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Ibnu Purwanto,1,* Benedreky Leo,2,* Susanna Hilda Hutajulu,1 Johan Kurnianda,1 Kartika Widayati Taroeno-Hariadi,1 Mardiah Suci Hardianti,1 Amanda Dania Satiti,1 Ery Kus Dwianingsih,3 Didik Setyo Heriyanto,3 Irianiwati Widodo,3 Teguh Aryandono4 1Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University/Dr Sardjito Hospital, Yogyakarta, Indonesia; 2Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University/Dr Sardjito Hospital, Yogyakarta, Indonesia; 3Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University/Dr Sardjito Hospital, Yogyakarta, Indonesia; 4Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University/Dr Sardjito Hospital, Yogyakarta, Indonesia*These authors contributed equally to this workCorrespondence: Ibnu Purwanto, Jalan Farmako, Sekip Utara, Yogyakarta, 55281, Indonesia, Tel/Fax +62 274 560300, Email ibnupurwanto@ugm.ac.idPurpose: To determine the prognostic value of vimentin in triple negative breast cancer (TNBC) patients, specifically in relation to chemotherapy regimen and p53 mutant expression.Patient and Methods: We retrospectively analyzed the association of pre-treatment tumor expression of vimentin with 48-month overall survival (OS) of 72 all stages TNBC patients diagnosed between 2014 and 2018 in relation to chemotherapy regimen and expression of p53 mutant. Vimentin and p53 mutant expressions were examined using immunohistochemistry. Analysis was conducted on all patients collectively, then repeated on two cohorts divided according to the chemotherapy regimen. Sub-analysis was performed to determine the effect of p53 mutant expression on the prognostic value of vimentin.Results: Vimentin was expressed in 43.1% of patients and was not associated with clinicopathologic characteristics. Vimentin was associated with improved 48-month OS in all patients in univariate analysis but not significant in multivariate analysis. When analyzed according to chemotherapy regimen, vimentin was independently associated with improved 48-month OS in patients receiving non-platinum-based chemotherapy (80% vs 15.8%; HR: 0.17, 95% CI: 0.05– 0.58, p: 0.005). Other independent prognostic factors include T (HR: 6.18, 95% CI: 1.38– 27.7, p: 0.017) and M (HR: 5.64, 95% CI: 1.2– 26.33, p: 0.028). On subanalysis, vimentin was significantly associated with improved 48-month OS in patients expressing p53 mutant (69.2% vs 22.2%, p: 0.006) but was not significant in patients not expressing p53 mutant.Conclusion: Vimentin expression was independently associated with improved 48-month OS in TNBC patients treated with non–platinum–based chemotherapy. Expression of p53 mutant significantly affected the prognostic value of vimentin.Keywords: vimentin, p53 mutant, chemotherapy, platinum resistance, TNBC, prognostic factor |
