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, 121 (12), 1009-1015

Androgen Receptor Expression and Response to Chemotherapy in Breast Cancer Patients Treated in the Neoadjuvant TECHNO and PREPARE Trial

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Androgen Receptor Expression and Response to Chemotherapy in Breast Cancer Patients Treated in the Neoadjuvant TECHNO and PREPARE Trial

Isabell Witzel et al. Br J Cancer.

Abstract

Background: The androgen receptor (AR) is discussed as a prognostic and/or predictive marker in breast cancer patients.

Methods: AR mRNA expression was analysed by RT-qPCR in breast cancer patients treated in the neoadjuvant TECHNO (n = 118, HER2-positive) and PREPARE trial (n = 321, HER2-positive and -negative). In addition, mRNA expression of the AR transcript variants 1 (AR1) and 2 (AR2) was measured.

Results: Regarding subtypes, high AR mRNA levels were frequent in HER2-positive (61.3%, 92/150) and luminal tumours (60.0%, 96/160) but almost absent in triple-negative tumours (4.3%, 3/69) (p < 0.0001). Overall, high AR mRNA levels were found to be associated with lower pathological complete remission (pCR) rates (OR 0.77 per unit, 95% CI 0.67-0.88, p = 0.0002) but also with better prognosis in terms of longer disease-free survival (DFS) (HR 0.57, 95% CI 0.39-0.85, p = 0.0054) and overall survival (OS) (HR 0.43, 95% CI, 0.26-0.71, p = 0.0011). In the PREPARE trial, a survival difference for patients with high and low AR1 mRNA levels could only be seen in the standard chemotherapy arm but not in the dose-dense treatment arm (OS: HR 0.41; 95% CI 0.22-0.74 vs. HR 1.05; 95% CI 0.52-2.13; p = 0.0459).

Conclusions: We provide evidence that AR mRNA predicts response to chemotherapy in breast cancer patients.

Conflict of interest statement

R.W. is employee of Stratifyer Molecular Oncology. V.M. received speaker honoraria from Amgen, Astra Zeneca, Celgene, Daiichi-Sankyo, Eisai, Pfizer, Novartis, Roche, Teva, and consultancy honoraria from Genomic Health, Hexal, Roche, Pierre Fabre, Amgen, Novartis, MSD, Daiichi-Sankyo and Eisai, Lilly, Tesaro and Nektar and research support from Novartis, Roche, Seattle Genetics, Genentech. All other authors declare that they have no conflict of interest.

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