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Cascianelli S, Molineris I, Isella C, Masseroli M, Medico E. Machine learning for RNA sequencing-based intrinsic subtyping of breast cancer. Sci Rep 2020; 10:14071. [PMID: 32826944 PMCID: PMC7442834 DOI: 10.1038/s41598-020-70832-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/23/2020] [Indexed: 01/01/2023] Open
Abstract
Stratification of breast cancer (BC) into molecular subtypes by multigene expression assays is of demonstrated clinical utility. In principle, global RNA-sequencing (RNA-seq) should enable reconstructing existing transcriptional classifications of BC samples. Yet, it is not clear whether adaptation to RNA-seq of classifiers originally developed using PCR or microarrays, or reconstruction through machine learning (ML) is preferable. Hence, we focused on robustness and portability of PAM50, a nearest-centroid classifier developed on microarray data to identify five BC "intrinsic subtypes". We found that standard PAM50 is profoundly affected by the composition of the sample cohort used for reference construction, and we propose a strategy, named AWCA, to mitigate this issue, improving classification robustness, with over 90% of concordance, and prognostic ability; we also show that AWCA-based PAM50 can even be applied as single-sample method. Furthermore, we explored five supervised learners to build robust, single-sample intrinsic subtype callers via RNA-seq. From our ML-based survey, regularized multiclass logistic regression (mLR) displayed the best performance, further increased by ad-hoc gene selection on the global transcriptome. On external test sets, mLR classifications reached 90% concordance with PAM50-based calls, without need of reference sample; mLR proven robustness and prognostic ability make it an equally valuable single-sample method to strengthen BC subtyping.
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Affiliation(s)
- Silvia Cascianelli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy.
| | - Ivan Molineris
- Candiolo Cancer Institute, FPO-IRCCS, S.P. 142, km 3.95, 10060, Candiolo, TO, Italy
| | - Claudio Isella
- Candiolo Cancer Institute, FPO-IRCCS, S.P. 142, km 3.95, 10060, Candiolo, TO, Italy
| | - Marco Masseroli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy
| | - Enzo Medico
- Candiolo Cancer Institute, FPO-IRCCS, S.P. 142, km 3.95, 10060, Candiolo, TO, Italy
- Department of Oncology, University of Torino, S.P. 142, km 3.95, 10060, Candiolo, TO, Italy
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Robertson S, Acs B, Lippert M, Hartman J. Prognostic potential of automated Ki67 evaluation in breast cancer: different hot spot definitions versus true global score. Breast Cancer Res Treat 2020; 183:161-175. [PMID: 32572716 PMCID: PMC7376512 DOI: 10.1007/s10549-020-05752-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/13/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE The proliferation-associated biomarker Ki67 has potential utility in breast cancer, including aiding decisions based on prognosis, but has unacceptable inter- and intralaboratory variability. The aim of this study was to compare the prognostic potential for Ki67 hot spot scoring and global scoring using different digital image analysis (DIA) platforms. METHODS An ER+/HER2- breast cancer cohort (n = 139) with whole slide images of sequential sections stained for hematoxylin-eosin, pancytokeratin and Ki67, was analyzed using two DIA platforms. For hot spot analysis virtual dual staining was applied, aligning pancytokeratin and Ki67 images and 22 hot spot algorithms with different features were designed. For global Ki67 scoring an automated QuPath algorithm was applied on Ki67-stained whole slide images. Clinicopathological data included overall survival (OS) and recurrence-free survival (RFS) along with PAM50 molecular subtypes. RESULTS We show significant variations in Ki67 hot spot scoring depending on number of included tumor cells, hot spot size, shape and location. The higher the number of scored tumor cells, the higher the reproducibility of Ki67 proliferation values. Hot spot scoring had greater prognostic potential for RFS in high versus low Ki67 subgroups (hazard ratio (HR) 6.88, CI 2.07-22.87, p = 0.002), compared to global scoring (HR 3.13, CI 1.41-6.96, p = 0.005). Regarding OS, global scoring (HR 7.46, CI 2.46-22.58, p < 0.001) was slightly better than hot spot scoring (HR 6.93, CI 1.61-29.91, p = 0.009). In adjusted multivariate analysis, only global scoring was an independent prognostic marker for both RFS and OS. In addition, global Ki67-based surrogate subtypes reached higher concordance with PAM50 molecular subtype for luminal A and B tumors (66.3% concordance rate, κ = 0.345), than using hot spot scoring (55.8% concordance rate, κ = 0.250). CONCLUSIONS We conclude that the automated global Ki67 scoring is feasible and shows clinical validity, which, however, needs to be confirmed in a larger cohort before clinical implementation.
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Affiliation(s)
- Stephanie Robertson
- Department of Oncology and Pathology, CCK, Karolinska Institutet, R8:04, 17176, Stockholm, Sweden.
- Department of Clinical Pathology and Cytology, Karolinska University Laboratory, Stockholm, Sweden.
| | - Balazs Acs
- Department of Oncology and Pathology, CCK, Karolinska Institutet, R8:04, 17176, Stockholm, Sweden
- Department of Clinical Pathology and Cytology, Karolinska University Laboratory, Stockholm, Sweden
| | | | - Johan Hartman
- Department of Oncology and Pathology, CCK, Karolinska Institutet, R8:04, 17176, Stockholm, Sweden
- Department of Clinical Pathology and Cytology, Karolinska University Laboratory, Stockholm, Sweden
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Horimoto Y, Sasahara N, Sasaki R, Hlaing MT, Sakaguchi A, Saeki H, Arakawa A, Himuro T, Saito M. High FOXA1 protein expression might predict late recurrence in patients with estrogen-positive and HER2-negative breast cancer. Breast Cancer Res Treat 2020; 183:41-48. [PMID: 32572714 DOI: 10.1007/s10549-020-05751-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 06/13/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Multi-gene expression assays have been developed with the aim of predicting late recurrence in patients with estrogen receptor (ER)-positive breast cancer. However, establishment of alternative markers based on immunohistochemistry is also important for achieving practical use. Based on our previous study, forkhead box A1 (FOXA1) protein was tested as a potentially useful predictive marker for late recurrence. METHODS 117 patients with ER-positive HER2-negative invasive breast cancer who developed distant metastasis following curative surgery were retrospectively investigated. We also evaluated responsiveness to endocrine therapy according to FOXA1 expression. Furthermore, publicly available mRNA microarray data were analyzed to examine patterns of metastasis according to FOXA1 mRNA expression, employing the Kaplan-Meier plotter. RESULTS High expression of FOXA1 was an independent factor predicting long disease-free survival (DFS), along with small tumor size (p = 0.010 and 0.016, respectively). Discrimination of DFS was improved by combining these two factors, i.e., patients with FOXA1-high small tumors had the longest DFS while those with FOXA1-low large tumors had the shortest DFS. Moreover, we revealed that risk of distant metastasis started to increase after the completion of adjuvant endocrine therapy in patients with FOXA1-high tumors. CONCLUSION Among patients who developed distant metastasis, those with FOXA1-high tumors had significantly longer DFS. We believe our data to raise the possibility of FOXA1 being a useful predictive marker for late recurrence and to provide new insights into the biology of FOXA1-high breast cancers.
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MESH Headings
- Adult
- Aged
- Breast Neoplasms/chemistry
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Disease-Free Survival
- Estrogens
- Female
- Gene Expression Regulation, Neoplastic
- Hepatocyte Nuclear Factor 3-alpha/biosynthesis
- Hepatocyte Nuclear Factor 3-alpha/genetics
- Hepatocyte Nuclear Factor 3-alpha/physiology
- Humans
- Kaplan-Meier Estimate
- Middle Aged
- Neoplasm Invasiveness
- Neoplasm Proteins/biosynthesis
- Neoplasm Proteins/genetics
- Neoplasm Proteins/physiology
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/genetics
- Neoplasms, Hormone-Dependent/metabolism
- RNA, Messenger/biosynthesis
- RNA, Messenger/genetics
- RNA, Neoplasm/biosynthesis
- RNA, Neoplasm/genetics
- Receptor, ErbB-2/analysis
- Receptors, Estrogen/analysis
- Recurrence
- Time Factors
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Affiliation(s)
- Yoshiya Horimoto
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
- Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Noriko Sasahara
- Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Ritsuko Sasaki
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - May Thinzar Hlaing
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Asumi Sakaguchi
- Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Harumi Saeki
- Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Atsushi Arakawa
- Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Takanori Himuro
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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Floiras JL, Hacene K, Turpin F, Spyratos F. Is Adjuvant Tamoxifen Recommended in Post-Menopausal Node-Negative Breast Cancer Patients with High Estrogen Receptor Values? Int J Biol Markers 2018; 15:135-8. [PMID: 10883886 DOI: 10.1177/172460080001500202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The impact of ER levels on the response to tamoxifen was evaluated in 1,623 postmenopausal primary breast cancer patients treated at our center (median follow-up 8.2 years). In patients receiving adjuvant tamoxifen a significantly longer disease-free survival (DFS) was observed when ER levels were elevated (p<0.00001). Very high ER (>424 fmol/mg protein) appeared to be detrimental in node-negative patients not treated with tamoxifen.
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MESH Headings
- Aged
- Antineoplastic Agents, Hormonal/administration & dosage
- Antineoplastic Agents, Hormonal/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Breast Neoplasms/chemistry
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Chemotherapy, Adjuvant
- Combined Modality Therapy
- Disease-Free Survival
- Drug Evaluation
- Estrogen Antagonists/administration & dosage
- Estrogen Antagonists/therapeutic use
- Estrogens
- Female
- Humans
- Life Tables
- Lymph Node Excision
- Lymph Nodes/pathology
- Mastectomy, Modified Radical
- Mastectomy, Segmental
- Middle Aged
- Neoplasm Proteins/analysis
- Neoplasm Staging
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/surgery
- Postmenopause
- Prognosis
- Receptors, Estrogen/analysis
- Retrospective Studies
- Tamoxifen/administration & dosage
- Tamoxifen/therapeutic use
- Treatment Outcome
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Affiliation(s)
- J L Floiras
- Department of Radiotherapy, Centre René Huguenin, St-Cloud, France
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5
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Ruibal A, Schneider J, del Rio C, Arias J, Núñez MJ, Piqueras V, Tejerina A. pS2 Negativity in Postmenopausal Women with ER+PgR+ Infiltrating Ductal Breast Carcinoma is Associated with Reduced Hormone Dependence and Increased Proliferation and Aneuploidy of the Tumors. Int J Biol Markers 2018; 14:186-8. [PMID: 10569142 DOI: 10.1177/172460089901400311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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6
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Locurto P, Antona AD, Grillo A, Ciulla A, Martorana S, Cipolla C, Graceffa G, Vieni S. Primary neuroendocrine carcinoma of the breast A single Center experience and review of the literature. Ann Ital Chir 2016; 87:S2239253X1602658X. [PMID: 27905324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED Neuroendocrine carcinoma of the breast is an extremely rare tumor. A standard treatment has yet to be established because only a few cases have been reported in literature. The authors report five cases observed from January 2007 to December 2014 and a review of literature. Four patients underwent quadrantectomy and in two cases axillary nodal dissection and only one to mastectomy with axillary nodal dissection. Tumor size was from T1 to T2 with N0 to N1, according TNM classification. Pathological specimens were stained with hematoxylin and eosin and an immunohistochemical panel of antibodies (Neuron-specific enolase, Chromogranin, Synaptophysin, Estrogen and Progesterone receptors, c-erb and Ki-67). All cases showed markers positivity to Neuron-specific enolase, Chromogranin, Synaptophysin and Estrogen and Progesterone receptors were found. Ki-67 was higher than 40% in four patients. Adjuvant chemotherapy was administrated in patients with Ki-67>10%; every patients were treated with radiotherapy and with hormonal therapy too. Although Neuroendocrine breast tumor is considered a distinct entity, the best treatment seems to be correlate to the size of tumor and to the lymph node status and to Ki-67 index like the common breast cancer. KEY WORDS Diagnosis, Neuroendocrine breast carcinoma.
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MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/analysis
- Breast Neoplasms/chemistry
- Breast Neoplasms/diagnosis
- Breast Neoplasms/epidemiology
- Breast Neoplasms/therapy
- Carcinoma, Neuroendocrine/chemistry
- Carcinoma, Neuroendocrine/diagnosis
- Carcinoma, Neuroendocrine/epidemiology
- Carcinoma, Neuroendocrine/therapy
- Chemotherapy, Adjuvant
- Cisplatin/administration & dosage
- Combined Modality Therapy
- Estrogens
- Etoposide/administration & dosage
- Female
- Humans
- Mastectomy/methods
- Middle Aged
- Neoplasm Proteins/analysis
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/diagnosis
- Neoplasms, Hormone-Dependent/epidemiology
- Neoplasms, Hormone-Dependent/therapy
- Progesterone
- Radiotherapy, Adjuvant
- Radiotherapy, High-Energy
- Receptors, Steroid/analysis
- Retrospective Studies
- Sentinel Lymph Node Biopsy
- Tamoxifen/administration & dosage
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7
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Penault-Llorca F. [Breast cancer classification is evolving]. Biol Aujourdhui 2014; 208:251-9. [PMID: 25840451 DOI: 10.1051/jbio/2014028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Indexed: 11/14/2022]
Abstract
Diagnostic strategy of breast cancer has changed enormously during the last thirty years. To classical obligatory morphological data on the macroscopical and microscopical levels are now added imunocytochemistry, which is capable of detecting therapeutic targets such hormonal receptors and HER2 (Human Epidermal growth factor Receptor2), and molecular biology, which yields the molecular profile of tumors and their multigenic properties. By leaning on up-to-date classifications (TNM system and UICC grades), the pathologist is able to evaluate not only diagnostic but also pronostic criteria, leading to personalized and predictive treatments.
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8
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Lai CR, Hsu CY, Chen YJ, Yen MS, Chao KC, Li AFY. Ovarian cancers arising from endometriosis: a microenvironmental biomarker study including ER, HNF1ß, p53, PTEN, BAF250a, and COX-2. J Chin Med Assoc 2013; 76:629-34. [PMID: 23962610 DOI: 10.1016/j.jcma.2013.07.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 03/07/2013] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The microenvironmental biomarkers of different subtypes of ovarian cancers arising from endometriosis have not been studied in Taiwan. Their expression can help in understanding the carcinogenic mechanism. METHODS Our study used immunohistochemistry to compare the expression of estrogen receptor (ER), hepatocyte nuclear factor-1 beta (HNF1ß), p53, phosphatase and tensin homolog (PTEN), BAF250a, and cyclooxygenase-2 (COX-2) among 79 cases of endometriosis-associated ovarian cancers, including 40 (50%) clear cell carcinomas (CCCs), 33 (41%) endometrioid (EM) adenocarcinomas, four (5%) serous carcinomas, one adenosquamous carcinoma, and one adenosarcoma. RESULTS Positive stainings for ER, HNF1ß, p53, and COX-2 were identified in 34 (43%), 30 (38%), 10 (13%), and 44 (56%) cases. Loss of PTEN and BAF250a were noted in 29 (37%) and 37 (47%) cases. The expression of ER was reversely correlated with that of HNF1ß (rho = -0.417, p < 0.001) and correlated with p53 (rho = 0.284, p = 0.011). ER positivity was commonly identified in EM adenocarcinomas (91%), and rarely in CCCs (8%) and serous carcinoma (0%; p < 0.001). By contrast, HNF1ß expression was frequently noted in CCCs (65%) and serous carcinomas (50%), but less in EM adenocarcinoma (6%; p < 0.001). All staining results were similar between atypical endometriosis glandular epithelium and contiguous malignant parts. Only nine cases showed 10 minor differences (10/474, 2%) in ER, HNF1ß, and BAF250a. For the staining patterns of p53, COX-2, and PTEN, there was no difference between the invasive and precursor parts. CONCLUSION Our results supported the suggestion that estrogen-dependent ovarian cancer arising from endometriosis is substantially more associated with EM adenocarcinoma than CCCs. The positive HNF1ß staining was a frequent finding in CCCs, but not in EM adenocarcinoma. The similar staining patterns of atypical endometriosis glandular cells with the invasive parts confirmed their precursor status.
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Affiliation(s)
- Chiung-Ru Lai
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Pathology, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
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9
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Jiménez-Vieyra CR, Quintana-Romero V, Aguilera-Maldonado LV, Solís-Moreno TK. [Case report. Aggressive angiomyxoma of vagina. A rare tumor diagnosed]. Ginecol Obstet Mex 2013; 81:403-408. [PMID: 23971387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The case of a female patient of 35 years of age, with a pedunculated tumor dependent of the vagina, of approximately 25 x 12 x 8 cm, who had a wide resection. The report was consistent with myxoid aggressive angiomyxoma. This is a myxoid mesenchymal neoplasm of slow growth, which mainly appears in deep soft tissues of the pelvic, genital or perineal areas of adult women. It is usually diagnosed after surgical resection by histopathologic examination. Routine evaluation includes: complete physical examination, imaging and pathology report of diagnostic confirmation.
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Affiliation(s)
- Carlos Ramón Jiménez-Vieyra
- Hospital Victor Manuel Espinosa de los Reyes Sánchez, Institute Mexicano del Seguro Social (IMSS), México DF
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10
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Abu Rabi Z, Todorovic-Rakovic N, Markicevic M, Stamatovic L, Vujasinovic T, Nikolic-Vukosavljevic D. Change of influence of prognostic markers on metastasis free interval during and after adjuvant tamoxifen therapy in breast cancer patients. J BUON 2013; 18:321-327. [PMID: 23818341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE To evaluate the influence of molecular biomarkers (estrogen receptor - ER, progesterone receptor - PR, and human epidermal growth factor receptor2 - HER2) and pathological parameters on metastasis free interval (MFI) in adjuvantly tamoxifen-treated breast cancer patients, during different follow up periods (0-2.5 years, 2.5-5 years and 5-12 years). METHODS The study included 113 postmenopausal breast cancer patients with known pathological parameters. Steroid receptors were determined by ligand-binding assay and HER2 amplification status by chromogenic in situ hybridization (CISH). RESULTS During the first 2.5 years of therapy patients with ER <5 fmol/mg, PR <5 fmol/mg or pT2 (≥2cm) tumors had higher probability of distant metastasis. For the period between 2.5-5 years, analysis of MFI according to pathological parameters and molecular biomarkers, separately, did not show any statistically significant difference. Patients with pT≥2 cm and HER2 amplification had much greater chance of developing distant metastasis when compared to other phenotypes (HER2-negative/pT1, HER2-negative/pT2 and HER2-positive/pT1). Patiens with ER ≥160 fmol/mg and PR ≥45 fmol/mg had good prognosis after 5 years of tamoxifen therapy. CONCLUSION Our study indicates that there is a change of influence of the analyzed pathological parameters on MFI, depending on different follow up periods. Steroid receptor status, tumor size and HER2 status (alone or in combination) are significant parameters for the course of disease of postmenopausal ER-positive breast cancer patients, but during different periods of follow up.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents, Hormonal/therapeutic use
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Breast Neoplasms/chemistry
- Breast Neoplasms/drug therapy
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Chemotherapy, Adjuvant
- Disease-Free Survival
- Female
- Humans
- Kaplan-Meier Estimate
- Middle Aged
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/pathology
- Postmenopause
- Receptor, ErbB-2/genetics
- Receptors, Estrogen/analysis
- Receptors, Progesterone/analysis
- Risk Factors
- Tamoxifen/therapeutic use
- Time Factors
- Treatment Outcome
- Tumor Burden
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Affiliation(s)
- Z Abu Rabi
- Laboratory for Receptors and Biology of Malignant Tumors, Division of Experimental Oncology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
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11
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Inal A, Akman T, Yaman S, Demir Ozturk S, Geredeli C, Bilici M, Inanc M, Harputoglu H, Demirci U, Balakan O, Yesil Cinkir H, Alici S, Uysal Sonmez O, Goksel G, Gokoz Dogu G, Umit Unal O, Tamozlu T, Buyukberber S, Melih Boruban C, Isikdogan A. Endocrine therapy alone vs. chemotherapy plus endocrine therapies for the treatment of elderly patients with endocrine-responsive and node positive breast cancer: a retrospective analysis of a multicenter study (Anatolian Society of Medical Oncology). J BUON 2013; 18:64-69. [PMID: 23613390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE The extra benefit of adding chemotherapy to effective endocrine therapy (ET) has not been clearly or consistently identified in patients older than 70 years with estrogen receptor (ER) positive and node positive breast cancer. The aim of this study was to evaluate the efficacy of adjuvant ET vs. chemotherapy plus endocrine therapies (Chemo/ET) in such patients. METHODS In this retrospective multicenter study 191 patients ≥ 70 years with operated hormone receptor breast cancer, who were administered adjuvant ET or Chemo/ET were assessed. RESULTS The median patient follow-up time was 29.0 months (range 1-252). Therefore disease free survival (DFS) and overall survival (OS) analysis was limited, due to the rather short median follow-up, and only 30-month cumulative percentages are reported herein. The 30-month DFS rates were 50.0% in the ET arm and 49.0% in the Chemo/ET arm (p=0.79). The 30-month OS rates were 86% in the ET arm and 96.0% in the Chemo/ET arm (p=0.08). Cox proportional hazard model showed that only surgery was independent prognostic factor for survival (p=0.047), while tumor size showed a strong trend for statistical significance (p=0.051). CONCLUSION The addition of chemotherapy to endocrine therapy in older patients has no significant impact on DFS and OS.
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Affiliation(s)
- A Inal
- Dicle University, Department of Medical Oncology, Diyarbakir, Turkey.
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12
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Andreeva OE, Shcherbakov AM, Shatskaia VA, Krasil'nikov MA. [The role of transcription factor Snail1 in the regulation of hormonal sensitivity of in vitro cultured breast cancer cells]. Vopr Onkol 2012; 58:71-76. [PMID: 22629832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The loss of hormonal dependency in breast tumor cells is often accompanied by epithelial-mesenchymal transition (EMT) features and an increase in cell metastasizing and invasiveness. Here we studied the role of transcription factors Snail1--the central mediator of EMT, in the progression of hormonal resistance of breast cancer cells. The experiments were performed on the estrogen receptor(ER)-positive estrogen-dependent MCF-7 breast cancer cells, ER-positive estrogen-resistant MCF-7/LS subline generated through long-term cultivation of the parental cells in steroid-free medium, and ER-negative estrogen-resistant HBL-100 breast cancer cells. We found that decrease in the estrogen dependency of breast cancer cells is accompanied by an increase in Snail1 expression and activity, and demonstrated the Snail1 involvement in the negative regulation of ER. NF-kappaB was found to serve as a positive regulator of Snail1 in breast cancer cells, and simultaneous inhibition of NF-kappaB and Snail1 by RNA interference resulted in marked increase of cell response to antiestrogen tamoxifen. In general, the results obtained demonstrate that direct inhibition of NF-kappaB and Snail1 partially restores the estrogen receptor machinery, and show that Snail1 and NF-kappaB may serve as an important targets in the treatment of breast cancer.
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Abstract
Aromatase is the rate-limiting enzyme in estrogen biosynthesis. As a cytochrome P450, it utilizes electrons from NADPH-cytochrome P450 reductase (CPR) to produce estrogen from androgen. Estrogen is a key factor in the promotion of hormone-dependent breast cancer growth. Aromatase inhibitors (AIs) are drugs that block estrogen synthesis, and are widely used to treat estrogen-dependent breast cancer. Structure-function experiments have been performed to study how CPR and AIs interact with aromatase to further the understanding of how these drugs elicit their effects. Our studies have revealed a strong interaction between aromatase and CPR, and that the residue K108 is situated in a region important to the interaction of aromatase with CPR. The published X-ray structure of aromatase indicates that the F221, W224 and M374 residues are located in the active site. Our site-directed mutagenesis experiments confirm their importance in the binding of the androgen substrate as well as AIs, but these residues interact differently with steroidal inhibitors (exemestane) and non-steroidal inhibitors (letrozole and anastrozole). Furthermore, our results predict that the residue W224 also participates in the mechanism-based inhibition of exemestane, as time-dependent inhibition is eliminated with mutation on this residue. Together with previous research from our laboratory, this study confirms that W224, E302, D309 and S478 are important active site residues involved in the suicide mechanism of exemestane against aromatase.
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Maldonado Cid P, Sendagorta Cudós E, Noguera Morel L, Beato Merino MJ. Bilateral segmental neurofibromatosis diagnosed during pregnancy. Dermatol Online J 2011; 17:6. [PMID: 21635828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Bilateral segmental neurofibromatosis is a rare subtype of neurofibromatosis type 1 defined by lesions affecting a single segment of the body and crossing the midline, with no systemic involvement. We present a case diagnosed during pregnancy because of the characteristic increase in size of the lesions during this period.
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Affiliation(s)
- P Maldonado Cid
- Departments of Dermatology and Pathology, Hospital Universitario La Paz, Madrid, Spain.
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15
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Semilgazov VF, Manikhas AG, Semiglazov VV, Bozhok AA, Dashian GA, Ivanov VG, Paltuev RM, Vasil'ev AG, Shchedrin DE, Ermachenkova AM, Nikitina IV, Pen'kov KD, Bessonov AA, Tabagua TT, Kolar'kova VV. [Long-term results of adjuvant endocrine therapy for hormone receptor-positive breast cancer]. Vopr Onkol 2011; 57:567-577. [PMID: 22238925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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16
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Li CI, Chlebowski RT, Freiberg M, Johnson KC, Kuller L, Lane D, Lessin L, O'Sullivan MJ, Wactawski-Wende J, Yasmeen S, Prentice R. Alcohol consumption and risk of postmenopausal breast cancer by subtype: the women's health initiative observational study. J Natl Cancer Inst 2010; 102:1422-31. [PMID: 20733117 DOI: 10.1093/jnci/djq316] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Alcohol consumption is a well-established risk factor for breast cancer. This association is thought to be largely hormonally driven, so alcohol use may be more strongly associated with hormonally sensitive breast cancers. Few studies have evaluated how alcohol-related risk varies by breast cancer subtype. METHODS We assessed the relationship between self-reported alcohol consumption and postmenopausal breast cancer risk among 87 724 women in the Women's Health Initiative Observational Study prospective cohort from 1993 through 1998. Multivariable adjusted Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). All statistical tests were two-sided. RESULTS A total of 2944 invasive breast cancer patients were diagnosed during follow-up through September 15, 2005. In multivariable adjusted analyses, alcohol consumption was positively related to risk of invasive breast cancer overall, invasive lobular carcinoma, and hormone receptor-positive tumors (all P(trend) ≤ .022). However, alcohol consumption was more strongly related to risk of certain types of invasive breast cancer compared with others. Compared with never drinkers, women who consumed seven or more alcoholic beverages per week had an almost twofold increased risk of hormone receptor-positive invasive lobular carcinoma (HR = 1.82; 95% CI = 1.18 to 2.81) but not a statistically significant increased risk of hormone receptor-positive invasive ductal carcinoma (HR = 1.14; 95% CI = 0.87 to 1.50; difference in HRs per drink per day among current drinkers = 1.15; 95% CI = 1.01 to 1.32, P = .042). The absolute rates of hormone receptor-positive lobular cancer among never drinkers and current drinkers were, 5.2 and 8.5 per 10 000 person-years, respectively, whereas for hormne receptor-positive ductal cancer they were 15.2 and 17.9 per 10 000 person-years, respectively. CONCLUSIONS Alcohol use may be more strongly associated with risk of hormone-sensitive breast cancers than hormone-insensitive subtypes, suggesting distinct etiologic pathways for these two breast cancer subtypes.
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MESH Headings
- Aged
- Alcohol Drinking/adverse effects
- Biomarkers, Tumor/analysis
- Breast Neoplasms/chemistry
- Breast Neoplasms/epidemiology
- Breast Neoplasms/etiology
- Carcinoma, Ductal, Breast/chemistry
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/etiology
- Carcinoma, Lobular/chemistry
- Carcinoma, Lobular/epidemiology
- Carcinoma, Lobular/etiology
- Female
- Humans
- Middle Aged
- Multivariate Analysis
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/epidemiology
- Neoplasms, Hormone-Dependent/etiology
- Observation
- Odds Ratio
- Postmenopause
- Proportional Hazards Models
- Prospective Studies
- Receptors, Estrogen/analysis
- Receptors, Progesterone/analysis
- Risk Factors
- United States/epidemiology
- Women's Health
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Affiliation(s)
- Christopher I Li
- Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
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17
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Reich O, Regauer S, Scharf S. High levels of xenoestrogens in patients with low-grade endometrial stromal sarcoma--report of two cases. EUR J GYNAECOL ONCOL 2010; 31:105-106. [PMID: 20349793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Endometrial stromal sarcomas (ESS) are rare uterine tumors with unknown etiological risk factors, but estrogen-dependent growth promotion. CASES We present two patients with advanced ESS, who had increased levels of p,p-DDE; hexachlorobenzene; PCB 28; PCB 52; PCB 101; PCB 138; PCB 153 and PCB 180 in abdominal adipose tissue. Other xenoestrogens were within expected limits for the non-exposed European population. CONCLUSION Increased levels of xenoestrogens in patients with ESS may be involved in the pathogenesis of ESS. Chronic exposure to xenoestrogens may be a risk factor for tumor progression.
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Affiliation(s)
- O Reich
- Department of Obstetrics and Gynecology, Medical University of Graz, Austria.
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Kurian AW, McClure LA, John EM, Horn-Ross PL, Ford JM, Clarke CA. Second primary breast cancer occurrence according to hormone receptor status. J Natl Cancer Inst 2009; 101:1058-65. [PMID: 19590058 PMCID: PMC2720990 DOI: 10.1093/jnci/djp181] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Revised: 05/06/2009] [Accepted: 05/22/2009] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Contralateral second primary breast cancers occur in 4% of female breast cancer survivors. Little is known about differences in risk for second primary breast cancers related to the estrogen and progesterone receptor (hormone receptor [HR]) status of the first tumor. METHODS We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for contralateral primary breast cancers among 4927 women diagnosed with a first breast cancer between January 1, 1992, and December 31, 2004, using the National Cancer Institute's Surveillance, Epidemiology, and End Results database. RESULTS For women whose first breast tumors were HR positive, risk of contralateral primary breast cancer was elevated, compared with the general population, adjusted for age, race, and calendar year (SIR = 2.22, 95% CI = 2.15 to 2.29, absolute risk [AR] = 13 cases per 10 000 person-years [PY]), and was not related to the HR status of the second tumor. For women whose first breast tumors were HR negative, the risk of a contralateral primary tumor was statistically significantly higher than that for women whose first tumors were HR positive (SIR = 3.57, 95% CI = 3.38 to 3.78, AR = 18 per 10 000 PY), and it was associated with a much greater likelihood of an HR-negative second tumor (SIR for HR-positive second tumors = 1.94, 95% CI = 1.77 to 2.13, AR = 20 per 10 000 PY; SIR for HR-negative second tumors = 9.81, 95% CI = 9.00 to 10.7, AR = 24 per 10 000 PY). Women who were initially diagnosed with HR-negative tumors when younger than 30 years had greatly elevated risk of HR-negative contralateral tumors, compared with the general population (SIR = 169, 95% CI = 106 to 256, AR = 77 per 10 000 PY). Incidence rates for any contralateral primary cancer following an HR-negative or HR-positive tumor were higher in non-Hispanic blacks, Hispanics, and Asians or Pacific Islanders than in non-Hispanic whites. CONCLUSIONS Risk for contralateral second primary breast cancers varies substantially by HR status of the first tumor, age, and race and/or ethnicity. Women with HR-negative first tumors have nearly a 10-fold elevated risk of developing HR-negative second tumors, compared with the general population. These findings warrant intensive surveillance for second breast cancers in women with HR-negative tumors.
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Affiliation(s)
- Allison W Kurian
- Northern California Cancer Center, 2201 Walnut Ave., Fremont, CA 94538-2334, USA
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19
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MESH Headings
- Asian People/genetics
- Biomarkers, Tumor/analysis
- Breast Neoplasms/chemistry
- Breast Neoplasms/genetics
- Carcinoma, Ductal, Breast/chemistry
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Intraductal, Noninfiltrating/chemistry
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Female
- Gene Frequency
- Genetic Predisposition to Disease
- Humans
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/genetics
- Polymorphism, Single Nucleotide
- Predictive Value of Tests
- Prognosis
- Receptors, Estrogen/analysis
- White People/genetics
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21
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Fehm T, Krawczyk N, Solomayer EF, Becker-Pergola G, Dürr-Störzer S, Neubauer H, Seeger H, Staebler A, Wallwiener D, Becker S. ERalpha-status of disseminated tumour cells in bone marrow of primary breast cancer patients. Breast Cancer Res 2008; 10:R76. [PMID: 18793387 PMCID: PMC2614509 DOI: 10.1186/bcr2143] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2008] [Revised: 09/11/2008] [Accepted: 09/15/2008] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Isolated disseminated tumour cells (DTC) are regarded as surrogate markers for minimal residual disease in breast cancer. Characterisation of these cells could help understand the known limitations of adjuvant therapy. Of particular interest is their oestrogen-receptor (ER) status because endocrine adjuvant therapy remains a cornerstone of breast cancer treatment. METHODS Bone marrow (BM) aspirates from 254 patients with primary breast cancer were included in this study. A double immunofluorescence staining procedure was established for the identification of cytokeratin (CK) positive/Eralpha-positive cells. ERalpha status of the primary tumour was assessed immunohistochemically using the same antibody against ERalpha. RESULTS In 107 of 254 (42%) breast cancer patients, CK-positive cells could be detected in the BM. More than one DTC in the BM was observed in 38 of the 107 patients. The number of detected cells ranged between 1 and 55 cells per 2 x 10(6) mononuclear cells. DTCs demonstrated ERalpha positivity in 12% of the patients. The ERalpha expression was heterogeneous in 10 of the 38 (26%) patients with more than one DTC. The concordance rate of ERalpha status between primary tumour and DTC was 28%. Only 12 of 88 patients with ERalpha-positive tumours also had ERalpha-positive DTCs. CONCLUSIONS Primary tumours and DTCs displayed a concordant ERalpha status in only 28% of cases. Most of the DTCs were ERalpha negative despite the presence of an ERalpha-positive primary tumour. These findings further underline the distinct nature of DTCs and may explain the failure rates seen in conventional endocrine adjuvant therapy.
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Affiliation(s)
- Tanja Fehm
- Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, D-72076 Tuebingen, Germany
| | - Natalia Krawczyk
- Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, D-72076 Tuebingen, Germany
| | - Erich-Franz Solomayer
- Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, D-72076 Tuebingen, Germany
| | - Graziella Becker-Pergola
- Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, D-72076 Tuebingen, Germany
| | - Silke Dürr-Störzer
- Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, D-72076 Tuebingen, Germany
| | - Hans Neubauer
- Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, D-72076 Tuebingen, Germany
| | - Harald Seeger
- Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, D-72076 Tuebingen, Germany
| | - Annette Staebler
- Department of Pathology, University of Tuebingen, Liebermeisterstrasse 8, D-72076 Tuebingen, Germany
| | - Diethelm Wallwiener
- Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, D-72076 Tuebingen, Germany
| | - Sven Becker
- Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, D-72076 Tuebingen, Germany
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Caan B, Habel L, Quesenberry C, Kushi L, Herrinton L. Re: Declines in invasive breast cancer and use of postmenopausal hormone therapy in a screening mammography population. J Natl Cancer Inst 2008; 100:597-8; author reply 599. [PMID: 18398101 DOI: 10.1093/jnci/djn079] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chen JH, Nalcioglu O, Su MY. MR imaging features of invasive breast cancer correlated with hormonal receptors: does progesterone receptor matter? Ann Oncol 2008; 19:1024-6. [PMID: 18375524 DOI: 10.1093/annonc/mdn120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
MESH Headings
- Adult
- Breast Neoplasms/chemistry
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/chemistry
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Lobular/chemistry
- Carcinoma, Lobular/pathology
- Female
- Humans
- Magnetic Resonance Imaging
- Neoplasm Invasiveness
- Neoplasm Proteins/analysis
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/pathology
- Progesterone
- Receptors, Estrogen/analysis
- Receptors, Progesterone/analysis
- Retrospective Studies
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Srivastava M, Torosyan Y, Raffeld M, Eidelman O, Pollard HB, Bubendorf L. ANXA7 expression represents hormone-relevant tumor suppression in different cancers. Int J Cancer 2007; 121:2628-36. [PMID: 17708571 DOI: 10.1002/ijc.23008] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Tumor suppressor function of ubiquitously expressed Annexin-A7, ANXA7 (10q21) that is involved in exocytosis and membrane fusion was based on cancer prone phenotype in Anxa7(+/-) mice as well as ANXA7 role in human prostate and breast cancers. To clarify ANXA7 biomarker and tumor suppressor function, we analyzed its expression pattern in comparison to the prostate-specific biomarker NKX3.1. Immunohistochemistry-based ANXA7 and NKX3.1 protein expression was analyzed on human tissue microarrays of 4,061 specimens from a wide spectrum of the histopathologically well-characterized tumors in different stages compared to corresponding normal tissues. Decreased ANXA7 expression was mostly associated with high invasive potential in multiple tumors. Although some metastases retained relatively high ANXA7 rates compared to primary cancer tissues, the lymph node metastases from different sites (including prostate and breast) had decreased ANXA7 expression in comparison to the intact lymphatic tissues. Major ANXA7 downregulation pattern was deviated in tumors of glandular (especially neuroendocrine) origin. ANXA7 and NKX3.1 proteins were synexpressed in the male urogenital system and adrenal gland. Gene expression profiling in prostate and breast cancers (SMD) revealed distinct hormone-related profiles for NKX3.1 and ANXA7, where ANXA7 expression correlated with steroid sulfatase which has a pivotal role in steroidogenesis. Abundant protein presence in adrenal gland and its loss in hormone-refractory prostate cancer indicated that ANXA7 can be relevant to steroidogenesis and androgen sensitivity in particular. With tumor suppressor pattern validated in different tumors, ANXA7 can be an attractive diagnostic and therapeutic target associated with the hormone and/or neurotransmitter-mediated modulation of tumorigenesis.
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Affiliation(s)
- Meera Srivastava
- Department of Anatomy, Physiology and Genetics, and Institute for Molecular Medicine, Uniformed Services University School of Medicine (USUHS), Bethesda, MD, USA.
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Imaoka T, Nishimura M, Kakinuma S, Hatano Y, Ohmachi Y, Yoshinaga S, Kawano A, Maekawa A, Shimada Y. High Relative Biologic Effectiveness of Carbon Ion Radiation on Induction of Rat Mammary Carcinoma and its Lack of H-ras and Tp53 Mutations. Int J Radiat Oncol Biol Phys 2007; 69:194-203. [PMID: 17707273 DOI: 10.1016/j.ijrobp.2007.05.026] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2006] [Revised: 05/15/2007] [Accepted: 05/15/2007] [Indexed: 12/31/2022]
Abstract
PURPOSE The high relative biologic effectiveness (RBE) of high-linear energy transfer (LET) heavy-ion radiation has enabled powerful radiotherapy. The potential risk of later onset of secondary cancers, however, has not been adequately studied. We undertook the present study to clarify the RBE of therapeutic carbon ion radiation and molecular changes that occur in the rat mammary cancer model. METHODS AND MATERIALS We observed 7-8-week-old rats (ACI, F344, Wistar, and Sprague-Dawley) until 1 year of age after irradiation (0.05-2 Gy) with either 290 MeV/u carbon ions with a spread out Bragg peak (LET 40-90 keV/mum) generated from the Heavy-Ion Medical Accelerator in Chiba or (137)Cs gamma-rays. RESULTS Carbon ions significantly induced mammary carcinomas in Sprague-Dawley rats but less so in other strains. The dose-effect relationship for carcinoma incidence in the Sprague-Dawley rats was concave downward, providing an RBE of 2 at a typical therapeutic dose per fraction. In contrast, approximately 10 should be considered for radiation protection at low doses. Immunohistochemically, 14 of 18 carcinomas were positive for estrogen receptor alpha. All carcinomas examined were free of common H-ras and Tp53 mutations. Importantly, lung metastasis (7%) was characteristic of carbon ion-irradiated rats. CONCLUSIONS We found clear genetic variability in the susceptibility to carbon ion-induced mammary carcinomas. The high RBE for carbon ion radiation further supports the importance of precise dose localization in radiotherapy. Common point mutations in H-ras and Tp53 were not involved in carbon ion induction of rat mammary carcinomas.
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MESH Headings
- Animals
- Carbon/adverse effects
- Cesium Radioisotopes
- Dose-Response Relationship, Radiation
- Female
- Genes, p53/genetics
- Genes, ras/genetics
- Genetic Predisposition to Disease
- Heavy Ions/adverse effects
- Linear Energy Transfer
- Mammary Neoplasms, Experimental/chemistry
- Mammary Neoplasms, Experimental/etiology
- Mammary Neoplasms, Experimental/genetics
- Neoplasm Proteins/analysis
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Radiation-Induced/chemistry
- Neoplasms, Radiation-Induced/genetics
- Point Mutation
- Radiation Protection
- Rats
- Rats, Inbred ACI
- Rats, Inbred F344
- Rats, Sprague-Dawley
- Rats, Wistar
- Receptors, Estrogen/analysis
- Relative Biological Effectiveness
- Species Specificity
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Affiliation(s)
- Tatsuhiko Imaoka
- Experimental Radiobiology for Children's Health Research Group, Anagawa, Chiba, Japan.
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Tamimi RM, Byrne C, Colditz GA, Hankinson SE. Endogenous hormone levels, mammographic density, and subsequent risk of breast cancer in postmenopausal women. J Natl Cancer Inst 2007; 99:1178-87. [PMID: 17652278 DOI: 10.1093/jnci/djm062] [Citation(s) in RCA: 173] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Mammographic density and circulating sex hormones are two well-confirmed predictors of breast cancer risk. Whether mammographic density reflects levels of endogenous sex hormones is unclear. We examined whether these predictors are independently associated with breast cancer risk in a prospective study. METHODS We conducted a nested case-control study within the Nurses' Health Study cohort of 253 case subjects with breast cancer and 520 control subjects. All participants were postmenopausal women who were not using postmenopausal hormones at the time of both blood collection and mammography. Plasma levels of estradiol, free estradiol, testosterone, and free testosterone were evaluated. Mammographic density was assessed by use of computer-assisted analysis of mammograms. Logistic regression models that were adjusted for matching variables and potential confounders were used to calculate relative risks (RRs) and 95% confidence intervals (CIs). All statistical tests were two-sided. RESULTS Levels of circulating sex steroids and mammographic density were both statistically significantly and independently associated with breast cancer risk. The relative risk of breast cancer associated with mammographic density (RR for highest quartile compared with lowest quartile = 3.8, 95% CI = 2.2 to 6.6; P(trend)<.001) changed little when the analysis was adjusted for circulating estradiol (RR = 3.9, 95% CI = 2.2 to 6.9; P(trend)<.001) or circulating testosterone (RR = 4.1, 95% CI = 2.3 to 7.2; P(trend)<.001). Circulating levels of estradiol (RR = 2.4, 95% CI = 1.4 to 4.0) and of testosterone (RR = 2.0, 95% CI = 1.2 to 3.1) were both associated with breast cancer risk, before and after adjustment for mammographic density. In a joint analysis of mammographic density and plasma testosterone, the risk of breast cancer was highest in the highest tertiles of both relative to the lowest tertiles of both (RR = 6.0, 95% CI = 2.6 to 14.0). A similar pattern was observed in the joint analysis of estradiol and mammographic density (RR = 4.1, 95% CI = 1.7 to 9.8). CONCLUSIONS Circulating sex steroid levels and mammographic density appear strongly and independently associated with the risk of breast cancer in postmenopausal women.
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Affiliation(s)
- Rulla M Tamimi
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Ave, Boston, MA 02115, USA.
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Hrushesky WJM, Retsky M, Baum M, Demicheli R. Re: Prognostic value of Ki67 expression after short-term presurgical endocrine therapy for primary breast cancer. J Natl Cancer Inst 2007; 99:1053; author reply 1053-4. [PMID: 17596578 DOI: 10.1093/jnci/djm019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
MESH Headings
- Antineoplastic Agents, Hormonal/therapeutic use
- Biomarkers, Tumor
- Biopsy, Needle
- Breast Neoplasms/chemistry
- Breast Neoplasms/drug therapy
- Breast Neoplasms/immunology
- Breast Neoplasms/surgery
- Chemotherapy, Adjuvant
- Data Interpretation, Statistical
- Disease-Free Survival
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Ki-67 Antigen/analysis
- Ki-67 Antigen/metabolism
- Middle Aged
- Neoadjuvant Therapy/methods
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/immunology
- Neoplasms, Hormone-Dependent/surgery
- Time Factors
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Tanaka S, Kawamura T, Nakamura N, Teramoto K, Arii S. Mucinous cystadenocarcinoma of the pancreas developing during hormone replacement therapy. Dig Dis Sci 2007; 52:1326-8. [PMID: 17372823 DOI: 10.1007/s10620-006-9482-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2006] [Accepted: 06/11/2006] [Indexed: 12/09/2022]
Abstract
Hormone replacement therapy (HRT) containing estrogens is generally used to relieve climacteric symptoms and to prevent osteoporosis and coronary heart disease [1], however, there has been increasing evidence of the HRT as the risk of hormone-dependent neoplasms including breast cancer [2], uterine endometrial cancer [3], ovarian cancer [4], and even lung cancer [5]. Noteworthy is mucinous cyst neoplasms (MCNs) of the pancreas, characterized by mucin-producing columnar epithelium supported by "ovarian-like" mesenchymal stroma, occur mostly in females expressing estrogen receptors [6, 7]. Although several reports regarding the closed relationship between MCNs and pregnancy [8, 9] might imply potential sex hormone-dependency of the MCNs [10], no correlation has been reported. This is the first case report of malignant MCN developing during continuous HRT after hysterectomy.
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MESH Headings
- Cystadenocarcinoma, Mucinous/chemically induced
- Cystadenocarcinoma, Mucinous/chemistry
- Cystadenocarcinoma, Mucinous/pathology
- Cystadenocarcinoma, Mucinous/surgery
- Estrogen Replacement Therapy/adverse effects
- Female
- Humans
- Hysterectomy
- Inhibins/analysis
- Middle Aged
- Neoplasms, Hormone-Dependent/chemically induced
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/surgery
- Pancreatectomy
- Pancreatic Neoplasms/chemically induced
- Pancreatic Neoplasms/chemistry
- Pancreatic Neoplasms/pathology
- Pancreatic Neoplasms/surgery
- Receptors, Estrogen/analysis
- Receptors, Progesterone/analysis
- Splenectomy
- Stromal Cells/chemistry
- Stromal Cells/drug effects
- Stromal Cells/pathology
- Treatment Outcome
- Ultrasonography/methods
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Affiliation(s)
- Shinji Tanaka
- Department of Hepato-Biliary-Pancreatic Surgery, Tokyo Medical and Dental University, Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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Dowsett M, Smith IE, Ebbs SR, Dixon JM, Skene A, A'Hern R, Salter J, Detre S, Hills M, Walsh G. Prognostic value of Ki67 expression after short-term presurgical endocrine therapy for primary breast cancer. J Natl Cancer Inst 2007; 99:167-70. [PMID: 17228000 DOI: 10.1093/jnci/djk020] [Citation(s) in RCA: 473] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Tumor expression of the proliferation antigen Ki67 is widely used to assess the prognosis of cancer patients. A change in the expression of Ki67 after short-term exposure of patients to therapeutic agents is frequently used as a pharmacodynamic marker of efficacy, particularly among breast cancer patients before undergoing surgery. To determine the clinical significance of the level of tumor cell proliferation during endocrine therapy for breast cancer, we measured the expression of Ki67 in tumor biopsy samples taken before and after 2 weeks of presurgical treatment with anastrozole or tamoxifen or the combination of anastrozole plus tamoxifen in 158 patients with hormone receptor-positive primary disease. In a multivariable analysis, we found that higher Ki67 expression after 2 weeks of endocrine therapy was statistically significantly associated with lower recurrence-free survival (P = .004) whereas higher Ki67 expression at baseline was not. Larger baseline tumor size and lower estrogen receptor level after 2 weeks of treatment were also statistically significantly associated with poorer recurrence-free survival (P < .001 and P = .04, respectively). Our data indicate that measurements of tumor Ki67 level after short-term endocrine treatment may improve the prediction of recurrence-free survival by integrating the prognostic value of Ki67 level at baseline with changes in Ki67 level that are associated with treatment benefit.
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Affiliation(s)
- Mitch Dowsett
- Academic Department of Biochemistry, 4th Floor, Wallace Wing, The Royal Marsden Hospital, Fulham Road, London SW3 6 JJ, UK.
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30
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Coates AS, Keshaviah A, Thürlimann B, Mouridsen H, Mauriac L, Forbes JF, Paridaens R, Castiglione-Gertsch M, Gelber RD, Colleoni M, Láng I, Del Mastro L, Smith I, Chirgwin J, Nogaret JM, Pienkowski T, Wardley A, Jakobsen EH, Price KN, Goldhirsch A. Five years of letrozole compared with tamoxifen as initial adjuvant therapy for postmenopausal women with endocrine-responsive early breast cancer: update of study BIG 1-98. J Clin Oncol 2007; 25:486-92. [PMID: 17200148 DOI: 10.1200/jco.2006.08.8617] [Citation(s) in RCA: 662] [Impact Index Per Article: 38.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Previous analyses of the Breast International Group (BIG) 1-98 four-arm study compared initial therapy with letrozole or tamoxifen including patients randomly assigned to sequential treatment whose information was censored at the time of therapy change. Because this presentation may unduly reflect early events, the present analysis is limited to patients randomly assigned to the continuous therapy arms and includes protocol-defined updated results. PATIENTS AND METHODS Four thousand nine hundred twenty-two of the 8,028 postmenopausal women with receptor-positive early breast cancer randomly assigned (double-blind) to the BIG 1-98 trial were assigned to 5 years of continuous adjuvant therapy with either letrozole or tamoxifen; the remainder of women were assigned to receive the agents in sequence. Disease-free survival (DFS) was the primary end point. RESULTS At a median follow-up time of 51 months, we observed 352 DFS events among 2,463 women receiving letrozole and 418 events among 2,459 women receiving tamoxifen. This reflected an 18% reduction in the risk of an event (hazard ratio, 0.82; 95% CI, 0.71 to 0.95; P = .007). No predefined subsets showed differential benefit. Adverse events were similar to previous reports. Patients on tamoxifen experienced more thromboembolic events, endometrial pathology, hot flashes, night sweats, and vaginal bleeding. Patients on letrozole experienced more bone fractures, arthralgia, low-grade hypercholesterolemia, and cardiovascular events other than ischemia and cardiac failure. CONCLUSION The present updated analysis, which was limited to patients on monotherapy arms in BIG 1-98, yields results similar to those from the previous primary analysis but more directly comparable with results from other trials of continuous therapy using a single endocrine agent.
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Affiliation(s)
- Alan S Coates
- International Breast Cancer Study Group (IBCSG), IBCSG Coordinating Center, Bern, Switzerland.
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31
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Agoulnik IU, Vaid A, Nakka M, Alvarado M, Bingman WE, Erdem H, Frolov A, Smith CL, Ayala GE, Ittmann MM, Weigel NL. Androgens modulate expression of transcription intermediary factor 2, an androgen receptor coactivator whose expression level correlates with early biochemical recurrence in prostate cancer. Cancer Res 2006; 66:10594-602. [PMID: 17079484 DOI: 10.1158/0008-5472.can-06-1023] [Citation(s) in RCA: 138] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Prostate cancer is an androgen-dependent disease; metastatic prostate cancer is typically treated by androgen receptor (AR) blockade. Recurrence after androgen ablation and evidence that AR continues to play a role in many prostate cancers has led to an examination of other factors that potentiate AR activity. AR is a ligand-activated transcription factor whose activity is regulated not only by hormone but also by the levels of coactivators recruited by AR to facilitate transcription. We sought to assess the consequences of reducing expression of the transcription intermediary factor 2 (TIF2) coactivator on prostate cancer cell growth and AR action in cell lines to examine TIF2 expression in prostate cancer and to correlate expression with clinical outcome. Depletion of TIF2 reduced expression of AR-induced target genes and slowed proliferation of AR-dependent and AR-independent prostate cancer cells. Remarkably, we found that TIF2 expression is directly repressed by high levels of androgens in multiple AR-expressing cell lines. Expression of a reporter containing 5'-flanking region of the TIF2 was repressed both by androgens and by the antagonist, Casodex. Expression of TIF2 correlates with biochemical (prostate-specific antigen) recurrence (P = 0.0136). In agreement with our in vitro findings, the highest expression of TIF2 was found in patients whose cancer relapsed after androgen ablation therapy, supporting the idea that AR blockade might activate pathways that lead to stimulation of AR-dependent and AR-independent proliferation of prostate epithelium. The elevated expression of TIF2 at low hormone levels likely aids in inducing AR activity under these conditions; treatment with Casodex has the potential to counteract this induction.
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Affiliation(s)
- Irina U Agoulnik
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
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32
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Regan MM, Viale G, Mastropasqua MG, Maiorano E, Golouh R, Carbone A, Brown B, Suurküla M, Langman G, Mazzucchelli L, Braye S, Grigolato P, Gelber RD, Castiglione-Gertsch M, Price KN, Coates AS, Goldhirsch A, Gusterson B. Re-evaluating adjuvant breast cancer trials: assessing hormone receptor status by immunohistochemical versus extraction assays. J Natl Cancer Inst 2006; 98:1571-81. [PMID: 17077359 DOI: 10.1093/jnci/djj415] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Tumor levels of steroid hormone receptors, a factor used to select adjuvant treatment for early-stage breast cancer, are currently determined with immunohistochemical assays. These assays have a discordance of 10%-30% with previously used extraction assays. We assessed the concordance and predictive value of hormone receptor status as determined by immunohistochemical and extraction assays on specimens from International Breast Cancer Study Group Trials VIII and IX. These trials predominantly used extraction assays and compared adjuvant chemoendocrine therapy with endocrine therapy alone among pre- and postmenopausal patients with lymph node-negative breast cancer. Trial conclusions were that combination therapy provided a benefit to pre- and postmenopausal patients with estrogen receptor (ER)-negative tumors but not to ER-positive postmenopausal patients. ER-positive premenopausal patients required further study. METHODS Tumor specimens from 571 premenopausal and 976 postmenopausal patients on which extraction assays had determined ER and progesterone receptor (PgR) levels before randomization from October 1, 1988, through October 1, 1999, were re-evaluated with an immunohistochemical assay in a central pathology laboratory. The endpoint was disease-free survival. Hazard ratios of recurrence or death for treatment comparisons were estimated with Cox proportional hazards regression models, and discriminatory ability was evaluated with the c index. All statistical tests were two-sided. RESULTS Concordance of hormone receptor status determined by both assays ranged from 74% (kappa = 0.48) for PgR among postmenopausal patients to 88% (kappa = 0.66) for ER in postmenopausal patients. Hazard ratio estimates were similar for the association between disease-free survival and ER status (among all patients) or PgR status (among postmenopausal patients) as determined by the two methods. However, among premenopausal patients treated with endocrine therapy alone, the discriminatory ability of PgR status as determined by immunohistochemical assay was statistically significantly better (c index = 0.60 versus 0.51; P = .003) than that determined by extraction assay, and so immunohistochemically determined PgR status could predict disease-free survival. CONCLUSIONS Trial conclusions in which ER status (for all patients) or PgR status (for postmenopausal patients) was determined by immunohistochemical assay supported those determined by extraction assays. However, among premenopausal patients, trial conclusions drawn from PgR status differed--immunohistochemically determined PgR status could predict response to endocrine therapy, unlike that determined by the extraction assay.
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Affiliation(s)
- Meredith M Regan
- IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, 44 Binney St., Boston, MA 02115, USA.
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33
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Yie SM, Luo B, Ye NY, Xie K, Ye SR. Detection of Survivin-expressing circulating cancer cells in the peripheral blood of breast cancer patients by a RT-PCR ELISA. Clin Exp Metastasis 2006; 23:279-89. [PMID: 17086357 DOI: 10.1007/s10585-006-9037-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Accepted: 09/08/2006] [Indexed: 01/17/2023]
Abstract
Survivin mRNA expression was detected in 69.2%-93.8% of primary breast carcinomas, but is rarely expressed in normal breast tissues and hematopoietic cells. The objective of this study was to investigate the significance that the detection of Survinin-expressing circulating breast cancer cells in the peripheral blood has on clinical outcomes. The detection method was based on a RT-PCR ELISA technique developed in our laboratory. Sixty-seven breast cancer patients in various stages and 135 normal healthy women were investigated. Survivin-expressing circulating cancer cells were detected in the peripheral blood samples from 34 (50.7%) out of 67 breast cancer patients, but not in the healthy women that were used as controls. The presence of Survivin-expressing circulating breast cancer cells was found to be significantly associated with various clinicopathological parameters such as vessel infiltration, histological grade, tumor size, nodal status, ER/PgR status, Her-2 status and clinical stages of the disease (P < 0.01). During a follow-up period of 36 months, 9 out of 11 (81.8%) breast cancer patients that had a positive Survivin-expressing at the time of the initial assay test suffered a relapse of the disease, whereas recurrence was only found in 2 out of 6 (33.3%) breast cancer patients that had a negative Survivin-expression. Thus, the detection of circulating cancer cells expressing Survivin mRNA could provide valuable information for the prediction of metastasis and recurrence of breast cancer.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/genetics
- Breast Neoplasms/blood
- Breast Neoplasms/chemistry
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/blood
- Carcinoma, Ductal, Breast/chemistry
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/blood
- Carcinoma, Lobular/chemistry
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/secondary
- Cell Line, Tumor
- Chemotherapy, Adjuvant
- Combined Modality Therapy
- Enzyme-Linked Immunosorbent Assay
- Estrogens
- Female
- Humans
- Inhibitor of Apoptosis Proteins
- Lymphatic Metastasis
- Mastectomy
- Microtubule-Associated Proteins/blood
- Microtubule-Associated Proteins/genetics
- Middle Aged
- Neoplasm Invasiveness
- Neoplasm Proteins/blood
- Neoplasm Proteins/genetics
- Neoplasm Staging
- Neoplasms, Hormone-Dependent/blood
- Neoplasms, Hormone-Dependent/chemistry
- Neoplastic Cells, Circulating
- Predictive Value of Tests
- Progesterone
- Prognosis
- RNA, Messenger/blood
- RNA, Neoplasm/blood
- Receptor, ErbB-2/analysis
- Receptors, Estrogen/analysis
- Receptors, Progesterone/analysis
- Reverse Transcriptase Polymerase Chain Reaction
- Sensitivity and Specificity
- Survivin
- Tumor Burden
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Affiliation(s)
- Shang-Mian Yie
- Chengdu Bio-Engineering Institute for Cancer Research, Chengdu, Sichuan, PR China.
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Chong SJ, Kim SY, Kim HS, Kim GM, Kim SY, Jung JH. Cutaneous ciliated cyst in a 16-year-old girl. J Am Acad Dermatol 2006; 56:159-60. [PMID: 17097367 DOI: 10.1016/j.jaad.2006.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2006] [Revised: 08/01/2006] [Accepted: 08/03/2006] [Indexed: 12/19/2022]
Abstract
A 16-year-old girl was seen for a painless subcutaneous mass of 1 year's duration. On excisional biopsy, a collapsed cystic structure lined by stratified, ciliated, columnar epithelium was noted; findings were consistent with cutaneous ciliated cyst. Immunohistochemical staining for progesterone receptor and epithelial membrane antigen were positive, whereas it was negative for carcinoembryonic antigen, which supports the theory of heteropia of the ciliated epithelium from the Müllerian epithelium in its histopathogenesis.
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Affiliation(s)
- Su-Jean Chong
- Department of Dermatology, St. Vincent Hospital, The Catholic University, Suwon, Republic of Korea
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35
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Ghebeh H, Mohammed S, Al-Omair A, Qattan A, Lehe C, Al-Qudaihi G, Elkum N, Alshabanah M, Amer SB, Tulbah A, Ajarim D, Al-Tweigeri T, Dermime S. The B7-H1 (PD-L1) T lymphocyte-inhibitory molecule is expressed in breast cancer patients with infiltrating ductal carcinoma: correlation with important high-risk prognostic factors. Neoplasia 2006; 8:190-8. [PMID: 16611412 PMCID: PMC1578520 DOI: 10.1593/neo.05733] [Citation(s) in RCA: 461] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
B7-H1 molecule increases the apoptosis of tumor-reactive T lymphocytes and reduces their immunogenicity. Breast cancer is the second most common cause of mortality after lung cancer. Direct evidence linking B7-H1 with cancer has been shown in several malignancies; however, its expression in breast cancer has not been investigated. We used immunohistochemistry to investigate the expression of the B7-H1 molecule in 44 breast cancer specimens and to study its correlation with patients' clinicopathological parameters. The expression of B7-H1 was shown in 22 of 44 patients and was not restricted to the tumor epithelium (15 of 44, 34% in tumor cells), but was also expressed by tumor-infiltrating lymphocytes (TIL; 18 of 44, 41%). Interestingly, intratumor expression of B7-H1 was significantly associated with histologic grade III-negative (P = .012), estrogen receptor-negative (P = .036), and progesterone receptor-negative (P = .040) patients. In addition, the expression of B7-H1 in TIL was associated with large tumor size (P = .042), histologic grade III (P = .015), positivity of Her2/neu status (P = .019), and severe tumor lymphocyte infiltration (P = .001). Taken together, these data suggest that B7-H1 may be an important risk factor in breast cancer patients and may represent a potential immunotherapeutic target using monoclonal antibody against the B7-H1 molecule.
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MESH Headings
- Adult
- Aged
- Antigens, CD/analysis
- B7-H1 Antigen
- Breast Neoplasms/chemistry
- Breast Neoplasms/drug therapy
- Breast Neoplasms/epidemiology
- Breast Neoplasms/immunology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/chemistry
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/immunology
- Carcinoma, Ductal, Breast/surgery
- Cell Line, Tumor/chemistry
- Cell Line, Tumor/immunology
- Cell Line, Tumor/pathology
- Combined Modality Therapy
- Epithelial Cells/metabolism
- Estrogens
- Female
- Humans
- Lymphatic Metastasis
- Lymphocytes, Tumor-Infiltrating/metabolism
- Mastectomy
- Middle Aged
- Neoadjuvant Therapy
- Neoplasm Proteins/analysis
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/immunology
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/surgery
- Progesterone
- Prognosis
- Receptors, Estrogen/analysis
- Receptors, Progesterone/analysis
- Risk Factors
- Saudi Arabia/epidemiology
- Tumor Burden
- Tumor Escape/immunology
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Affiliation(s)
- Hazem Ghebeh
- Tumor Immunology Unit, Department of Biological and Medical Research; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Shamayel Mohammed
- Department of Pathology; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Abeer Al-Omair
- Tumor Immunology Unit, Department of Biological and Medical Research; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Amal Qattan
- Breast Cancer Unit, Department of Biological and Medical Research; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Cynthia Lehe
- Tumor Immunology Unit, Department of Biological and Medical Research; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Ghofran Al-Qudaihi
- Tumor Immunology Unit, Department of Biological and Medical Research; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Naser Elkum
- Department of Biostatistics, Epidemiology, and Scientific Computing, King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Mohamed Alshabanah
- Department of Oncology, King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Suad Bin Amer
- Breast Cancer Unit, Department of Biological and Medical Research; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Asma Tulbah
- Department of Pathology; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Dahish Ajarim
- Department of Oncology, King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Taher Al-Tweigeri
- Department of Oncology, King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Said Dermime
- Tumor Immunology Unit, Department of Biological and Medical Research; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
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36
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Gil JM, Rubio-Terrés C, Del Castillo A, González P, Canorea F. Pharmacoeconomic analysis of adjuvant therapy with exemestane, anastrozole, letrozole or tamoxifen in postmenopausal women with operable and estrogen receptor-positive breast cancer. Clin Transl Oncol 2006; 8:339-48. [PMID: 16760009 DOI: 10.1007/s12094-006-0180-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To compare the efficiency of adjuvant therapy with aromatase inhibitors or with tamoxifen in postmenopausal women with operable breast cancer and positive estrogen receptors. MATERIAL AND METHODS A cost-utility analysis was performed based on a Markov model, from the Spanish National Health Care System perspective, comparing the treatment with exemestane (EXE: 25 mg/day) or tamoxifen (TAM: 20 mg/day) after 2-3 years of monotherapy with TAM; anastrozole (ANA, 1 mg/day) or TAM (20 mg/day) without previous TAM therapy; and letrozole (LET: 2.5 mg/day) or placebo after 5 years of monotherapy with TAM. The follow-up of a hypothetical cohort of women starting treatment at 63 years of age was simulated during 10 and 20 years. The probabilities of transition between health states and quality adjusted life years (QALYs) were obtained from the literature, and the unit costs (euro corresponding to 2004) from a Spanish database. RESULTS After 10 and 20 years of follow-up, more QALYs per patient would be gained with the EXE scheme (0.230-0.286 and 0.566-0.708, respectively) than with ANA (0.114 and 0.285) and LET (0.176 and 0.474). The cost of gaining one QALY was lower with the EXE scheme (50,801-62,522 euro and 28,849- 35,371 euro, respectively) than with ANA (104,272 euro and 62,477 euro) and LET (91,210 euro and 49,460 euro). The result was stable for the cost per life-year gained (LYG) and in the sensitivity analysis. CONCLUSIONS The EXE scheme after TAM is more cost-effective than the ANA and LET schemes.
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MESH Headings
- Anastrozole
- Androstadienes/economics
- Androstadienes/therapeutic use
- Antineoplastic Agents, Hormonal/economics
- Antineoplastic Agents, Hormonal/therapeutic use
- Aromatase Inhibitors/economics
- Aromatase Inhibitors/therapeutic use
- Breast Neoplasms/chemistry
- Breast Neoplasms/drug therapy
- Breast Neoplasms/economics
- Breast Neoplasms/surgery
- Chemotherapy, Adjuvant/economics
- Cohort Studies
- Computer Simulation
- Cost-Benefit Analysis
- Estrogen Antagonists/economics
- Estrogen Antagonists/therapeutic use
- Estrogens
- Fees, Pharmaceutical
- Female
- Follow-Up Studies
- Humans
- Letrozole
- Markov Chains
- Middle Aged
- Models, Theoretical
- Neoplasm Proteins/analysis
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/economics
- Neoplasms, Hormone-Dependent/surgery
- Nitriles/economics
- Nitriles/therapeutic use
- Postmenopause
- Quality-Adjusted Life Years
- Randomized Controlled Trials as Topic/statistics & numerical data
- Receptors, Estrogen/analysis
- Tamoxifen/economics
- Tamoxifen/therapeutic use
- Triazoles/economics
- Triazoles/therapeutic use
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Affiliation(s)
- J M Gil
- Oncology Unit-Unidad Funcional de Mama, Institut Catalá d'Oncología, L'Hospitalet, Barcelona, Spain
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Kikugawa T, Kinugasa Y, Shiraishi K, Nanba D, Nakashiro KI, Tanji N, Yokoyama M, Higashiyama S. PLZF regulates Pbx1 transcription and Pbx1-HoxC8 complex leads to androgen-independent prostate cancer proliferation. Prostate 2006; 66:1092-9. [PMID: 16637071 DOI: 10.1002/pros.20443] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Promyelocytic leukemia zinc finger (PLZF) protein, a transcriptional repressor and negative regulator of the cell cycle, has been characterized as a prostatic androgen-responsive gene. DU145 cells show androgen-independent growth and lack PLZF gene expression. METHODS We analyzed PLZF-regulating genes by DNA microarray using DU145 cells infected with LacZ- or PLZF-carrying adenoviruses. RESULTS DNA microarray revealed that Pbx1 is a prominent suppressed gene in PLZF-overexpressing DU145 cells. Androgen receptor (AR)-expressing DU145 cells recovered androgen-dependent PLZF expression and subsequent repression of Pbx1 expression. Immunoprecipitation of Pbx1 in DU145 cells revealed a Pbx1-HoxC8 heterocomplex. siRNAs for Pbx1 and HoxC8 knocked downexpression of each, and this suppressed androgen-independent cell growth. Double knockdown of both Pbx1 and HoxC8 suppressed cell growth much more significantly. CONCLUSIONS Androgen-independent cell line DU145 cells lack PLZF gene expression, resulting in the upregulation of Pbx1 and HoxC8 expression. The Pbx1-HoxC8 heterocomplex may lead to androgen-independent growth in prostate cancer.
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MESH Headings
- Androgens/physiology
- Blotting, Western
- Cell Cycle/genetics
- Cell Cycle/physiology
- Cell Line, Tumor
- Cell Proliferation
- DNA, Neoplasm/analysis
- DNA, Neoplasm/genetics
- DNA-Binding Proteins/analysis
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/physiology
- Down-Regulation
- Gene Expression Profiling
- Gene Expression Regulation, Neoplastic/drug effects
- Gene Expression Regulation, Neoplastic/physiology
- Genes, Tumor Suppressor/physiology
- Homeodomain Proteins/analysis
- Homeodomain Proteins/genetics
- Homeodomain Proteins/physiology
- Humans
- Kruppel-Like Transcription Factors
- Male
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/genetics
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/physiopathology
- Oligonucleotide Array Sequence Analysis
- Pre-B-Cell Leukemia Transcription Factor 1
- Promyelocytic Leukemia Zinc Finger Protein
- Prostatic Neoplasms/chemistry
- Prostatic Neoplasms/genetics
- Prostatic Neoplasms/pathology
- Prostatic Neoplasms/physiopathology
- Protein Binding
- Proto-Oncogene Proteins/analysis
- Proto-Oncogene Proteins/genetics
- Proto-Oncogene Proteins/physiology
- RNA, Small Interfering/pharmacology
- Reverse Transcriptase Polymerase Chain Reaction
- Transcription Factors/analysis
- Transcription Factors/genetics
- Transcription Factors/physiology
- Transcription, Genetic/physiology
- Transfection
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Affiliation(s)
- Tadahiko Kikugawa
- Department of Biochemistry and Molecular Genetics, Ehime University School of Medicine, Shitsukawa, To-on, Ehime, Japan
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Abstract
BACKGROUND Phosphatase and tensin homolog deleted on chromosome 10 (PTEN) is lost as a function of prostate tumor androgen dependence. While the transcriptional activity of the androgen receptor (AR) is inhibited by PTEN in androgen sensitive prostate cancer (CaP), the role of PTEN in androgen disease is unclear. METHODS We developed a system where PTEN can be conditionally re-expressed at physiologic levels into a PTEN null metastatic human CaP cell line, C4-2, and androgen responsiveness examined. RESULTS PTEN induction reduces cell growth and blocks the growth effect of synthetic androgen R1881. The anti-androgen Casodex enhances the growth-inhibitory action of PTEN and this effect is independent of Akt phosphorylation. Combined PTEN induction and Casodex, result in a further decrease in prostate specific antigen promoter activity compared to PTEN but not Casodex alone. CONCLUSIONS PTEN induction confers androgen independent CaP cells enhanced responsiveness to the anti-proliferative effects of anti-androgens and this action may involve non-AR mediated effects.
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MESH Headings
- Androgen Antagonists/pharmacology
- Androgen Receptor Antagonists
- Androgens/physiology
- Anilides/pharmacology
- Blotting, Western
- Cell Cycle/drug effects
- Cell Cycle/physiology
- Cell Line, Tumor
- Cell Proliferation/drug effects
- Doxycycline/pharmacology
- Gene Expression Regulation, Neoplastic/physiology
- Genes, Tumor Suppressor/physiology
- Humans
- Male
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/genetics
- Neoplasms, Hormone-Dependent/physiopathology
- Nitriles
- Oncogene Protein v-akt/physiology
- PTEN Phosphohydrolase/analysis
- PTEN Phosphohydrolase/genetics
- PTEN Phosphohydrolase/physiology
- Phosphatidylinositol 3-Kinases/physiology
- Promoter Regions, Genetic/genetics
- Promoter Regions, Genetic/physiology
- Prostate-Specific Antigen/genetics
- Prostate-Specific Antigen/physiology
- Prostatic Neoplasms/chemistry
- Prostatic Neoplasms/genetics
- Prostatic Neoplasms/physiopathology
- Receptors, Androgen/physiology
- Signal Transduction/drug effects
- Signal Transduction/physiology
- Tosyl Compounds
- Transfection
- Tumor Suppressor Protein p53/analysis
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Affiliation(s)
- Z Wu
- Department of Molecular Physiology and Biological Physics, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908, USA
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Nobert GS, Kraak MM, Crawford S. Estrogen dependent growth inhibitory effects of tamoxifen but not genistein in solid tumors derived from estrogen receptor positive (ER+) primary breast carcinoma MCF7: single agent and novel combined treatment approaches. Bull Cancer 2006; 93:E59-66. [PMID: 16873071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
While many studies have documented tamoxifen's benefits as an adjuvant therapy in the treatment and prevention of recurrent breast cancer in estrogen receptor positive (ER+) breast carcinoma, this beneficial effect may decrease with long-term tamoxifen use. This experimental study was designed to compare the cytotoxic responses of ER+ primary breast cancer solid tumors derived from the MCF7 cell line to experimental therapeutics, including genistein, tamoxifen, all-trans retinoic acid (ATRA) and parthenolide in the presence and absence of exogenous beta-estradiol. The results of this study suggest that the growth inhibitory effects of tamoxifen, were dependent on beta-estradiol levels. In contrast, the cytotoxic effects of the isoflavone soy derivative, genistein, were observed to be independent of exogenous estrogen. Moreover, combined therapy using tamoxifen and genistein produced enhanced cytotoxic effects also independent of beta-estradiol levels. Additional studies involving the use of the novel agents all trans retinoic acid (ATRA) and parthenolide produced notable tumor responses and combined effects that were also estrogen-independent. Overall, these preclinical research findings suggest possible clinical applications suggesting that genistein might be a useful clinical adjuvant, particularly in post-menopausal women in whom breast cancer occurs more frequently. Moreover, this research suggests that combined treatment approaches involving the use of tamoxifen in conjunction with agents that inhibit NFkappaB pathway signaling, such as parthenolide and genistein, warrant further study.
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Affiliation(s)
- Gayle S Nobert
- Department of Biology, Cancer Biology Laboratory, Southern Connecticut State University, New Haven, CT 06515, USA
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Terry S, Queires L, Gil-Diez-de-Medina S, Chen MW, Taille ADL, Allory Y, Tran PL, Abbou CC, Buttyan R, Vacherot F. Protocadherin-PC promotes androgen-independent prostate cancer cell growth. Prostate 2006; 66:1100-13. [PMID: 16637074 PMCID: PMC2660890 DOI: 10.1002/pros.20446] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Protocadherin-PC (PCDH-PC) expression is upregulated in apoptosis-resistant sublines of the LNCaP human prostate cancer (CaP) cell line. Here, we assess the role of PCDH-PC in CaP cells and its mRNA expression in human prostate tissues. METHODS LNCaP cells transfected with PCDH-PC were tested for their ability to grow in vitro and in vivo in androgen-deprived conditions. PCDH-PC mRNA expression was evaluated by semi-quantitative RT-PCR and by in situ hybridization. RESULTS PCDH-PC expression induced Wnt signaling in CaP cells and permitted androgen-independent growth of hormone-sensitive CaP cells. Expression of PCDH-PC-homologous transcripts was low and restricted to some epithelial cells in normal tissue and to CaP cells in tumors. However, hormone-resistant CaP cells expressed significantly higher levels of PCDH-PC-related mRNA. CONCLUSIONS Our findings suggest a novel mechanism for the progression of CaP involving expression of PCDH-PC. This novel protocadherin induces Wnt signaling, promotes malignant behavior and hormone-resistance of CaP cells.
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Affiliation(s)
- Stephane Terry
- Department of Urology and Pathology of CHU Henri Mondor, INSERM E 03-37, Université Paris XII, Centre de Recherches Chirurgicales, Assistance Publique des Hôpitaux de Paris, Créteil, France
| | - Luis Queires
- Department of Urology and Pathology of CHU Henri Mondor, INSERM E 03-37, Université Paris XII, Centre de Recherches Chirurgicales, Assistance Publique des Hôpitaux de Paris, Créteil, France
- Department of Sciences, State University of Bahia, Salvador Bahia, Brazil
| | - Sixtina Gil-Diez-de-Medina
- Department of Urology and Pathology of CHU Henri Mondor, INSERM E 03-37, Université Paris XII, Centre de Recherches Chirurgicales, Assistance Publique des Hôpitaux de Paris, Créteil, France
| | - Min-Wei Chen
- Departments of Urology and Pathology of the College of Physicians and Surgeons of Columbia University, New York, New York
| | - Alexandre de la Taille
- Department of Urology and Pathology of CHU Henri Mondor, INSERM E 03-37, Université Paris XII, Centre de Recherches Chirurgicales, Assistance Publique des Hôpitaux de Paris, Créteil, France
| | - Yves Allory
- Department of Urology and Pathology of CHU Henri Mondor, INSERM E 03-37, Université Paris XII, Centre de Recherches Chirurgicales, Assistance Publique des Hôpitaux de Paris, Créteil, France
| | - Phuong-Lan Tran
- SATIE, UMR 8029, Ecole Normale Supérieure de Cachan, Cachan, France
| | - Claude C. Abbou
- Department of Urology and Pathology of CHU Henri Mondor, INSERM E 03-37, Université Paris XII, Centre de Recherches Chirurgicales, Assistance Publique des Hôpitaux de Paris, Créteil, France
| | - Ralph Buttyan
- Departments of Urology and Pathology of the College of Physicians and Surgeons of Columbia University, New York, New York
| | - Francis Vacherot
- Department of Urology and Pathology of CHU Henri Mondor, INSERM E 03-37, Université Paris XII, Centre de Recherches Chirurgicales, Assistance Publique des Hôpitaux de Paris, Créteil, France
- Correspondence to: Dr. Francis Vacherot, INSERM E 03 37, Faculté de Médecine, 8 rue du Général Sarrail, 94010 Créteil, France. E-mail:
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Kojima S, Mulholland DJ, Ettinger S, Fazli L, Nelson CC, Gleave ME. Differential regulation of IGFBP-3 by the androgen receptor in the lineage-related androgen-dependent LNCaP and androgen-independent C4-2 prostate cancer models. Prostate 2006; 66:971-86. [PMID: 16541420 DOI: 10.1002/pros.20420] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Despite evidence implicating insulin-like growth factor binding protein-3 (IGFBP-3) as a growth inhibitor of prostate cancer (CaP), little is known about changes in its regulation and function during progression to androgen independence. METHODS The expression levels of IGFBP-3 were determined by cDNA microarray analysis and tissue microarrays (TMAs) after androgen ablations. LNCaP (LN-BP3) and C4-2 (C4-2-BP3) sublines were used to compare the apoptotic effects of IGFBP-3 in LNCaP (androgen-dependent) and C4-2 (androgen-independent) cells. RESULTS After androgen deprivation, IGFBP-3 mRNA levels increased more in C4-2 compared to LNCaP cells. Androgens suppressed IGFBP-3 levels in a dose-dependent manner in LNCaP and C4-2 cell. IGFBP-3 expression was increased after NHT in human CaP tissues. Apoptotic rates increased in LN-BP3, but not C4-2-BP3 cells, following doxycycline-mediated IGFBP-3 induction. CONCLUSIONS C4-2 cell survival in an androgen-depleted environment may be facilitated through differential resistance to the apoptotic effects elicited by IGFBP-3.
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MESH Headings
- Androgens/pharmacology
- Androgens/physiology
- Apoptosis/genetics
- Apoptosis/physiology
- Cell Line, Tumor
- Cell Lineage
- Cell Survival
- Disease Progression
- Dose-Response Relationship, Drug
- Doxycycline/pharmacology
- Gene Expression Regulation, Neoplastic/drug effects
- Gene Expression Regulation, Neoplastic/physiology
- Humans
- Insulin-Like Growth Factor Binding Protein 3/genetics
- Insulin-Like Growth Factor Binding Protein 3/physiology
- Male
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/genetics
- Neoplasms, Hormone-Dependent/pathology
- Oligonucleotide Array Sequence Analysis
- Prostatic Neoplasms/chemistry
- Prostatic Neoplasms/genetics
- Prostatic Neoplasms/pathology
- RNA, Messenger/analysis
- RNA, Messenger/genetics
- Receptors, Androgen/physiology
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Affiliation(s)
- Satoko Kojima
- The Prostate Centre, Vancouver General Hospital, Vancouver, British Columbia, Canada
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Rae JM, Johnson MD, Cordero KE, Scheys JO, Larios JM, Gottardis MM, Pienta KJ, Lippman ME. GREB1 is a novel androgen-regulated gene required for prostate cancer growth. Prostate 2006; 66:886-94. [PMID: 16496412 DOI: 10.1002/pros.20403] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Gene regulated in breast cancer 1 (GREB1) is a novel estrogen-regulated gene shown to play a pivotal role in hormone-stimulated breast cancer growth. GREB1 is expressed in the prostate and its putative promoter contains potential androgen receptor (AR) response elements. METHODS We investigated the effects of androgens on GREB1 expression and its role in androgen-dependent prostate cancer growth. RESULTS Real-time PCR demonstrated high level GREB1 expression in benign prostatic hypertrophy (BPH), localized prostate cancer (L-PCa), and hormone refractory prostate cancer (HR-PCa). Androgen treatment of AR-positive prostate cancer cells induced dose-dependent GREB1 expression, which was blocked by anti-androgens. AR binding to the GREB1 promoter was confirmed by chromatin immunoprecipitation (ChIP) assays. Suppression of GREB1 by RNA interference blocked androgen-stimulated LNCaP cell proliferation. CONCLUSIONS GREB1 is expressed in proliferating prostatic tissue and prostate cancer, is regulated by androgens, and suppression of GREB1 blocks androgen-induced growth suggesting GREB1 may be critically involved in prostate cancer proliferation.
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MESH Headings
- Androgens/pharmacology
- Cell Line, Tumor
- Cell Proliferation/drug effects
- Chromatin Immunoprecipitation
- DNA, Neoplasm/drug effects
- DNA, Neoplasm/genetics
- Dose-Response Relationship, Drug
- Estrogens/pharmacology
- Gene Expression Regulation, Neoplastic/drug effects
- Humans
- Male
- Neoplasm Proteins/analysis
- Neoplasm Proteins/genetics
- Neoplasm Proteins/physiology
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/genetics
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/physiopathology
- Oligonucleotide Array Sequence Analysis
- Prostatic Neoplasms/chemistry
- Prostatic Neoplasms/genetics
- Prostatic Neoplasms/pathology
- Prostatic Neoplasms/physiopathology
- RNA, Messenger/analysis
- RNA, Messenger/genetics
- RNA, Small Interfering/pharmacology
- Reverse Transcriptase Polymerase Chain Reaction
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Affiliation(s)
- James M Rae
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA.
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43
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Han W, Han MR, Kang JJ, Bae JY, Lee JH, Bae YJ, Lee JE, Shin HJ, Hwang KT, Hwang SE, Kim SW, Noh DY. Genomic alterations identified by array comparative genomic hybridization as prognostic markers in tamoxifen-treated estrogen receptor-positive breast cancer. BMC Cancer 2006; 6:92. [PMID: 16608533 PMCID: PMC1459182 DOI: 10.1186/1471-2407-6-92] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Accepted: 04/12/2006] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND A considerable proportion of estrogen receptor (ER)-positive breast cancer recurs despite tamoxifen treatment, which is a serious problem commonly encountered in clinical practice. We tried to find novel prognostic markers in this subtype of breast cancer. METHODS We performed array comparative genomic hybridization (CGH) with 1,440 human bacterial artificial chromosome (BAC) clones to assess copy number changes in 28 fresh-frozen ER-positive breast cancer tissues. All of the patients included had received at least 1 year of tamoxifen treatment. Nine patients had distant recurrence within 5 years (Recurrence group) of diagnosis and 19 patients were alive without disease at least 5 years after diagnosis (Non-recurrence group). RESULTS Potential prognostic variables were comparable between the two groups. In an unsupervised clustering analysis, samples from each group were well separated. The most common regions of gain in all samples were 1q32.1, 17q23.3, 8q24.11, 17q12-q21.1, and 8p11.21, and the most common regions of loss were 6q14.1-q16.3, 11q21-q24.3, and 13q13.2-q14.3, as called by CGH-Explorer software. The average frequency of copy number changes was similar between the two groups. The most significant chromosomal alterations found more often in the Recurrence group using two different statistical methods were loss of 11p15.5-p15.4, 1p36.33, 11q13.1, and 11p11.2 (adjusted p values < 0.001). In subgroup analysis according to lymph node status, loss of 11p15 and 1p36 were found more often in Recurrence group with borderline significance within the lymph node positive patients (adjusted p = 0.052). CONCLUSION Our array CGH analysis with BAC clones could detect various genomic alterations in ER-positive breast cancers, and Recurrence group samples showed a significantly different pattern of DNA copy number changes than did Non-recurrence group samples.
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MESH Headings
- Adult
- Aged
- Antineoplastic Agents, Hormonal/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Breast Neoplasms/chemistry
- Breast Neoplasms/drug therapy
- Breast Neoplasms/genetics
- Breast Neoplasms/radiotherapy
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/chemistry
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Chemotherapy, Adjuvant
- Chromosomes, Artificial, Bacterial
- Cluster Analysis
- Combined Modality Therapy
- Cyclophosphamide/administration & dosage
- DNA, Neoplasm/genetics
- Disease-Free Survival
- Estrogen Receptor Modulators/therapeutic use
- Estrogens
- Female
- Fluorouracil/administration & dosage
- Humans
- Life Tables
- Mastectomy
- Methotrexate/administration & dosage
- Middle Aged
- Neoplasm Metastasis
- Neoplasm Proteins/analysis
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/genetics
- Neoplasms, Hormone-Dependent/radiotherapy
- Neoplasms, Hormone-Dependent/surgery
- Nucleic Acid Hybridization
- Oligonucleotide Array Sequence Analysis
- Prognosis
- Radiotherapy, Adjuvant
- Receptors, Estrogen/analysis
- Tamoxifen/therapeutic use
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Affiliation(s)
- Wonshik Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Mi-Ryung Han
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | | | - Ji-Yeon Bae
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | | | | | - Jeong Eon Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyuk-Jae Shin
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Ki-Tae Hwang
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Sung-Eun Hwang
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Sung-Won Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Young Noh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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He ML, Yuan HQ, Jiang AL, Gong AY, Chen WW, Zhang PJ, Young CYF, Zhang JY. Gum mastic inhibits the expression and function of the androgen receptor in prostate cancer cells. Cancer 2006; 106:2547-55. [PMID: 16691616 DOI: 10.1002/cncr.21935] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Accumulating evidence suggests that the androgen receptor (AR) may play an important role in the development and progression of prostate cancer. To find new, useful compounds that effectively may attenuate the function of AR in prostate cancer cells, the authors investigated the effect of gum mastic, a natural resin, on AR activity. An androgen-responsive prostate cancer cell line LNCaP was used as a model for this study. Gene transfer, reverse transcriptase-polymerase chain reaction analysis, electrophoretic mobility shift assay, and Western blot analysis were used to test the effect of gum mastic on the expression and function of the AR. To demonstrate the inhibitory effect of gum mastic on the function of the AR, the expression of androgen-regulated genes, including prostate-specific antigen (PSA), human kallikrein 2 (hK2), and NKX3.1 were measured. In addition, transient transfection assays with the PSA promoter and the AR promoter also were used to test the effects of mastic. The results showed that gum mastic inhibited the expression of the AR at the transcriptional level, resulting in the down-regulation of both AR messenger RNA and protein levels. Therefore, the function of the AR was inhibited, as reflected by the reduced expression of NKX3.1 and PSA and by androgen-stimulated growth. Because gum mastic exhibited a strong in vitro potency to attenuate the expression and function of the AR, further investigation will be required to determine whether this naturally occurring substance has in vivo potency to inhibit prostate cancer development.
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MESH Headings
- Androgens/pharmacology
- Blotting, Western
- Cell Line, Tumor
- Cell Proliferation/drug effects
- Cyclin D1/genetics
- Cyclin D1/physiology
- Disease Progression
- Electrophoretic Mobility Shift Assay
- Gene Expression Regulation, Neoplastic/drug effects
- Homeodomain Proteins/genetics
- Homeodomain Proteins/physiology
- Humans
- Male
- Mastic Resin
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/genetics
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/physiopathology
- Promoter Regions, Genetic/genetics
- Prostate-Specific Antigen/analysis
- Prostate-Specific Antigen/genetics
- Prostatic Neoplasms/genetics
- Prostatic Neoplasms/physiopathology
- Prostatic Neoplasms/prevention & control
- Protein Binding/drug effects
- Receptors, Androgen/analysis
- Receptors, Androgen/drug effects
- Receptors, Androgen/genetics
- Receptors, Androgen/physiology
- Resins, Plant/pharmacology
- Reverse Transcriptase Polymerase Chain Reaction
- Tissue Kallikreins/genetics
- Tissue Kallikreins/physiology
- Transcription Factors/genetics
- Transcription Factors/physiology
- Transcription, Genetic/drug effects
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Affiliation(s)
- Mei-Lan He
- Institute of Cancer Research, Life Science School, Tongji University, Shanghai, People's Republic of China
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45
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MESH Headings
- Animals
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/pharmacology
- Antibodies, Monoclonal, Humanized
- Antineoplastic Combined Chemotherapy Protocols/pharmacology
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Breast Neoplasms/chemistry
- Breast Neoplasms/drug therapy
- Clinical Trials as Topic
- Drug Resistance, Neoplasm
- Estradiol/administration & dosage
- Estradiol/analogs & derivatives
- Estrogens
- Female
- Fulvestrant
- Gefitinib
- Humans
- Mice
- Neoplasm Proteins/analysis
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/drug therapy
- Prognosis
- Quinazolines/administration & dosage
- Quinazolines/pharmacology
- Receptor Cross-Talk
- Receptor, ErbB-2/analysis
- Receptor, ErbB-2/antagonists & inhibitors
- Receptors, Estrogen/analysis
- Receptors, Estrogen/antagonists & inhibitors
- Tamoxifen/administration & dosage
- Trastuzumab
- Tumor Cells, Cultured/drug effects
- Tumor Escape
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Zeina A Nahleh
- Division of Hematology-Oncology, University of Cincinnati Medical Center, The Barrett Cancer Center, Cincinnati, OH 45267, USA.
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46
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Abstract
BACKGROUND Androgen-dependent prostate cancer (PrCa) xenograft models are required to study PrCa biology in the clinically relevant in vivo environment. METHODS Human PrCa tissue from a femoral bone metastasis biopsy (BM18) was grown and passaged subcutaneously through male severe combined immune-deficient (SCID) mice. Human mitochondria (hMt), prostate specific antigen (PSA), androgen receptor (AR), cytokeratin-18 (CK-18), pan-cytokeratin, and high molecular weight-cytokeratin (HMW-CK) were assessed using immunohistochemistry (IHC). Surgical castration was performed to examine androgen dependence. Serum was collected pre- and post-castration for monitoring of PSA levels. RESULTS BM18 stained positively for hMt, PSA, AR, CK-18, pan keratin, and negatively for HMW-CK, consistent with the staining observed in the original patient material. Androgen-deprivation induced tumor regression in 10/10 castrated male SCID mice. Serum PSA levels positively correlated with BM18 tumor size. CONCLUSIONS BM18 expresses PSA and AR, and rapidly regresses in response to androgen withdrawal. This provides a new clinically significant PrCa model for the study of androgen-dependent growth.
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Affiliation(s)
- Daniel R McCulloch
- Bernard O'Brien Institute of Microsurgery, University of Melbourne, Fitzroy, Australia
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47
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Lai JS, Brown LG, True LD, Hawley SJ, Etzioni RB, Higano CS, Ho SM, Vessella RL, Corey E. Metastases of prostate cancer express estrogen receptor-beta. Urology 2005; 64:814-20. [PMID: 15491740 DOI: 10.1016/j.urology.2004.05.036] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2004] [Accepted: 05/25/2004] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine estrogen receptor-beta (ERbeta) expression in prostate cancer (CaP) metastases, thereby providing a basis for conducting estrogen therapy studies in patients with metastatic CaP. Advanced androgen-independent CaP is a serious health problem with no effective treatment at present. Estrogens have been reported to inhibit the growth of CaP cells in androgen-free environments. Recent reports have shown that the prostatic epithelium and primary CaP cells express ERbeta, with decreased expression of ERbeta accompanying CaP progression. It has been proposed that ERbeta may play a role in the growth regulation of prostate cells. The targeting of ERs by selective ER modulators might be an effective method of treating advanced CaP. METHODS The anti-ERbeta antibody GC17 was used in immunohistochemistry to characterize the expression of ERbeta in CaP metastasis specimens (n = 60) obtained from 20 patients who had died of CaP. Statistical analyses were performed to evaluate the association of ERbeta expression with clinical parameters, including prostate-specific antigen levels, radiotherapy, and estrogen exposure. RESULTS Nuclear ERbeta staining was detected in all bone CaP metastases (33 of 33) and nonosseous CaP metastases (27 of 27). However, a large variability in the percentage of immunoreactive cells (5% to 100%) was found among patients, as well as among individual patient samples. A statistically significant negative association between nuclear ERbeta staining and estrogen exposure (P = 0.05) was detected. CONCLUSIONS Our data have shown that ERbeta is expressed in CaP metastases, validating the initiation of studies to evaluate selective ER modulators for treatment of advanced CaP.
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Affiliation(s)
- Janice S Lai
- Department of Urology, University of Washington School of Medicine, Seattle, Washington 98195, USA
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48
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Sánchez Salmón A, Argibay S, Arias JI, Ruibal A. [Cytosolic pS2 levels and cellular proliferation in ER-positive and PgR-positive infiltrating ductal carcinomas of the breast]. ACTA ACUST UNITED AC 2005; 24:185-90. [PMID: 15847785 DOI: 10.1157/13073789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The trefoil factor 1 (TFF1/pS2) is an estrogen-induced molecule in breast tumours. We wanted to study its expression in ER+ and PgR+ infiltrating ductal carcinomas of the breast (IDCs), and to correlate it with other clinical-biological parameters and the outcome. MATERIAL AND METHODS Cytosolic pS2 levels were measured using an IRMA (CIS. Biointernational. France) in 170 tumors. Likewise we determined the cytosolic levels of cathepsin D and tissue-type plasminogen activator (t-PA), as well as the concentrations of the epidermal growth factor receptor (EGFR), erbB2 oncoprotein, CD44v5 and CD44v6 on cell surfaces. Also the tumour size, histological grade (HG), axillary lymph node involvement, distant metastasis, ploidy, DNA index and of cellular synthesis phase (SP) was taken in account. RESULTS The pS2-positive (> 5 ng/mg prot.) tumours showed higher concentrations of cathepsin D (p: 0.0043) and t-PA (p: 0.0089) than the pS2-negative ones. Likewise, they were less frequently HG3 (p: 0.0231), SP > 7 % (p: 0.0005) and SP > 14% (p:0.0014). During the follow-up time (r: 1-147; 50,1+/-31,7; median 37 months) the pS2-positive tumors showed a less number of recurrences (5/101 vs 6/69; p: 0.059) but not of deaths by the tumor (1/101 vs 2/69). CONCLUSIONS These results support an inverse relationship between pS2 positivity and cellular proliferation in IDCs and suggest a new role of this protein (different of the hormone dependence) in the biology of these breast carcinomas, while further studies will be required to establish the impact of this finding on their outcome.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Aneuploidy
- Breast Neoplasms/chemistry
- Breast Neoplasms/classification
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/chemistry
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/pathology
- Cathepsin D/analysis
- Cell Division
- Cytosol/chemistry
- DNA, Neoplasm/analysis
- Disease-Free Survival
- ErbB Receptors/analysis
- Estrogens
- Female
- Follow-Up Studies
- Glycoproteins/analysis
- Humans
- Hyaluronan Receptors/analysis
- Middle Aged
- Neoplasm Proteins/analysis
- Neoplasm Proteins/physiology
- Neoplasm Staging
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/mortality
- Neoplasms, Hormone-Dependent/pathology
- Progesterone
- Prognosis
- Receptor, ErbB-2/analysis
- Receptors, Estrogen/analysis
- Receptors, Progesterone/analysis
- Tissue Plasminogen Activator/analysis
- Trefoil Factor-1
- Tumor Suppressor Proteins/analysis
- Tumor Suppressor Proteins/physiology
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Affiliation(s)
- A Sánchez Salmón
- Servicio de Medicina Nuclear, Hospital Clínico Universitario, 15706 Santiago de Compostela
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Li R, Wheeler T, Dai H, Frolov A, Thompson T, Ayala G. High level of androgen receptor is associated with aggressive clinicopathologic features and decreased biochemical recurrence-free survival in prostate: cancer patients treated with radical prostatectomy. Am J Surg Pathol 2004; 28:928-34. [PMID: 15223964 DOI: 10.1097/00000478-200407000-00013] [Citation(s) in RCA: 141] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prostate cancer (PCa) is androgen dependent and is regulated by androgen/androgen receptor (AR) signaling pathway. However, the clinical significance of AR is in question. In this regard, we have correlated levels of AR expression with some well-established clinical and pathologic parameters and assessed the prognostic value of AR expression in PCa patients treated with radical prostatectomy. DESIGN A total of 640 cases treated with radical prostatectomy were used to build tissue microarrays. Normal prostate tissue, benign prostatic hyperplasia, and index tumor were cored in triplicate (0.6 mm). An array (2 mm) of 177 metastatic PCa was built as well. Slides were immunostained with an antibody to AR and Ki-67 and digitized. Correlations between AR expression and clinicopathologic variables were analyzed by the Spearman test. Biochemical recurrence-free survival analysis was performed using Kaplan-Meier analysis, and Cox proportional hazard regression was used to determine the probability of disease recurrence. RESULTS AR was found in epithelial nuclei of both benign and cancer tissues. AR index was higher in normal prostate tissues than that in PCa and benign prostatic hyperplasia and decreased in metastases than PCa. High level of AR expression was correlated with clinical stage, lymph node status, extracapsular extension, seminal vesicle invasion, and Gleason score. High levels of AR status also correlated with high Ki-67 index (r = 0.211, P = 0.0000). By Kaplan-Meier actuarial model, high expression of AR was predictive of a higher probability of recurrence (P = 0.0046, hazards ratio 2.72 [confidence interval 1.28-4.011]). By multivariate analysis, a high level of AR expression was an independent prognostic indicator of biochemical recurrence-free survival (P = 0.0042; hazards ratio 2.422 [confidence interval 1.32-4.44]). CONCLUSIONS High levels of AR are associated with increased proliferation, markers of aggressive disease and are predictive of decreased biochemical recurrence-free survival independently. This confirms the role of AR in tumor growth and progression in hormonally naive PCa.
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Affiliation(s)
- Rile Li
- Department of Pathology, Baylor College of Medicine, Houston, TX 77030, USA
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50
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Nuzzo A. [Breast cancer adjuvants: results of a DUR (drug utilization research) study]. Suppl Tumori 2004; 3:S86-7. [PMID: 15206223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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