Meta-analysis of the impact of progesterone receptor status on oncological outcomes in oestrogen receptor-positive breast cancer

Abstract

Background: Assessment of the oestrogen receptor (ER) provides important prognostic information in breast cancer. The impact of progesterone receptor (PgR) status is less clear. Standardization of immunohistochemical analysis of these receptors has reduced interstudy heterogeneity. The aim of this meta-analysis was to evaluate the impact of PgR negativity on outcomes in ER-positive (ER+) breast cancer.Methods: This study was performed according to PRISMA and MOOSE guidelines. PubMed, Embase and the Cochrane Library were searched systematically to identify studies comparing disease-free survival as the primary outcome and overall survival as secondary outcome between PgR-positive (PgR+) and PgR-negative (PgR-) status in ER+ breast cancer. A meta-analysis of time-to-effect measures from included studies was undertaken.Results: Eight studies including 13 667 patients, 11 838 in the ER+PgR+ group and 1829 in the ER+PgR-group, met the inclusion criteria. Treatment characteristics did not differ significantly between the two groups. Patients in the ER+PgR-group had a higher risk of disease recurrence than those who had ER+PgR+ disease (hazard ratio (HR) 1⋅57, 95 per cent c.i. 1⋅38 to 1⋅79; P < 0⋅001). This hazard was increased in patients with human epidermal growth factor receptor 2-negative tumours (HR 1⋅62, 1⋅37 to 1⋅93; P < 0⋅001). A similar result was observed for overall survival (HR 1⋅69, 1⋅33 to 2⋅14; P < 0⋅001).Conclusion: PgR negativity is associated with significant reductions in disease-free and overall survival in ER+ breast cancer. Treatment and surveillance strategies in these patients should be tailored accordingly.

MST1R (RON) expression is a novel prognostic biomarker for metastatic progression in breast cancer patients

“…An emerging body of literature reports prognostic features of PR-negativity in BC in general [45,46] and more specifically with respect to BC recurrence [47][48][49][50]. Our analyses support poor survival for PR-negative samples and further show distinct groups of high MST1R and low MST1R expression with poorer survival outcomes in the PR-negative, MST1R High population.…”

Impact of progesterone receptor status on response to neoadjuvant chemotherapy in estrogen receptor‐positive breast cancer patients

“…As a nuclear transcription factor, progesterone receptors mediate estrogen and progesterone hormonal activity and are thought to be present in over two‐thirds of ER+ breast cancers 9 . The value of PgR status as a component of treatment planning and as a marker of prognosis has been the subject of significant debate over the last decade but more recent evidence suggests that PgR negativity in the context of ER‐positive patients adversely affects disease‐free and overall survival 10‐15 . Furthermore, a lack of consensus on the use of PgR status in prognostication has been due to significant inconsistency throughout published studies regarding the % level at which PgR status is deemed positive 16,17 .…”

Comment on: Meta-analysis of the impact of progesterone receptor status on oncological outcomes in oestrogen receptor-positive breast cancer

“…We read with great interest the article of Boland et al . The authors stated that progesterone receptor (PgR) negativity is associated with significant reductions in disease‐free survival (DFS) and overall survival in oestrogen receptor‐positive (ER+) breast cancer.…”