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Androgen Receptor in Stage I-II Primary Breast Cancer -Prognostic Value and Distribution in Subgroups

Niméus, Emma LU ; Folkesson, Elin LU ; Nodin, Björn LU ; Hartman, Linda LU orcid and Klintman, Marie LU (2017) In Anticancer research 37(12). p.6845-6853
Abstract

BACKGROUND/AIM: The value of androgen receptor (AR) in breast cancer has gained renewed interest as a prognostic and treatment predictive biomarker. The aims of this work were to study the associations and the prognostic value of AR in patients from two clinical cohorts.

MATERIALS AND METHODS: Cohort 1 included 208 premenopausal, node-negative patients of whom 87% had received no adjuvant medical treatment; cohort 2 consisted of 263 patients with stage II disease who had all received 2 years of adjuvant tamoxifen. A semi-quantitative assessment of nuclear AR expression divided into five groups (0-1%, 2-10%, 11-50%, 51-75%, and 76-100%) was performed. Survival analyses, stratified by cohort, were performed using both a trend-test... (More)

BACKGROUND/AIM: The value of androgen receptor (AR) in breast cancer has gained renewed interest as a prognostic and treatment predictive biomarker. The aims of this work were to study the associations and the prognostic value of AR in patients from two clinical cohorts.

MATERIALS AND METHODS: Cohort 1 included 208 premenopausal, node-negative patients of whom 87% had received no adjuvant medical treatment; cohort 2 consisted of 263 patients with stage II disease who had all received 2 years of adjuvant tamoxifen. A semi-quantitative assessment of nuclear AR expression divided into five groups (0-1%, 2-10%, 11-50%, 51-75%, and 76-100%) was performed. Survival analyses, stratified by cohort, were performed using both a trend-test and a cut-off of >10% for positivity.

RESULTS: A total of 76% of all patients were AR+, and 89%, 48%, and 23% of the estrogen receptor-positive, negative, and triple-negative, respectively. In Cox regression, stratified by cohort, AR divided into five groups was a prognostic factor for 5-year distant disease-free survival with a hazard ratio of 0.86 per step in fraction score (p=0.018). With a predefined cut-off at 10%, moderate evidence of an effect remained (Hazard Ratio=0.67, p=0.077). In multivariable analysis, AR did not retain an independent prognostic value.

CONCLUSION: AR is a weak, however, not independent prognostic factor for distant metastasis. Although the prognostic value of AR may be questionable, the study identified a subset of AR-positive triple-negative patients as being potential candidates for AR-directed therapy for which further studies are warranted.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Androgen receptor status, breast cancer, endocrine treatment, prognosis, steroid receptors
in
Anticancer research
volume
37
issue
12
pages
9 pages
publisher
International Institute of Cancer Research
external identifiers
  • pmid:29187464
  • wos:000417022100041
  • scopus:85038130016
ISSN
1791-7530
DOI
10.21873/anticanres.12146
language
English
LU publication?
yes
id
440ce85f-649d-4313-8a49-3b503c733b74
date added to LUP
2018-01-10 16:27:35
date last changed
2025-01-08 02:39:53
@article{440ce85f-649d-4313-8a49-3b503c733b74,
  abstract     = {{<p>BACKGROUND/AIM: The value of androgen receptor (AR) in breast cancer has gained renewed interest as a prognostic and treatment predictive biomarker. The aims of this work were to study the associations and the prognostic value of AR in patients from two clinical cohorts.</p><p>MATERIALS AND METHODS: Cohort 1 included 208 premenopausal, node-negative patients of whom 87% had received no adjuvant medical treatment; cohort 2 consisted of 263 patients with stage II disease who had all received 2 years of adjuvant tamoxifen. A semi-quantitative assessment of nuclear AR expression divided into five groups (0-1%, 2-10%, 11-50%, 51-75%, and 76-100%) was performed. Survival analyses, stratified by cohort, were performed using both a trend-test and a cut-off of &gt;10% for positivity.</p><p>RESULTS: A total of 76% of all patients were AR+, and 89%, 48%, and 23% of the estrogen receptor-positive, negative, and triple-negative, respectively. In Cox regression, stratified by cohort, AR divided into five groups was a prognostic factor for 5-year distant disease-free survival with a hazard ratio of 0.86 per step in fraction score (p=0.018). With a predefined cut-off at 10%, moderate evidence of an effect remained (Hazard Ratio=0.67, p=0.077). In multivariable analysis, AR did not retain an independent prognostic value.</p><p>CONCLUSION: AR is a weak, however, not independent prognostic factor for distant metastasis. Although the prognostic value of AR may be questionable, the study identified a subset of AR-positive triple-negative patients as being potential candidates for AR-directed therapy for which further studies are warranted.</p>}},
  author       = {{Niméus, Emma and Folkesson, Elin and Nodin, Björn and Hartman, Linda and Klintman, Marie}},
  issn         = {{1791-7530}},
  keywords     = {{Androgen receptor status; breast cancer; endocrine treatment; prognosis; steroid receptors}},
  language     = {{eng}},
  month        = {{12}},
  number       = {{12}},
  pages        = {{6845--6853}},
  publisher    = {{International Institute of Cancer Research}},
  series       = {{Anticancer research}},
  title        = {{Androgen Receptor in Stage I-II Primary Breast Cancer -Prognostic Value and Distribution in Subgroups}},
  url          = {{http://dx.doi.org/10.21873/anticanres.12146}},
  doi          = {{10.21873/anticanres.12146}},
  volume       = {{37}},
  year         = {{2017}},
}