Prognostic significance of androgen receptor expression in HER2-positive and triple-negative breast cancer

Abstract

Triple-negative breast cancer (TNBC) and HER2-positive breast cancer are more aggressive than other subtypes of breast cancer. Due to the limited number of treatment alternatives and the absence of target receptors in TNBC, and because of progression in the HER2-positive group despite targeted treatments, new treatment targets and therapeutic combinations are required. In this context, the present study aims to evaluate the prognostic importance of immunohistochemical androgen receptor (AR) expression in HER2-positive breast cancer and TNBC subtypes. AR nuclear staining density was evaluated immunohistochemically. A total of 111 operated patients with breast cancer were included in the study; 44 (39.6%) belonged to the HER2-positive breast cancer subgroup and 67 (60.4%) belonged to the TNBC subgroup. AR expression was 34.3% and 79.5% in TNBC and HER2-positive groups, respectively. The 5-year overall survival (OS) was 76% and 58% for the group with an AR-expression > 7.5% and AR-expression < 7.5%, respectively, in the TNBC subgroup (p = 0.042). In the HER2-positive patient group, the subgroups characterised by an AR-expression > 7.5% and AR-expression < 7.5% had 5-year OS rates of 57.6% and 63.5%, respectively (p = 0.91). Including the assessment of AR expression in the routine pathological examination will contribute to our understanding of the relevance of AR in the biology and prognosis of breast cancer.

The Effects of Low HER2/neu Expression on the Clinicopathological Characteristics of Triple-Negative Breast Cancer Patients

“…Breast cancer (BC) is referred to as type of mixed tumors with different actions, prognosis, and difficult to treat (Noman et al, 2016) Many studies reported that about 15% of BC patients are TNBC positive. This type of cancer is more aggressive than other BC types and has poorer prognosis compared to other BC types (Speers et al, 2017;Kucukzeybek et al, 2018) Recent studies revealed that BC heterogeneity extends to the classic IHC-based subtypes of ER, PR, and HER2 receptors. (Gradishar et al, 2016;Kurozumi et al, 2016) Nowadays, new treatment methods are suggested for TNBC according to new biomarkers and gene expression profile (Burstein et al, 2015;Sarin et al, 2016).…”

Androgen Receptor in Breast Cancer: From Bench to Bedside

“…Besides, patients treated with first-line trastuzumab, AR+ tumors had longer PFS (15.8 vs. 8.2 months, P = 0.005) and 5-year OS rate (66.2 vs. 26.2%, P = 0.009) compared with AR-negative subjects ( 48 ). In addition, a study involving 111 operated patients with BC revealed no significant correlations between AR expression and prognostic values in the HER2+ group ( 49 ). On the contrary, a notable finding of a meta-analysis, including three studies with 358 patients, revealed the worse clinical outcome conferred by AR expression in patients with HER2+ER-(Her2-enriched) BC ( 44 ).…”

Prognostic Significance of Androgen Receptor Expression in Triple Negative Breast Cancer: A Systematic Review and Meta-Analysis

“…[9][10][11] Nevertheless, the role of AR expression as a prognostic factor in TNBC is still controversial. In some trials, patients with TNBC with AR expression had a better prognosis [12][13][14][15][16][17][18][19][20] ; however, others indicated that AR positivity was associated with poor prognosis. [21][22][23][24][25][26] In addition, in several studies, [27][28][29][30][31][32][33][34][35][36][37][38] it was illustrated that AR expression did not correlate with the prognosis of TNBC.…”

“…39,40 In a previous meta-analysis, it was confirmed that AR positivity was associated with a lower risk of disease recurrence. 41 However, studies [12][13][14][15][21][22][23]27,28,32,[34][35][36][37][38] assessing the connection of AR expression and its prognostic value have recently been published, and have added to the inconsistent evidence. According to the Cochrane Handbook for Systematic Reviews of Interventions, 42 the meta-analysis should be updated every 2 years.…”