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Prognostic and predictive impact of stroma cells defined by PDGFRb expression in early breast cancer : results from the randomized SweBCG91RT trial

Strell, Carina ; Stenmark Tullberg, Axel ; Jetne Edelmann, Reidunn ; Akslen, Lars Andreas ; Malmström, Per LU ; Fernö, Mårten LU ; Holmberg, Erik ; Östman, Arne and Karlsson, Per (2021) In Breast Cancer Research and Treatment 187(1). p.45-55
Abstract

Purpose: Predictive biomarkers are needed to aid the individualization of radiotherapy (RT) in breast cancer. Cancer-associated fibroblasts have been implicated in tumor radioresistance and can be identified by platelet-derived growth factor receptor-beta (PDGFRb). This study aims to analyze how PDGFRb expression affects RT benefit in a large randomized RT trial. Methods: PDGFRb was assessed by immunohistochemistry on tissue microarrays from 989 tumors of the SweBCG91RT trial, which enrolled lymph node-negative, stage I/IIA breast cancer patients randomized to RT after breast-conserving surgery. Outcomes were analyzed at 10 years for ipsilateral breast tumor recurrence (IBTR) and any recurrence and 15 years for breast cancer specific... (More)

Purpose: Predictive biomarkers are needed to aid the individualization of radiotherapy (RT) in breast cancer. Cancer-associated fibroblasts have been implicated in tumor radioresistance and can be identified by platelet-derived growth factor receptor-beta (PDGFRb). This study aims to analyze how PDGFRb expression affects RT benefit in a large randomized RT trial. Methods: PDGFRb was assessed by immunohistochemistry on tissue microarrays from 989 tumors of the SweBCG91RT trial, which enrolled lymph node-negative, stage I/IIA breast cancer patients randomized to RT after breast-conserving surgery. Outcomes were analyzed at 10 years for ipsilateral breast tumor recurrence (IBTR) and any recurrence and 15 years for breast cancer specific death (BCSD). Results: PDGFRb expression correlated with estrogen receptor negativity and younger age. An increased risk for any recurrence was noted in univariable analysis for the medium (HR 1.58, CI 95% 1.11–2.23, p = 0.011) or PDGFRb high group (1.49, 1.06–2.10, p = 0.021) compared to the low group. No differences in IBTR or BCSD risk were detected. RT benefit regarding IBTR risk was significant in the PDGFRb low (0.29, 0.12–0.67, p = 0.004) and medium (0.31, 0.16–0.59, p < 0.001) groups but not the PDGFRb high group (0.64, 0.36–1.11, p = 0.110) in multivariable analysis. Likewise, risk reduction for any recurrence was less pronounced in the PDGFRb high group. No significant interaction between RT and PDGFRb-score could be detected. Conclusion: A higher PDGFRb-score conferred an increased risk of any recurrence, which partly can be explained by its association with estrogen receptor negativity and young age. Reduced RT benefit was noted among patients with high PDGFRb, however without significant interaction.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Early breast cancer, Fibroblasts, PDGFR, Radiotherapy, Tumor microenvironment
in
Breast Cancer Research and Treatment
volume
187
issue
1
pages
11 pages
publisher
Springer
external identifiers
  • scopus:85102024622
  • pmid:33661437
ISSN
0167-6806
DOI
10.1007/s10549-021-06136-4
language
English
LU publication?
yes
id
0a682767-9ff6-45aa-b544-1d07e23dd1a7
date added to LUP
2021-03-22 09:51:11
date last changed
2024-06-14 11:57:36
@article{0a682767-9ff6-45aa-b544-1d07e23dd1a7,
  abstract     = {{<p>Purpose: Predictive biomarkers are needed to aid the individualization of radiotherapy (RT) in breast cancer. Cancer-associated fibroblasts have been implicated in tumor radioresistance and can be identified by platelet-derived growth factor receptor-beta (PDGFRb). This study aims to analyze how PDGFRb expression affects RT benefit in a large randomized RT trial. Methods: PDGFRb was assessed by immunohistochemistry on tissue microarrays from 989 tumors of the SweBCG91RT trial, which enrolled lymph node-negative, stage I/IIA breast cancer patients randomized to RT after breast-conserving surgery. Outcomes were analyzed at 10 years for ipsilateral breast tumor recurrence (IBTR) and any recurrence and 15 years for breast cancer specific death (BCSD). Results: PDGFRb expression correlated with estrogen receptor negativity and younger age. An increased risk for any recurrence was noted in univariable analysis for the medium (HR 1.58, CI 95% 1.11–2.23, p = 0.011) or PDGFRb high group (1.49, 1.06–2.10, p = 0.021) compared to the low group. No differences in IBTR or BCSD risk were detected. RT benefit regarding IBTR risk was significant in the PDGFRb low (0.29, 0.12–0.67, p = 0.004) and medium (0.31, 0.16–0.59, p &lt; 0.001) groups but not the PDGFRb high group (0.64, 0.36–1.11, p = 0.110) in multivariable analysis. Likewise, risk reduction for any recurrence was less pronounced in the PDGFRb high group. No significant interaction between RT and PDGFRb-score could be detected. Conclusion: A higher PDGFRb-score conferred an increased risk of any recurrence, which partly can be explained by its association with estrogen receptor negativity and young age. Reduced RT benefit was noted among patients with high PDGFRb, however without significant interaction.</p>}},
  author       = {{Strell, Carina and Stenmark Tullberg, Axel and Jetne Edelmann, Reidunn and Akslen, Lars Andreas and Malmström, Per and Fernö, Mårten and Holmberg, Erik and Östman, Arne and Karlsson, Per}},
  issn         = {{0167-6806}},
  keywords     = {{Early breast cancer; Fibroblasts; PDGFR; Radiotherapy; Tumor microenvironment}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{1}},
  pages        = {{45--55}},
  publisher    = {{Springer}},
  series       = {{Breast Cancer Research and Treatment}},
  title        = {{Prognostic and predictive impact of stroma cells defined by PDGFRb expression in early breast cancer : results from the randomized SweBCG91RT trial}},
  url          = {{http://dx.doi.org/10.1007/s10549-021-06136-4}},
  doi          = {{10.1007/s10549-021-06136-4}},
  volume       = {{187}},
  year         = {{2021}},
}