Potential clinically useful prognostic biomarkers in triple-negative breast cancer: preliminary results of a retrospective analysis

Abstract

BackgroundTriple-negative breast cancer (TNBC) has a poor prognosis, even in its early stages. In the absence of postoperative targeted treatments, intensive adjuvant chemotherapy regimens are proposed. For those favorable histologies, such as apocrine and adenoid cystic carcinoma, which frequently belong to TNBC, aggressive treatments are unnecessary.Patients and methodsWe retrospectively analyzed 631 cases of breast cancer, primary operated curatively, and followed up at our institution for at least 36 months to identify the bio-markers assessable by immunohistochemistry, to be proposed as prognostic score for tailoring adjuvant treatment to TNBC patients.ResultsThe triple-negative phenotype was found in 85 patients (13.5%). Over a mean followup of 55.7 months, relapses occurred in 106 patients (16.8%), of which 18 (2.8%) were TNBC. Recurrence was directly correlated with Ki67 and cytokeratin 5/6 (CK5/6) immunoreactivity in all breast cancer patients (P=0.005), but only marginally with CK5/6 and epithelial cadherin (E-cad) expression in TNBC patients (P=0.07). Mean event-free survival (EFS) in TNBC patients was 85.52 months compared with 100.4 months in non-TNBC patients (P=0.228). The EFS of CK5/6-negative triple-negative patients was 68.84 months compared with 98.84 months in those who were CK5/6 positive (HR =5.08; P=0.038). EFS differed among patients identified as double-positive for E-cad and CK5/6 (83.87 months), those expressing E-cad or CK5/6 (64.23 months), and those negative for both biomarkers (39.64 months).ConclusionThese preliminary results suggest that CK5/6 and E-cad are possible core biomarkers for a cost-effective prognostic evaluation of primary operable TNBC patients.

Androgen Receptor mRNA levels determine the prognosis in triple-negative breast cancer patients

“…AR positivity was defined by nuclear localization in > 1% of tumor cells [11]. Nuclear Ki67 staining of < 20% was considered low risk, and > 20% was considered high risk [20].…”

Multiplexed Imaging Analysis of the Tumor-Immune Microenvironment Reveals Predictors of Outcome in Triple-Negative Breast Cancer

“…Their effectiveness is limited, necessitating further interrogation of cancer-cell cues, factors in the tumor microenvironment, and host-related influences 10 . There is a need to identify additional biomarkers of TNBC to aid prognosis and identify new immunotherapies [11][12][13] . Identifying predictors of recurrence and survival in TNBC patients would serve two critical purposes.…”

“…However, its survival estimates vary considerably because other prognostically relevant factors are excluded 13 . There is a need to identify additional biomarkers of TNBC to aid prognosis [14][15][16] . Identifying predictors of recurrence and survival in TNBC patients would allow improved patient stratification and targeted treatment plans, which would lead to better outcomes and spare patients from unnecessary aggressive therapies 17 .…”

Neoadjuvant Chemotherapy in Triple Negative Breast Cancer: Correlation between Androgen Receptor Expression and Pathological Response

“…Generally, high Ki-67 expression was significantly associated with the TNBC subtype (Ilie et al, 2018 andElnemr et al, 2016). In the current study, TNBC AR+ has lower proliferation rates and lower histological grade compared with QNBC.…”