Tailored therapy of patients with breast cancer – to avoid overtreatment as well as undertreatment – is dependent on the availability of prognostic and predictive biomarkers. Dr Jasmin Zeindler (University Hospital Basel, Switzerland) and colleagues presented two new prognostic biomarkers associated with survival: nectin-4 expression on triple-negative breast cancer cells and tumour infiltration by myeloperoxidase neutrophilic cells [1,2].
Triple-negative breast cancer represents about 10–20% of all invasive breast cancers and is associated with a poor prognosis. The nectin cell-adhesion protein 4 (nectin-4) is a junction protein involved in the formation and maintenance of cell junctions. Nectin-4 has previously shown to be expressed in about 60% of triple-negative breast cancer cells as well as in triple-negative breast cancer metastases, but to be absent in normal breast tissue, which makes it a potential specific target for triple-negative breast cancer therapy. Previous studies have shown an association of nectin-4 protein expression with worse prognosis in triple-negative breast cancer in a small patient cohort
To further explore the role of nectin-4 in triple-negative breast cancer and confirm its impact on survival, Zeindler et al. now performed immunohistochemical staining for nectin-4 on tumour tissue of 112 triple-negative breast cancer cases with detailed clinical annotation and outcomes data. A high expression of nectin-4 was present in 86 (76.8%) of the triple-negative breast cancer cases. In univariate survival analysis, high expression of nectin-4 was associated with a significantly worse overall survival when compared with low expression of nectin-4 (hazard ratio 0.022; P<0.0001). No correlation of nectin-4 expression with any other clinicopathological features could be found. The authors concluded that these results confirm the role of nectin-4 as a prognostic biomarker in triple-negative breast cancer.
Myeloperoxidase (MPO) is an enzyme secreted by neutrophil granulocytes as a result of phagocytosis during inflammation. In colorectal cancer, tumour infiltration by MPO-expressing cells has been shown to be independently associated with a favourable prognosis.
To explore the role of MPO-positive cell infiltration and its prognostic significance in invasive breast cancer, Zeindler et al. performed immunohistochemical staining for MPO on tumour tissue of 928 human breast cancer samples. MPO-positive cell infiltration (≥5 cells/tissue punch) was found in 150 (16%) of the 928 evaluable breast cancer cases. In univariate survival analyses, infiltration by MPO-positive cells was associated with a significantly better overall survival (P<0.001). In subset univariate analyses, the infiltration by MPO-positive cells was associated with significantly better overall survival in the Luminal B Her2-negative subtype (P=0.005), the Her2 subtype (P=0.011), and the basal-like subtype (P<0.001). In multivariate analysis, MPO expression proved to be an independent prognostic factor for improved overall survival (P<0.001). Based on these results, Zeindler et al. conclude that infiltration of MPO-positive cells is an independent prognostic biomarker for improved overall survival in human breast cancer.
- Zeindler J, et al. The Breast 2019; 44 (suppl 1): abstract P243.
- Zeindler J, et al. The Breast 2019; 44 (suppl 1): abstract P241.
« What is the clinical benefit of treatment of patients with early breast cancer? Next Article
Letter from the Editor »
Table of Contents: BCC 2019
St. Gallen Consensus
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.