Comparison of two oestrogen receptor assays in the prediction of the clinical course of patients with advanced breast cancer

Robertson, J. F. R.; Bates, Kaitlyn; Pearson, Derek; Blamey, R.W.; Nicholson, Robert Ian

doi:10.1038/bjc.1992.153

Cited by 47 publications

(31 citation statements)

References 21 publications

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“…Immunohistochemistry has both several advantages and limitations with regards to the DCC method, a theme widely discussed elsewhere (Pertschuk et al, 1985;McClelland et al, 1986;Hurlimann et al, 1993;de Mascarel et al, 1995). As previously reported by some authors (McCarty et al, 1985;Pertschuk et al, 1985Pertschuk et al, , 1990McClelland et al, 1986;Robertson et al, 1992b;Hurlimann et al, 1993) (Henry et al, 1989(Henry et al, , 1991Schwartz et al, 1991;Hurlimann et al, 1993;Wilson et al, 1994) except one (Luqmani et al, 1993), we confirm in our series the relevance of pS2 to predict tamoxifen-related tumour regression, especially when combined with ER r12 1124 status. We also note that pS2 alone was as predictive as ER alone and that pS2 expression was not linked to ER status.…”

Section: Discussionsupporting

confidence: 80%

pS2 protein: a marker improving prediction of response to neoadjuvant tamoxifen in post-menopausal breast cancer patients

Soubeyran

Quénel²,

Coindre³

et al. 1996

Br J Cancer

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Summary Tamoxifen as sole initial therapy is gaining importance in the management of post-menopausal breast cancer patients. Age, oestrogen (ER) and progesterone (PR) receptor status are accurately considered to select patients for hormonal treatment. However, additional markers are needed. By immunohistochemistry (IHC), we studied tumour expression of ER, PR, pS2, c-erbB-2 and glutathione S-transferase 7r (GSTh) on initial core biopsies of 208 post-menopausal patients with a non-metastatic invasive ductal carcinoma, treated by neoadjuvant tamoxifen therapy. A good response to tamoxifen was defined as tumoral regression >50% (110 patients). Relationship between response and age, tumour size, T, N, histological grade, ER and PR contents evaluated by radioimmunoassay, ER, PR, pS2, c-erbB-2 and GSTx expression evaluated by IHC were studied. Univariate and multivariate analysis showed that tumoral regression was linked only to pS2 (P = 0.004) and ER (P=0.018) IHC expression. According to the immunohistochemical profile, three groups could be defined: pS2-and ER-positive tumours, pS2-or ER-positive tumours and pS2-and ER-negative tumours with response rates of 60%, 45% and 8% respectively. Although prospective studies are needed to confirm these results, we conclude that pS2 and ER immunohistochemical status are useful tools for predicting tumour regression with neoadjuvant tamoxifen in post-menopausal breast carcinoma patients.

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Section: Discussionsupporting

confidence: 80%

pS2 protein: a marker improving prediction of response to neoadjuvant tamoxifen in post-menopausal breast cancer patients

Soubeyran

Quénel²,

Coindre³

et al. 1996

Br J Cancer

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“…However, cytosol-based biochemical methods are not highly specific (Helin et al, 1990). In breast carcinoma, immunohistochemical methods appear more sensitive, as they allow a better prediction of responsivness of the hormone therapy (Robertson et al, 1992). In analogy to breast carcinoma, we were able to demonstrate heterogeneous expression of ER and PR in…”

Section: Discussionmentioning

confidence: 62%

Expression of oestrogen and progesterone receptors in low-grade endometrial stromal sarcomas

et al. 2000

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We analysed oestrogen receptor (ER) and progesterone receptor (PR) expression in a retrospective series of 21 low-grade endometrial stromal sarcomas (LGSSs). Archival formalin-fixed and paraffin-embedded material was analysed by immunohistochemistry. ER and PR were measured with monoclonal antibodies and the peroxidase-antiperoxidase method and a score was calculated as for breast carcinoma based on both the percentage of positive tumour cell nuclei and the staining intensity. ER were seen in 15 (71%) and PR in 20 (95%) of tumours respectively. ER expression was scored as high in three (14%), moderate in four (19%), and low in eight (38%) tumours. Six (29%) tumours did not stain for ER and all of these were positive for PR. PR expression was scored as high in eight (38%), moderate in ten (47%) and weak in two (10%) LGSSs. Only one (5%) LGSS did not stain for PR (this tumour was positive for ER). ER and PR expression in LGSS is heterogeneous. This may have implications for hormone therapy in the management of these tumours. These results suggest that ER and PR should be routinely quantified in LGSSs by immunohistochemical methods. © 2000 Cancer Research Campaign

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“…The ER-ICA allowed assessment of tumour tissue sections (King and Green, 1984;Walker et al, 1988 (McCarty et al, 1986;Walker et al, 1988). This led to studies defining the number of ER-positive cells that a tumour required to accurately predict therapeutic response to endocrine therapy (Walker et al, 1988; Gaskell et al., 1989;Nicholson et al, 1991;Robertson et al, 1992 (Kiang and Kennedy, 1977;Tilley et al, 1978;Silfversward et al, 1980;Straus et al, 1982; Davis et al, 1984). This intra-tumour, intersample receptor variation was not time dependent as the multiple biopsies were taken from each tumour at the same time.…”

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confidence: 99%

“…The response rate for ER-negative tumours has varied for LBA between 0% and 17% (Walt et al, 1976;Lippman and Allegra, 1980;Osborne et al, 1980;Paridaens et al, 1980;Williams et al, 1987;Anderson et al, 1989), for EIA 8% (Robertson et al, 1992) and for ICA between 0% and 11% (Jonat et al, 1986;McClelland et al, 1986a,b;Robertson et al, 1992). As noted above PgR subdivides ER-positive tumours.…”

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confidence: 99%

Oestrogen receptor: a stable phenotype in breast cancer

Robertson

1996

Br J Cancer

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127

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Summary Oestrogen receptor (ER) expression in breast cancer is regarded as a phenotype that may change during the natural history of the disease or during endocrine therapy. It has been suggested that in up to 70% of tumours that show acquired resistance the mechanism may be changed in ER status from positive to negative. This paper proposes an alternative hypothesis that ER expression is a stable phenotype in breast cancer. The paper reviews the literature on ER expression during the natural history of breast cancer in patients and also presents data on the effect of endocrine therapy on ER expression. If the alternative hypothesis is true it has important implications for treatment from chemoprevention to acquired endocrine resistance in advanced disease. Equally, if the hypothesis is true, attempts to develop laboratory models of endocrine resistance where ER-positive tumours become ER negative need to be re-evaluated.Keywords: breast cancer; oestrogen receptor; stable phenotypeThe oestrogen receptor (ER) is a 65 kDa oestrogen-binding protein expressed by 46-77% of breast cancers (Walt et al., 1976;Knight et al., 1977; Maynard et al., 1978;Brooks et al., 1980;Osborne et al., 1980; Croton et al., 1981;Howell et al., 1984;Hawkins et al.,1987a;Williams et al., 1987;Clarke and McGuire, 1988). It is a generally held view that ER expression is not a permanent phenotype in breast cancer cells Moolgavakar et al., 1980; Encarnacion et al., 1993; Morrow and Jordon, 1993;Nomura et al., 1985;Jordan, 1994;Paik et al., 1994). One reason for this view is the belief that patients with ER-positive primary breast tumours often develop ER-negative metastases in regional lymph nodes or distant sites. This has been interpreted to show that ER negativity correlates with more aggressive tumour biology and loss of cellular control. A second reason is the strong correlation between ER and therapeutic response to primary endocrine therapy (Samaan et al., 1981;Howell et al., 1984;Williams et al., 1987), which formed the basis for early hypotheses of endocrine sensitivity and resistance. Up to 60% of ER-positive tumours respond to hormone therapy (e.g. Tamoxifen), while for ER-negative tumours the figure is around 10% Samaan et al., 1981;Williams et al., 1987). Therapeutic response to endocrine therapy is not permanent and eventually all such tumours progress. As ER negativity is strongly associated with primary resistance to endocrine therapy it is generally accepted that when responding tumours subsequently progress that in the majority of tumours this is due to loss of ER expression by the tumour Moolgavakar et al., 1980;Nomura et al., 1985; Encarnacion et al., 1993;Morrow and Jordan, 1993;Jordan, 1994;Paik et al., 1994). This paper proposes the alternative hypothesis that ER is a stable phenotype in breast cancer cells.The discovery of monoclonal antibodies (Kohler and Milstein, 1975) subsequently led to specific antibodies being raised to ER (Green and Jensen, 1982 . The ER-ICA allowed assessment of tumour tissue sections (King ...

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Comparison of two oestrogen receptor assays in the prediction of the clinical course of patients with advanced breast cancer

Cited by 47 publications

References 21 publications

pS2 protein: a marker improving prediction of response to neoadjuvant tamoxifen in post-menopausal breast cancer patients

pS2 protein: a marker improving prediction of response to neoadjuvant tamoxifen in post-menopausal breast cancer patients

Expression of oestrogen and progesterone receptors in low-grade endometrial stromal sarcomas

Oestrogen receptor: a stable phenotype in breast cancer

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