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Buisseret L, Pommey S, Allard B, Garaud S, Bergeron M, Cousineau I, Ameye L, Bareche Y, Paesmans M, Crown JPA, Di Leo A, Loi S, Piccart-Gebhart M, Willard-Gallo K, Sotiriou C, Stagg J. Clinical significance of CD73 in triple-negative breast cancer: multiplex analysis of a phase III clinical trial. Ann Oncol 2019; 29:1056-1062. [PMID: 29145561 DOI: 10.1093/annonc/mdx730] [Citation(s) in RCA: 121] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background CD73 is an ecto-enzyme that promotes tumor immune escape through the production of immunosuppressive extracellular adenosine in the tumor microenvironment. Several CD73 inhibitors and adenosine receptor antagonists are being evaluated in phase I clinical trials. Patients and methods Full-face sections from formalin-fixed paraffin-embedded primary breast tumors from 122 samples of triple-negative breast cancer (TNBC) from the BIG 02-98 adjuvant phase III clinical trial were included in our analysis. Using multiplex immunofluorescence and image analysis, we assessed CD73 protein expression on tumor cells, tumor-infiltrating leukocytes and stromal cells. We investigated the associations between CD73 protein expression with disease-free survival (DFS), overall survival (OS) and the extent of tumor immune infiltration. Results Our results demonstrated that high levels of CD73 expression on epithelial tumor cells were significantly associated with reduced DFS, OS and negatively correlated with tumor immune infiltration (Spearman's R= -0.50, P < 0.0001). Patients with high levels of CD73 and low levels of tumor-infiltrating leukocytes had the worse clinical outcome. Conclusions Taken together, our study provides further support that CD73 expression is associated with a poor prognosis and reduced anti-tumor immunity in human TNBC and that targeting CD73 could be a promising strategy to reprogram the tumor microenvironment in this BC subtype.
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Affiliation(s)
- L Buisseret
- Research Centre, University of Montreal Hospital, Montréal, Canada; Montreal Cancer Institute, Montréal, Canada; Faculty of Pharmacy, Université de Montréal, Montréal, Canada; Molecular Immunology Unit, Brussels, Belgium; Breast Cancer Translational Research Laboratory J-C Heuson, Brussels, Belgium
| | - S Pommey
- Research Centre, University of Montreal Hospital, Montréal, Canada; Montreal Cancer Institute, Montréal, Canada; Faculty of Pharmacy, Université de Montréal, Montréal, Canada
| | - B Allard
- Research Centre, University of Montreal Hospital, Montréal, Canada; Montreal Cancer Institute, Montréal, Canada; Faculty of Pharmacy, Université de Montréal, Montréal, Canada
| | - S Garaud
- Molecular Immunology Unit, Brussels, Belgium
| | - M Bergeron
- Research Centre, University of Montreal Hospital, Montréal, Canada; Montreal Cancer Institute, Montréal, Canada; Faculty of Pharmacy, Université de Montréal, Montréal, Canada
| | - I Cousineau
- Research Centre, University of Montreal Hospital, Montréal, Canada; Montreal Cancer Institute, Montréal, Canada; Faculty of Pharmacy, Université de Montréal, Montréal, Canada
| | - L Ameye
- Data Centre, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Y Bareche
- Breast Cancer Translational Research Laboratory J-C Heuson, Brussels, Belgium
| | - M Paesmans
- Data Centre, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - J P A Crown
- Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - A Di Leo
- Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - S Loi
- Division of Clinical Medicine and Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - M Piccart-Gebhart
- Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | - C Sotiriou
- Breast Cancer Translational Research Laboratory J-C Heuson, Brussels, Belgium
| | - J Stagg
- Research Centre, University of Montreal Hospital, Montréal, Canada; Montreal Cancer Institute, Montréal, Canada; Faculty of Pharmacy, Université de Montréal, Montréal, Canada.
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Buisseret L, Pommey S, Allard B, Garaud S, Bergeron MA, Cousineau I, Ameye L, Paesmans M, Crown JPA, Di Leo A, Piccart-Gebhart M, Willard-Gallo K, Sotiriou C, Stagg J. Abstract PD6-07: Clinical significance of CD73 expression in triple-negative breast cancer from the BIG 02-98 adjuvant phase III clinical trial. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd6-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: CD73 is an ecto-enzyme that promotes tumor immune escape through the production of immunosuppressive extracellular adenosine in the tumor microenvironment. Several CD73 inhibitors and adenosine receptor antagonists are being evaluated in phase I clinical trials.
Objective: To investigate the prognosis significance of CD73 in human triple-negative breast cancer.
Design and setting: This is a prospective-retrospective biomarker analysis. Using multiplex immunofluorescence and image analysis, we assessed CD73 protein expression on tumor cells, tumor-infiltrating leukocytes and stromal cells on full-face sections from formalin-fixed paraffin-embedded primary breast tumors.
Participants: 122 samples of triple-negative breast cancer from the BIG 02-98 adjuvant phase III clinical trial were included in our analysis. This trial compared the addition of taxanes to anthracyclines-based chemotherapy in node-positive breast cancer.
Results: Our results demonstrated that high levels of CD73 expression on epithelial tumor cells were significantly associated with reduced disease-free survival (DFS) and overall survival (OS) in patients with triple-negative breast cancer. Using the median as a threshold between low and high levels of CD73 on epithelial cells, hazard ratios (HR) adjusted for grade, number of positive lymph nodes and tumor size, were of 2.21 (95% confidence interval (CI): 1.15-4.25); p=0.02 for DFS and of 2.47 (95%CI: 1.21-5.07); p=0.01 for OS. CD73 expression negatively correlated with tumor immune infiltration (Spearman's R= -0.50, p<0.0001). Patients with high levels of CD73 and low levels of tumor-infiltrating leukocytes had the worse clinical outcome (HR: 4.24 (1.90-9.45), p<0.001 for DFS, HR: 3.91 (1.65-9.31), p=0.002 for OS) compared to patients with low CD73 and high tumor-immune infiltration. Flow cytometric analysis of tumor-infiltrating leukocytes revealed a high frequency of CD73-expressing B cells and higher CD73 expression on tumor-infiltrating myeloid cells and natural killer cells compared to peripheral blood.
Conclusion and relevance: Taken together, our study provides further support that CD73 expression is associated with a poor prognosis and reduced anti-tumor immunity in human triple-negative breast cancer and that targeting CD73 could be a promising strategy to reprogram the tumor microenvironment in this breast cancer subtype.
Citation Format: Buisseret L, Pommey S, Allard B, Garaud S, Bergeron MA, Cousineau I, Ameye L, Paesmans M, Crown JPA, Di Leo A, Piccart-Gebhart M, Willard-Gallo K, Sotiriou C, Stagg J. Clinical significance of CD73 expression in triple-negative breast cancer from the BIG 02-98 adjuvant phase III clinical trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD6-07.
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Affiliation(s)
- L Buisseret
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - S Pommey
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - B Allard
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - S Garaud
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - MA Bergeron
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - I Cousineau
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - L Ameye
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - M Paesmans
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - JPA Crown
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - A Di Leo
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - M Piccart-Gebhart
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - K Willard-Gallo
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - C Sotiriou
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - J Stagg
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
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