Molecular apocrine tumours in EORTC 10994/BIG 1-00 phase III study: pathological response after neoadjuvant chemotherapy and clinical outcomes.

Authors:
Herve Bonnefoi
Herve Bonnefoi
Swiss Institute of Bioinformatics
Switzerland
Coralie Poncet
Coralie Poncet
Université Paris Descartes
France
Richard Iggo
Richard Iggo
Swiss Institute for Experimental Cancer Research (ISREC)
Switzerland
Thomas Grellety
Thomas Grellety
Bordeaux University Hospital-CHU Bordeaux
France
Denis Larsimont
Denis Larsimont
Université Libre de Bruxelles
Belgium
Veronique Becette
Veronique Becette
Swiss Institute of Bioinformatics
Switzerland

Br J Cancer 2019 Apr 22;120(9):913-921. Epub 2019 Mar 22.

Anglo-Celtic Cooperative Oncology Group (ACCOG), Edinburgh, United Kingdom.

Background: We explored, within the EORTC10994 study, the outcomes for patients with molecular apocrine (MA) breast cancer, and defined immunohistochemistry (IHC) as androgen-receptor (AR) positive, oestrogen (ER) and progesterone (PR) negative. We also assessed the concordance between IHC and gene expression arrays (GEA) in the identification of MA cancers.

Methods: Centrally assessed biopsies for AR, ER, PR, HER2 and Ki67 by IHC were classified into six subtypes: MA, triple-negative (TN) basal-like, luminal A, luminal B HER2 negative, luminal B HER2 positive and "other". The two main objectives were the pCR rates and survival outcomes in the overall MA subtype (and further divided by HER2 status) and the remaining five subtypes.

Results: IHC subtyping was obtained in 846 eligible patients. Ninety-three (11%) tumours were classified as the MA subtype. Both IHC and GEA data were available for 64 patients. In this subset, IHC concordance was 88.3% in identifying MA tumours compared with GEA. Within the MA subtype, pCR was observed in 33.3% of the patients (95% CI: 29.4-43.9) and the 5-year recurrence-free interval was 59.2% (95% CI: 48.2-68.6). Patients with MA and TN basal-like tumours have lower survival outcomes.

Conclusions: Irrespective of their HER2 status, the prognosis for MA tumours remains poor and adjuvant trials evaluating anti-androgens should be considered.

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http://dx.doi.org/10.1038/s41416-019-0420-yDOI Listing
April 2019
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