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Expression of HGF, pMet, and pAkt is related to benefit of radiotherapy after breast-conserving surgery : a long-term follow-up of the SweBCG91-RT randomised trial

Sjöström, Martin LU ; Veenstra, Cynthia ; Holmberg, Erik ; Karlsson, Per ; Killander, Fredrika LU ; Malmström, Per LU ; Niméus, Emma LU ; Fernö, Mårten LU and Stål, Olle (2020) In Molecular Oncology 14(11). p.2713-2726
Abstract

Experimental studies suggest that hepatocyte growth factor (HGF) and its transmembrane tyrosine kinase receptor, Met, in part also relying on Akt kinase activity, mediate radioresistance. We investigated the importance of these biomarkers for the risk of ipsilateral breast tumour recurrence (IBTR) after adjuvant radiotherapy (RT) in primary breast cancer. HGF, phosphorylated Met (pMet) and phosphorylated Akt (pAkt) were evaluated immunohistochemically on tissue microarrays from 1004 patients in the SweBCG91-RT trial, which randomly assigned patients to breast-conserving therapy, with or without adjuvant RT. HGF was evaluated in the stroma (HGFstr); pMet in the membrane (pMetmem); HGF, pMet and pAkt in the cytoplasm... (More)

Experimental studies suggest that hepatocyte growth factor (HGF) and its transmembrane tyrosine kinase receptor, Met, in part also relying on Akt kinase activity, mediate radioresistance. We investigated the importance of these biomarkers for the risk of ipsilateral breast tumour recurrence (IBTR) after adjuvant radiotherapy (RT) in primary breast cancer. HGF, phosphorylated Met (pMet) and phosphorylated Akt (pAkt) were evaluated immunohistochemically on tissue microarrays from 1004 patients in the SweBCG91-RT trial, which randomly assigned patients to breast-conserving therapy, with or without adjuvant RT. HGF was evaluated in the stroma (HGFstr); pMet in the membrane (pMetmem); HGF, pMet and pAkt in the cytoplasm (HGFcyt, pMetcyt, pAktcyt); and pAkt in the nucleus (pAktnuc). The prognostic and treatment predictive effects were evaluated to primary endpoint IBTR as first event during the first 5 years. Patients with tumours expressing low levels of HGFcyt and pMetcyt and high levels of pAktnuc derived a larger benefit from RT [hazard ratio (HR): 0.11 (0.037–0.30), 0.066 (0.016–0.28) and 0.094 (0.028–0.31), respectively] compared to patients with high expression of HGFcyt and pMetcyt, and low pAktnuc [HR: 0.36 (0.19–0.67), 0.35 (0.20–0.64) and 0.47 (0.32–0.71), respectively; interaction analyses: P = 0.052, 0.035 and 0.013, respectively]. These differences remained in multivariable analysis when adjusting for patient age, tumour size, histological grade, St Gallen subtype and systemic treatment (interaction analysis, P-values: 0.085, 0.027, and 0.023, respectively). This study suggests that patients with immunohistochemically low HGFcyt, low pMetcyt and high pAktnuc may derive an increased benefit from RT after breast-conserving surgery concerning the risk of developing IBTR.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Akt, breast cancer, HGF, Met, radiotherapy, treatment prediction
in
Molecular Oncology
volume
14
issue
11
pages
14 pages
publisher
Elsevier
external identifiers
  • pmid:32946618
  • scopus:85091612879
ISSN
1574-7891
DOI
10.1002/1878-0261.12803
language
English
LU publication?
yes
id
468a17c1-1078-4f42-8aaf-ad8face328b1
date added to LUP
2020-10-28 13:34:13
date last changed
2024-04-03 16:19:33
@article{468a17c1-1078-4f42-8aaf-ad8face328b1,
  abstract     = {{<p>Experimental studies suggest that hepatocyte growth factor (HGF) and its transmembrane tyrosine kinase receptor, Met, in part also relying on Akt kinase activity, mediate radioresistance. We investigated the importance of these biomarkers for the risk of ipsilateral breast tumour recurrence (IBTR) after adjuvant radiotherapy (RT) in primary breast cancer. HGF, phosphorylated Met (pMet) and phosphorylated Akt (pAkt) were evaluated immunohistochemically on tissue microarrays from 1004 patients in the SweBCG91-RT trial, which randomly assigned patients to breast-conserving therapy, with or without adjuvant RT. HGF was evaluated in the stroma (HGF<sub>str</sub>); pMet in the membrane (pMet<sub>mem</sub>); HGF, pMet and pAkt in the cytoplasm (HGF<sub>cyt</sub>, pMet<sub>cyt</sub>, pAkt<sub>cyt</sub>); and pAkt in the nucleus (pAkt<sub>nuc</sub>). The prognostic and treatment predictive effects were evaluated to primary endpoint IBTR as first event during the first 5 years. Patients with tumours expressing low levels of HGF<sub>cyt</sub> and pMet<sub>cyt</sub> and high levels of pAkt<sub>nuc</sub> derived a larger benefit from RT [hazard ratio (HR): 0.11 (0.037–0.30), 0.066 (0.016–0.28) and 0.094 (0.028–0.31), respectively] compared to patients with high expression of HGF<sub>cyt</sub> and pMet<sub>cyt</sub>, and low pAkt<sub>nuc</sub> [HR: 0.36 (0.19–0.67), 0.35 (0.20–0.64) and 0.47 (0.32–0.71), respectively; interaction analyses: P = 0.052, 0.035 and 0.013, respectively]. These differences remained in multivariable analysis when adjusting for patient age, tumour size, histological grade, St Gallen subtype and systemic treatment (interaction analysis, P-values: 0.085, 0.027, and 0.023, respectively). This study suggests that patients with immunohistochemically low HGF<sub>cyt</sub>, low pMet<sub>cyt</sub> and high pAkt<sub>nuc</sub> may derive an increased benefit from RT after breast-conserving surgery concerning the risk of developing IBTR.</p>}},
  author       = {{Sjöström, Martin and Veenstra, Cynthia and Holmberg, Erik and Karlsson, Per and Killander, Fredrika and Malmström, Per and Niméus, Emma and Fernö, Mårten and Stål, Olle}},
  issn         = {{1574-7891}},
  keywords     = {{Akt; breast cancer; HGF; Met; radiotherapy; treatment prediction}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{2713--2726}},
  publisher    = {{Elsevier}},
  series       = {{Molecular Oncology}},
  title        = {{Expression of HGF, pMet, and pAkt is related to benefit of radiotherapy after breast-conserving surgery : a long-term follow-up of the SweBCG91-RT randomised trial}},
  url          = {{http://dx.doi.org/10.1002/1878-0261.12803}},
  doi          = {{10.1002/1878-0261.12803}},
  volume       = {{14}},
  year         = {{2020}},
}