Prognostic significance of RACGAP1 mRNA expression in high-risk early breast cancer: a study in primary tumors of breast cancer patients participating in a randomized Hellenic Cooperative Oncology Group trial.

Abstract

PURPOSE:

RACGAP1 is a Rac GTPase-activating protein involved in cell growth regulation, cell transformation and metastasis. The aim of the present study was to explore the prognostic and/or predictive significance of RACGAP1 mRNA expression on disease-free survival (DFS) and overall survival (OS) in high-risk early breast cancer patients and compare it to that of Ki67 protein expression and to the Nottingham prognostic index (NPI).

METHODS:

A total of 595 high-risk breast cancer patients were treated in a two-arm trial evaluating postoperative dose-dense sequential chemotherapy with epirubicin followed by CMF with or without paclitaxel. RNA was extracted from 314 formalin-fixed paraffin-embedded primary tumor tissue samples followed by one-step quantitative RT-PCR for assessing RACGAP1 mRNA expression.

RESULTS:

High RACGAP1 mRNA expression (above the median) was associated with poor DFS (log-rank, p = 0.002) and OS (p < 0.001). High histological grade, as well as high Ki67 protein expression, was more frequent in the high-expression group of RACGAP1. Results of the Cox multivariate regression analysis revealed that high RACGAP1 mRNA expression independently predicted poor overall survival (Wald's p = 0.008). High Ki67 protein expression was also an adverse prognostic factor for death (p = 0.016), while high NPI score values were not.

CONCLUSIONS:

High RACGAP1 mRNA expression, as assessed by qRT-PCR, was found to be of adverse prognostic significance in high-risk early breast cancer patients treated with dose-dense sequential chemotherapy. The utility of RACGAP1 mRNA expression in patient selection for treatment with aggressive chemotherapy regimens should be further explored and validated in larger cohorts.

• Authors: K Pliarchopoulou, K T Kalogeras, R Kronenwett, R M Wirtz, A G Eleftheraki, A Batistatou, M Bobos, N Soupos, G Polychronidou, H Gogas, E Samantas, C Christodoulou, T Makatsoris, N Pavlidis, D Pectasides, G Fountzilas
• Journal: Cancer chemotherapy and pharmacology (Cancer Chemother Pharmacol) Vol. 71 Issue 1 Pg. 245-55 (Jan 2013) ISSN: 1432-0843 [Electronic] Germany
• PMID: 23096218 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• GTPase-Activating Proteins
• Ki-67 Antigen
• RNA, Messenger
• mgcRacGAP

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, pharmacology)
• Breast Neoplasms (drug therapy, genetics, pathology)
• Disease-Free Survival
• Female
• GTPase-Activating Proteins (genetics)
• Gene Expression Regulation, Neoplastic
• Humans
• Ki-67 Antigen (genetics)
• Middle Aged
• Multivariate Analysis
• Patient Selection
• Prognosis
• Proportional Hazards Models
• RNA, Messenger (metabolism)
• Randomized Controlled Trials as Topic
• Regression Analysis
• Retrospective Studies
• Reverse Transcriptase Polymerase Chain Reaction
• Survival Rate
• Young Adult