Presence of Foxp3 expression in tumor cells predicts better survival in HER2-overexpressing breast cancer patients treated with neoadjuvant chemotherapy

Breast Cancer Res Treat. 2011 Jan;125(1):65-72. doi: 10.1007/s10549-010-0831-1. Epub 2010 Mar 13.


The Forkhead Box Protein 3 is highly expressed not only in regulatory T cells, but also in tumor cells, acting as a transcriptional repressor of breast oncogenes including HER2. We investigated the prognostic significance of Foxp3 expression in cancer cells in a large cohort of patients with HER2-overexpressing breast carcinoma treated with neoadjuvant chemotherapy. Foxp3-positive tumor cells were detected by immunohistochemistry in 103 patients with primary invasive HER2-overexpressing breast carcinoma, and treated with neoadjuvant chemotherapy, with or without trastuzumab. Kaplan-Meier analysis and Cox regression model were used to assess relapse-free and overall survival, respectively, and according to the presence or the absence of Foxp3 expression in tumor cells. Breast cancer cells were Foxp3+ in 57% of tumors. Foxp3 expression in breast cancer cells was associated with better relapse-free (P = 0.005) and overall survival (P = 0.03). By multivariate analysis, the presence of Foxp3+ tumor cells produced an independent prognostic factor for both better relapse-free (P = 0.006) and overall survival (P = 0.03). These findings indicate that the presence of Foxp3+ tumor cells represents a new independent prognostic factor of improved outcome in HER2-overexpressing breast carcinoma, which could help identify high-risk patients for additional therapies after neoadjuvant chemotherapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents / therapeutic use*
  • Biomarkers, Tumor / analysis*
  • Breast Neoplasms / chemistry
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Carcinoma / chemistry
  • Carcinoma / drug therapy*
  • Carcinoma / mortality
  • Carcinoma / pathology
  • Chemotherapy, Adjuvant
  • Chi-Square Distribution
  • Disease-Free Survival
  • Female
  • Forkhead Transcription Factors / analysis*
  • France
  • Humans
  • Immunohistochemistry
  • Kaplan-Meier Estimate
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Proportional Hazards Models
  • Receptor, ErbB-2 / analysis*
  • Receptor, ErbB-2 / antagonists & inhibitors
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Trastuzumab
  • Treatment Outcome
  • Up-Regulation


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Biomarkers, Tumor
  • FOXP3 protein, human
  • Forkhead Transcription Factors
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Trastuzumab