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Erschienen in: Cancer Chemotherapy and Pharmacology 3/2019

11.07.2019 | Original Article

A high AR:ERα or PDEF:ERα ratio predicts a sub-optimal response to tamoxifen therapy in ERα-positive breast cancer

verfasst von: Lu Cao, Guomin Xiang, Fang Liu, Cong Xu, Jing Liu, Qingxiang Meng, Shuhua Lyu, Shuling Wang, Yun Niu

Erschienen in: Cancer Chemotherapy and Pharmacology | Ausgabe 3/2019

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Abstract

Purpose

Approximately 30% oestrogen receptor alpha (ERα)-positive breast cancer (BC) patients exhibit intrinsic or recurrent resistance to adjuvant endocrine therapy with tamoxifen. The androgen receptor (AR) is expressed in about 90% of ERα-positive patients, with particularly high expression in tamoxifen-resistant tumours. Prostate-derived Ets factor (PDEF), which is a co-regulator of AR, plays a role in tamoxifen resistance in ERα-positive BC. The purpose of this research was to analyse the potential roles of AR, PDEF and ERα levels in the response to tamoxifen resistance in ERα-positive BC.

Methods

The nuclear AR:ERα and PDEF:ERα ratios were examined immunohistochemically in a cohort of 225 ERα-positive pre-menopausal BC patients who had received adjuvant tamoxifen therapy.

Results

For both AR:ERα and PDEF:ERα ratios, the optimal cutoff value was 2.0. Patients receiving adjuvant tamoxifen treatment who had a high AR:ERα (≥ 2.0) (HR = 3.90) or PDEF:ERα ratio (≥ 2.0) (HR = 2.77) had a beyond twofold increased risk of failure. Both the AR:ERα ratio (P = 0.001) and PDEF:ERα ratio (P = 0.002) were independently associated with the risk of tamoxifen treatment failure. Furthermore, both a high ratio of AR:ERα (≥ 2.0) and PDEF:ERα (≥ 2.0) were associated with shorter disease-free survival (DFS) and shorter disease-specific survival (DSS). In addition, both the AR:ERα ratio and PDEF:ERα ratio were independent predictors of DFS (both P < 0.0001) and DSS (P = 0.001 and P < 0.0001, respectively).

Conclusions

AR:ERα and PDEF:ERα ratios are independent predictors of the response to conventional ERα-directed tamoxifen endocrine therapy.
Literatur
7.
Zurück zum Zitat Ang WC, Farrell E, Vollenhoven B (2001) Effect of hormone replacement therapies and selective estrogen receptor modulators in postmenopausal women with uterine leiomyomas: a literature review. Climact J Int Menopause Soc 4(4):284–292CrossRef Ang WC, Farrell E, Vollenhoven B (2001) Effect of hormone replacement therapies and selective estrogen receptor modulators in postmenopausal women with uterine leiomyomas: a literature review. Climact J Int Menopause Soc 4(4):284–292CrossRef
13.
Zurück zum Zitat Guedj M, Marisa L, de Reynies A, Orsetti B, Schiappa R, Bibeau F, MacGrogan G, Lerebours F, Finetti P, Longy M, Bertheau P, Bertrand F, Bonnet F, Martin AL, Feugeas JP, Bieche I, Lehmann-Che J, Lidereau R, Birnbaum D, Bertucci F, de The H, Theillet C (2012) A refined molecular taxonomy of breast cancer. Oncogene 31(9):1196–1206. https://doi.org/10.1038/onc.2011.301 CrossRefPubMed Guedj M, Marisa L, de Reynies A, Orsetti B, Schiappa R, Bibeau F, MacGrogan G, Lerebours F, Finetti P, Longy M, Bertheau P, Bertrand F, Bonnet F, Martin AL, Feugeas JP, Bieche I, Lehmann-Che J, Lidereau R, Birnbaum D, Bertucci F, de The H, Theillet C (2012) A refined molecular taxonomy of breast cancer. Oncogene 31(9):1196–1206. https://​doi.​org/​10.​1038/​onc.​2011.​301 CrossRefPubMed
21.
Zurück zum Zitat Castellano I, Allia E, Accortanzo V, Vandone AM, Chiusa L, Arisio R, Durando A, Donadio M, Bussolati G, Coates AS, Viale G, Sapino A (2010) Androgen receptor expression is a significant prognostic factor in estrogen receptor positive breast cancers. Breast Cancer Res Treat 124(3):607–617. https://doi.org/10.1007/s10549-010-0761-y CrossRefPubMed Castellano I, Allia E, Accortanzo V, Vandone AM, Chiusa L, Arisio R, Durando A, Donadio M, Bussolati G, Coates AS, Viale G, Sapino A (2010) Androgen receptor expression is a significant prognostic factor in estrogen receptor positive breast cancers. Breast Cancer Res Treat 124(3):607–617. https://​doi.​org/​10.​1007/​s10549-010-0761-y CrossRefPubMed
23.
Zurück zum Zitat De Amicis F, Thirugnansampanthan J, Cui Y, Selever J, Beyer A, Parra I, Weigel NL, Herynk MH, Tsimelzon A, Lewis MT, Chamness GC, Hilsenbeck SG, Ando S, Fuqua SA (2010) Androgen receptor overexpression induces tamoxifen resistance in human breast cancer cells. Breast Cancer Res Treat 121(1):1–11. https://doi.org/10.1007/s10549-009-0436-8 CrossRefPubMed De Amicis F, Thirugnansampanthan J, Cui Y, Selever J, Beyer A, Parra I, Weigel NL, Herynk MH, Tsimelzon A, Lewis MT, Chamness GC, Hilsenbeck SG, Ando S, Fuqua SA (2010) Androgen receptor overexpression induces tamoxifen resistance in human breast cancer cells. Breast Cancer Res Treat 121(1):1–11. https://​doi.​org/​10.​1007/​s10549-009-0436-8 CrossRefPubMed
24.
Zurück zum Zitat Cochrane DR, Bernales S, Jacobsen BM, Cittelly DM, Howe EN, D’Amato NC, Spoelstra NS, Edgerton SM, Jean A, Guerrero J, Gomez F, Medicherla S, Alfaro IE, McCullagh E, Jedlicka P, Torkko KC, Thor AD, Elias AD, Protter AA, Richer JK (2014) Role of the androgen receptor in breast cancer and preclinical analysis of enzalutamide. Breast Cancer Res BCR 16(1):R7. https://doi.org/10.1186/bcr3599 CrossRefPubMed Cochrane DR, Bernales S, Jacobsen BM, Cittelly DM, Howe EN, D’Amato NC, Spoelstra NS, Edgerton SM, Jean A, Guerrero J, Gomez F, Medicherla S, Alfaro IE, McCullagh E, Jedlicka P, Torkko KC, Thor AD, Elias AD, Protter AA, Richer JK (2014) Role of the androgen receptor in breast cancer and preclinical analysis of enzalutamide. Breast Cancer Res BCR 16(1):R7. https://​doi.​org/​10.​1186/​bcr3599 CrossRefPubMed
27.
Zurück zum Zitat Oettgen P, Finger E, Sun Z, Akbarali Y, Thamrongsak U, Boltax J, Grall F, Dube A, Weiss A, Brown L, Quinn G, Kas K, Endress G, Kunsch C, Libermann TA (2000) PDEF, a novel prostate epithelium-specific Ets transcription factor, interacts with the androgen receptor and activates prostate-specific antigen gene expression. J Biolo Chem 275(2):1216–1225CrossRef Oettgen P, Finger E, Sun Z, Akbarali Y, Thamrongsak U, Boltax J, Grall F, Dube A, Weiss A, Brown L, Quinn G, Kas K, Endress G, Kunsch C, Libermann TA (2000) PDEF, a novel prostate epithelium-specific Ets transcription factor, interacts with the androgen receptor and activates prostate-specific antigen gene expression. J Biolo Chem 275(2):1216–1225CrossRef
33.
Zurück zum Zitat Peters AA, Buchanan G, Ricciardelli C, Bianco-Miotto T, Centenera MM, Harris JM, Jindal S, Segara D, Jia L, Moore NL, Henshall SM, Birrell SN, Coetzee GA, Sutherland RL, Butler LM, Tilley WD (2009) Androgen receptor inhibits estrogen receptor-alpha activity and is prognostic in breast cancer. Cancer Res 69(15):6131–6140. https://doi.org/10.1158/0008-5472.CAN-09-0452 CrossRefPubMed Peters AA, Buchanan G, Ricciardelli C, Bianco-Miotto T, Centenera MM, Harris JM, Jindal S, Segara D, Jia L, Moore NL, Henshall SM, Birrell SN, Coetzee GA, Sutherland RL, Butler LM, Tilley WD (2009) Androgen receptor inhibits estrogen receptor-alpha activity and is prognostic in breast cancer. Cancer Res 69(15):6131–6140. https://​doi.​org/​10.​1158/​0008-5472.​CAN-09-0452 CrossRefPubMed
34.
Zurück zum Zitat Panet-Raymond V, Gottlieb B, Beitel LK, Pinsky L, Trifiro MA (2000) Interactions between androgen and estrogen receptors and the effects on their transactivational properties. Mol Cell Endocrinol 167(1–2):139–150CrossRef Panet-Raymond V, Gottlieb B, Beitel LK, Pinsky L, Trifiro MA (2000) Interactions between androgen and estrogen receptors and the effects on their transactivational properties. Mol Cell Endocrinol 167(1–2):139–150CrossRef
35.
Zurück zum Zitat Pietri E, Conteduca V, Andreis D, Massa I, Melegari E, Sarti S, Cecconetto L, Schirone A, Bravaccini S, Serra P, Fedeli A, Maltoni R, Amadori D, De Giorgi U, Rocca A (2016) Androgen receptor signaling pathways as a target for breast cancer treatment. Endocr Relat Cancer 23(10):R485–R498. https://doi.org/10.1530/ERC-16-0190 CrossRefPubMed Pietri E, Conteduca V, Andreis D, Massa I, Melegari E, Sarti S, Cecconetto L, Schirone A, Bravaccini S, Serra P, Fedeli A, Maltoni R, Amadori D, De Giorgi U, Rocca A (2016) Androgen receptor signaling pathways as a target for breast cancer treatment. Endocr Relat Cancer 23(10):R485–R498. https://​doi.​org/​10.​1530/​ERC-16-0190 CrossRefPubMed
36.
Zurück zum Zitat Rizza P, Barone I, Zito D, Giordano F, Lanzino M, De Amicis F, Mauro L, Sisci D, Catalano S, Dahlman Wright K, Gustafsson JA, Ando S (2014) Estrogen receptor beta as a novel target of androgen receptor action in breast cancer cell lines. Breast Cancer Res BCR 16(1):R21. https://doi.org/10.1186/bcr3619 CrossRefPubMed Rizza P, Barone I, Zito D, Giordano F, Lanzino M, De Amicis F, Mauro L, Sisci D, Catalano S, Dahlman Wright K, Gustafsson JA, Ando S (2014) Estrogen receptor beta as a novel target of androgen receptor action in breast cancer cell lines. Breast Cancer Res BCR 16(1):R21. https://​doi.​org/​10.​1186/​bcr3619 CrossRefPubMed
38.
Zurück zum Zitat Ghadersohi A, Sood AK (2001) Prostate epithelium-derived Ets transcription factor mRNA is overexpressed in human breast tumors and is a candidate breast tumor marker and a breast tumor antigen. Clin Cancer Res 7(9):2731–2738PubMed Ghadersohi A, Sood AK (2001) Prostate epithelium-derived Ets transcription factor mRNA is overexpressed in human breast tumors and is a candidate breast tumor marker and a breast tumor antigen. Clin Cancer Res 7(9):2731–2738PubMed
39.
Zurück zum Zitat Feldman RJ, Sementchenko VI, Gayed M, Fraig MM, Watson DK (2003) Pdef expression in human breast cancer is correlated with invasive potential and altered gene expression. Cancer Res 63(15):4626–4631PubMed Feldman RJ, Sementchenko VI, Gayed M, Fraig MM, Watson DK (2003) Pdef expression in human breast cancer is correlated with invasive potential and altered gene expression. Cancer Res 63(15):4626–4631PubMed
40.
Zurück zum Zitat Feldman RJ, Sementchenko VI, Watson DK (2003) The epithelial-specific Ets factors occupy a unique position in defining epithelial proliferation, differentiation and carcinogenesis. Anticancer Res 23(3A):2125–2131PubMed Feldman RJ, Sementchenko VI, Watson DK (2003) The epithelial-specific Ets factors occupy a unique position in defining epithelial proliferation, differentiation and carcinogenesis. Anticancer Res 23(3A):2125–2131PubMed
41.
Zurück zum Zitat Viedma-Rodriguez R, Baiza-Gutman L, Salamanca-Gomez F, Diaz-Zaragoza M, Martinez-Hernandez G, Ruiz Esparza-Garrido R, Velazquez-Flores MA, Arenas-Aranda D (2014) Mechanisms associated with resistance to tamoxifen in estrogen receptor-positive breast cancer (review). Oncol Rep 32(1):3–15. https://doi.org/10.3892/or.2014.3190 CrossRefPubMed Viedma-Rodriguez R, Baiza-Gutman L, Salamanca-Gomez F, Diaz-Zaragoza M, Martinez-Hernandez G, Ruiz Esparza-Garrido R, Velazquez-Flores MA, Arenas-Aranda D (2014) Mechanisms associated with resistance to tamoxifen in estrogen receptor-positive breast cancer (review). Oncol Rep 32(1):3–15. https://​doi.​org/​10.​3892/​or.​2014.​3190 CrossRefPubMed
Metadaten
Titel
A high AR:ERα or PDEF:ERα ratio predicts a sub-optimal response to tamoxifen therapy in ERα-positive breast cancer
verfasst von
Lu Cao
Guomin Xiang
Fang Liu
Cong Xu
Jing Liu
Qingxiang Meng
Shuhua Lyu
Shuling Wang
Yun Niu
Publikationsdatum
11.07.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Cancer Chemotherapy and Pharmacology / Ausgabe 3/2019
Print ISSN: 0344-5704
Elektronische ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-019-03891-6

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