Biomarker changes associated with the development of resistance to aromatase inhibitors (AIs) in estrogen receptor-positive breast cancer.

Autor:	Arnedos M; Breast Cancer Unit, Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France., Drury S; NE Thames Regional Genetics Laboratory, Great Ormond Street Hospital, London., Afentakis M; Academic Department of Biochemistry, Royal Marsden Hospital, London., A'Hern R; Clinical Trials and Statistics Unit, The Institute of Cancer Research, London., Hills M; Academic Department of Biochemistry, Royal Marsden Hospital, London., Salter J; Breast Cancer Unit, Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France., Smith IE; Clinical Trials and Statistics Unit, The Institute of Cancer Research, London; Breast Unit., Reis-Filho JS; Memorial Sloan-Kettering Cancer Centre, New York, USA., Dowsett M; Breast Cancer Unit, Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France; NE Thames Regional Genetics Laboratory, Great Ormond Street Hospital, London. Electronic address: mitch.dowsett@icr.ac.uk.
Jazyk:	angličtina
Zdroj:	Annals of oncology : official journal of the European Society for Medical Oncology [Ann Oncol] 2014 Mar; Vol. 25 (3), pp. 605-610. Date of Electronic Publication: 2014 Feb 12.
DOI:	10.1093/annonc/mdt575
Abstrakt:	Background: The purpose of this study was to identify any differences in key biomarkers associated with estrogen action between biopsies taken at diagnosis and at recurrence or progression during treatment with an aromatase inhibitor (AI). Patients and Methods: Patients were retrospectively identified from a clinical database as having relapsed or progressed during AI treatment. Immunohistochemistry was carried out against estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor 2 (HER2), insulin-like growth factor type-1 receptor (IGF1R), insulin receptor substrate-1 (IRS-1), stathmin, phosphatase and tensin homolog and Ki67. Results: Fifty-five pairs of samples were identified with ER- and/or PgR-positive diseases. Four (7%) patients were ER-negative at progression. Overall, PgR levels were lower in the recurrence sample, but 35% of cases remained positive. IGF1R levels decreased significantly. There were no substantial changes in HER2, IRS-1 or stathmin levels to indicate a role in resistance. Higher Ki67 levels at resistance indicate more proliferative disease. Conclusions: The phenotype of AI-recurrent lesions shows high between-tumour heterogeneity. There is evidence of an increase in Ki67, a reduction in IGF1R and a loss of ER expression in some individuals and some activation of growth factor signalling pathways that may explain resistance in individuals and merit treatment targeted to those pathways. Biopsy at recurrence will be necessary to identify the relevant target for individuals.
Databáze:	MEDLINE
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