J 2007

The impact of signaling pathways stimulated by HER2 receptor on prediction of clinical outcome in metastatic breast cancer patients treated with trastuzumab.

GRELL, Peter, Marek SVOBODA, Pavel FABIAN, Lenka RADOVÁ, Marta DZIECHCIARKOVA et. al.

Basic information

Original name

The impact of signaling pathways stimulated by HER2 receptor on prediction of clinical outcome in metastatic breast cancer patients treated with trastuzumab.

Name in Czech

Význam signálních drah stimulovaných HER2 receptorem v predikci odpovědi na léčbu trastuzumabem u pacientek s metastatickým karcinomem prsu.

Authors

GRELL, Peter (703 Slovakia), Marek SVOBODA (203 Czech Republic, guarantor), Pavel FABIAN (203 Czech Republic), Lenka RADOVÁ (203 Czech Republic), Marta DZIECHCIARKOVA (203 Czech Republic), Markéta PALÁCOVÁ (203 Czech Republic), Rudolf NENUTIL (203 Czech Republic) and Rostislav VYZULA (203 Czech Republic)

Edition

Journal of Clinical Oncology, 2007, 0732-183X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 15.484

RIV identification code

RIV/00216224:14110/07:00028234

Organization unit

Faculty of Medicine

UT WoS

000208457400398

Keywords in English

breast cancer;trastuzumab;prognosis;prediction;HER-2/neu gene

Tags

International impact, Reviewed
Změněno: 14/9/2008 20:53, prof. MUDr. Marek Svoboda, Ph.D.

Abstract

V originále

Background: The overexpression of HER-2 (c-erbB2/Neu) in breast cancer is associated with poor prognosis, tumor recurrence and shortened survival. The administration of the trastuzumab significantly improves patients prognosis. However, in spite of these successful results, trastuzumab is effective only in 20-40% of cases. PI3K/Akt and Ras/MAPK signaling pathways are activated through HER-2 receptor and both play important role in tumor behavior. Methods: The study included 76 women with verified Her-2+ metastatic breast cancer (MBC) who were treated with trastuzumab based palliative chemotherapy. Immunohistochemistry was performed on formalin fixed, paraffin embedded tissue sections with antibodies against Akt-1, Akt-2, phospho(p)-Akt-Ser-473 and p-Akt-Thr-308, PTEN, S6K, p-S6K- Ser235/236, MAPK, p-MAPK-Thr202/Tyr204. Except PTEN, the cytoplasmatic and nuclear fractions were assessed separately. Results: Patients whose tumors showed high Akt-2 expression (> 80% positive cells) accompanied with nuclear and cytoplasmatic (n+c) positivity of a) p-Akt-473, b) p-Akt-308, c) or both p-Akts (p-Akt-473/308) exhibited improved TTP compared to those with any Akt-2 expression, but negative for nuclear staining of any p-Akt: a) TTP (13.1 vs 7.6 months; P<0.018, Hazard Ratio 2.09, CI95% 1.13- 3.5; b) TTP (17.1 vs 7.6 months; P<0.007, Hazard Ratio 2.41, CI95% 1.25-4.0; c) TTP (13.1 vs 7.6 months; P<0.028, Hazard Ratio 1.9, CI95% 1.12-3.49. Of the remaining results, only S6K kinase had significant impact on TTP. Activation of S6K was associated with shorter TTP. Median follow-up was 9.2 months. Conclusions: This study was the first to prove that prediction of the response to trastuzumab treatment depends on the Akt kinase iso-form, activity and compartmentalization. Patients, whose tumors had high level of Akt-2 and concurrent nuclear and cytoplasmatic presence of the activated forms of Akt kinase, had greater benefit from trastuzumab based therapy. In contrast, activation of S6K was associated with worse prognosis. Supported by the Internal Grant Agency of Ministry of Health, Czech Republic, No.NR/8335-3.

In Czech

Background: The overexpression of HER-2 (c-erbB2/Neu) in breast cancer is associated with poor prognosis, tumor recurrence and shortened survival. The administration of the trastuzumab significantly improves patients prognosis. However, in spite of these successful results, trastuzumab is effective only in 20-40% of cases. PI3K/Akt and Ras/MAPK signaling pathways are activated through HER-2 receptor and both play important role in tumor behavior. Methods: The study included 76 women with verified Her-2+ metastatic breast cancer (MBC) who were treated with trastuzumab based palliative chemotherapy. Immunohistochemistry was performed on formalin fixed, paraffin embedded tissue sections with antibodies against Akt-1, Akt-2, phospho(p)-Akt-Ser-473 and p-Akt-Thr-308, PTEN, S6K, p-S6K- Ser235/236, MAPK, p-MAPK-Thr202/Tyr204. Except PTEN, the cytoplasmatic and nuclear fractions were assessed separately. Results: Patients whose tumors showed high Akt-2 expression (> 80% positive cells) accompanied with nuclear and cytoplasmatic (n+c) positivity of a) p-Akt-473, b) p-Akt-308, c) or both p-Akts (p-Akt-473/308) exhibited improved TTP compared to those with any Akt-2 expression, but negative for nuclear staining of any p-Akt: a) TTP (13.1 vs 7.6 months; P<0.018, Hazard Ratio 2.09, CI95% 1.13- 3.5; b) TTP (17.1 vs 7.6 months; P<0.007, Hazard Ratio 2.41, CI95% 1.25-4.0; c) TTP (13.1 vs 7.6 months; P<0.028, Hazard Ratio 1.9, CI95% 1.12-3.49. Of the remaining results, only S6K kinase had significant impact on TTP. Activation of S6K was associated with shorter TTP. Median follow-up was 9.2 months. Conclusions: This study was the first to prove that prediction of the response to trastuzumab treatment depends on the Akt kinase iso-form, activity and compartmentalization. Patients, whose tumors had high level of Akt-2 and concurrent nuclear and cytoplasmatic presence of the activated forms of Akt kinase, had greater benefit from trastuzumab based therapy. In contrast, activation of S6K was associated with worse prognosis. Supported by the Internal Grant Agency of Ministry of Health, Czech Republic, No.NR/8335-3.

Links

NR8335, research and development project
Name: Predikce chemosenzitivity / chemorezistence na cílenou protinádorovou terapii u pacientek s karcinomem prsu s prokázanou HER-2 pozitivitou, na podkladě analýzy Akt signální dráhy a sérové hladiny HER-2 receptoru