Prognostic and predictive value of p-Akt, EGFR, and p-mTOR in early breast cancer.

Abstract

BACKGROUND AND PURPOSE:

There are scarce data available on the prognostic/predictive value of p-Akt and p-mTOR protein expression in patients with high-risk early breast cancer.

PATIENTS AND METHODS:

Formalin-fixed paraffin-embedded (FFPE) tumor tissue samples from 997 patients participating in two adjuvant phase III trials were assessed for EGFR, PTEN, p-Akt, p-mTOR protein expression, and PIK3CA mutational status. These markers were evaluated for associations with each other and with selected patient and tumor characteristics, immunohistochemical subtypes, disease-free survival (DFS), and overall survival (OS).

RESULTS:

p-mTOR protein expression was negatively associated with EGFR and positively associated with PTEN, with p-Akt473, and with the presence of PIK3CA mutations. EGFR expression was positively associated with p-Akt473, p-Akt308, and PIK3CA wild-type tumors. Finally, p-Akt308 was positively associated with p-Akt473 expression. In univariate analysis, EGFR (p = 0.016) and the coexpression of EGFR and p-mTOR (p = 0.015) were associated with poor OS. Among patients with p-Akt308-negative or low-expressing tumors, those treated with hormonal therapy were associated with decreased risk for both relapse and death (p = 0.013 and p < 0.001, respectively). In the subgroup of patients with locoregional relapse, positive EGFR and mTOR protein expression was found to be associated with increased (p = 0.034) and decreased (p < 0.001) risk for earlier relapse, respectively. In multivariate analysis, low levels of p-Akt308 and the coexpression of EGFR and p-mTOR retained their prognostic value.

CONCLUSION:

Low protein expression of p-Akt308 was associated with improved DFS and OS among patients treated with hormonal therapy following adjuvant chemotherapy. Coexpression of EGFR and p-mTOR was associated with worse OS.

• Authors: Georgios Lazaridis, Sofia Lambaki, Georgia Karayannopoulou, Anastasia G Eleftheraki, Irene Papaspirou, Mattheos Bobos, Ioannis Efstratiou, George Pentheroudakis, Nikolaos Zamboglou, George Fountzilas
• Journal: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] (Strahlenther Onkol) Vol. 190 Issue 7 Pg. 636-8, 640-5 (Jul 2014) ISSN: 1439-099X [Electronic] Germany
• PMID: 24658605 (Publication Type: Clinical Trial, Phase III, Journal Article)

Chemical References

• Biomarkers, Tumor
• MTOR protein, human
• EGFR protein, human
• ErbB Receptors
• Oncogene Protein v-akt
• TOR Serine-Threonine Kinases

Topics

• Biomarkers, Tumor (metabolism)
• Breast Neoplasms (diagnosis, metabolism, mortality, therapy)
• Early Detection of Cancer (methods)
• ErbB Receptors (metabolism)
• Female
• Greece (epidemiology)
• Humans
• Incidence
• Oncogene Protein v-akt (metabolism)
• Prognosis
• Reproducibility of Results
• Risk Assessment (methods)
• Sensitivity and Specificity
• Survival Rate
• TOR Serine-Threonine Kinases (metabolism)