jerusalem, Hamburg, Germany.
12
Department of Gynecology and Obstetrics, University Medical Center Aachen, Aachen, Germany.
13
Department of Obstetrics and Gynecology, Helios Hospital Berlin-Buch, Berlin, Germany.
14
Department of Gynecology, University Medical Center, Hamburg, Germany.

Abstract

BACKGROUND:

The androgen receptor (AR) is discussed as a prognostic and/or predictive marker in breast cancer patients.

METHODS:

AR mRNA expression was analysed by RT-qPCR in breast cancer patients treated in the neoadjuvant TECHNO (n  =  118, HER2-positive) and PREPARE trial (n  =  321, HER2-positive and -negative). In addition, mRNA expression of the AR transcript variants 1 (AR1) and 2 (AR2) was measured.

RESULTS:

Regarding subtypes, high AR mRNA levels were frequent in HER2-positive (61.3%, 92/150) and luminal tumours (60.0%, 96/160) but almost absent in triple-negative tumours (4.3%, 3/69) (p < 0.0001). Overall, high AR mRNA levels were found to be associated with lower pathological complete remission (pCR) rates (OR 0.77 per unit, 95% CI 0.67-0.88, p  =  0.0002) but also with better prognosis in terms of longer disease-free survival (DFS) (HR 0.57, 95% CI 0.39-0.85, p  =  0.0054) and overall survival (OS) (HR 0.43, 95% CI, 0.26-0.71, p  =  0.0011). In the PREPARE trial, a survival difference for patients with high and low AR1 mRNA levels could only be seen in the standard chemotherapy arm but not in the dose-dense treatment arm (OS: HR 0.41; 95% CI 0.22-0.74 vs. HR 1.05; 95% CI 0.52-2.13; p  =  0.0459).

CONCLUSIONS:

We provide evidence that AR mRNA predicts response to chemotherapy in breast cancer patients.

PMID:
31728025
DOI:
10.1038/s41416-019-0630-3

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