Elisabetta Munzone1, Kathryn P Gray2, Caterina Fumagalli3, Elena Guerini-Rocco4, István Láng5, Thomas Ruhstaller6, Lorenzo Gianni7, Roswitha Kammler8, Giuseppe Viale9, Angelo Di Leo10, Alan S Coates11, Richard D Gelber12, Meredith M Regan13, Aron Goldhirsch14, Massimo Barberis15, Marco Colleoni16. 1. Division of Medical Senology, European Institute of Oncology, Milan, Italy. Elisabetta.Munzone@ieo.it. 2. International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute, and Harvard T.H Chan School of Public Health, Boston, MA, USA. 3. Division of Pathology and Laboratory Medicine, European Institute of Oncology, Milan, Italy. 4. Division of Pathology and Laboratory Medicine, Department of Oncology and Hemato-oncology, European Institute of Oncology and University of Milan, Milan, Italy. 5. National Institute of Oncology, Budapest, Hungary. 6. Breast Center St. Gallen, Switzerland, Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland. 7. Divisione di Oncologia, Ospedale degli Infermi, Rimini, Dipartimento di Oncologia ed Ematologia, AUSL della Romagna, Rimini, Italy. 8. Translational Research Coordination and Central Pathology Office, International Breast Cancer Study Group Coordinating Center, Bern, Switzerland. 9. Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan and International Breast Cancer Study Group Central Pathology Office, Milan, Italy. 10. Hospital of Prato-AUSL Toscana Centro, Istituto Toscano Tumori, and International Breast Cancer Study Group, Prato, Italy. 11. International Breast Cancer Study Group and University of Sydney, Sydney, Australia. 12. International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute, Harvard T.H. Chan School of Public Health, Harvard Medical School and Frontier Science & Technology Research Foundation, Boston, MA, USA. 13. International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA. 14. Scientific & Clinical Evaluation Board, European Institute of Oncology and International Breast Cancer Study Group, Milan, Italy. 15. Division of Pathology and Laboratory Medicine, European Institute of Oncology and University of Milan, Milan, Italy. 16. Division of Medical Senology, European Institute of Oncology, and International Breast Cancer Study Group, Milan, Italy.
Abstract
PURPOSE: We investigated the occurrence and the prognostic and predictive relationship of a selected number of somatic mutations in triple-negative breast cancer (TNBC) patients having known clinical outcomes treated within the IBCSG Trial 22-00. METHODS:A matched case-control sampling selected patients enrolled in the IBCSG Trial 22-00 who had TNBC tumors, based on local assessment. Cases had invasive breast cancer recurrence (at local, regional, or distant site) according to the protocol definition. Matched controls had not recurred. Mutational analysis was performed with OncoCarta panel v1.0 using Mass Array System. The panel includes 19 genes belonging to different functional pathways as PI3K pathway, receptor tyrosine kinase, and cell cycle-metabolic group. Conditional logistic regression assessed the association of mutation status with breast cancer recurrence. RESULTS: Mutation assessment was successful for 135 patients (49 cases, 86 controls). A total of 37 (27.4%) of the 135 patients had at least one mutation in the selected genes. PIK3CA was the most common mutated gene (18/135; 13.3%), followed by BRAF, KIT and PDGFRA (each 4/135, 3.0%) and AKT1 (3/135; 2.2%). TNBC patients with at least one mutation had increased odds of recurrence compared with those with wild-type tumors (odds ratio (OR) 2.28; 95% CI 0.88-5.92), though this difference was not statistically significant (p = 0.09). We found no evidence that these mutations were predictive for the value of maintenance metronomic chemotherapy. CONCLUSIONS: Mutations in the tested oncogenes were not associated with breast cancer recurrence in this TNBC subset of patients. The question of whether any of these mutated genes (e.g., PIK3CA) may represent a useful therapeutic target in TNBC may be answered by ongoing clinical trials and/or larger dataset analysis.
RCT Entities:
PURPOSE: We investigated the occurrence and the prognostic and predictive relationship of a selected number of somatic mutations in triple-negative breast cancer (TNBC) patients having known clinical outcomes treated within the IBCSG Trial 22-00. METHODS: A matched case-control sampling selected patients enrolled in the IBCSG Trial 22-00 who had TNBC tumors, based on local assessment. Cases had invasive breast cancer recurrence (at local, regional, or distant site) according to the protocol definition. Matched controls had not recurred. Mutational analysis was performed with OncoCarta panel v1.0 using Mass Array System. The panel includes 19 genes belonging to different functional pathways as PI3K pathway, receptor tyrosine kinase, and cell cycle-metabolic group. Conditional logistic regression assessed the association of mutation status with breast cancer recurrence. RESULTS: Mutation assessment was successful for 135 patients (49 cases, 86 controls). A total of 37 (27.4%) of the 135 patients had at least one mutation in the selected genes. PIK3CA was the most common mutated gene (18/135; 13.3%), followed by BRAF, KIT and PDGFRA (each 4/135, 3.0%) and AKT1 (3/135; 2.2%). TNBC patients with at least one mutation had increased odds of recurrence compared with those with wild-type tumors (odds ratio (OR) 2.28; 95% CI 0.88-5.92), though this difference was not statistically significant (p = 0.09). We found no evidence that these mutations were predictive for the value of maintenance metronomic chemotherapy. CONCLUSIONS: Mutations in the tested oncogenes were not associated with breast cancer recurrence in this TNBC subset of patients. The question of whether any of these mutated genes (e.g., PIK3CA) may represent a useful therapeutic target in TNBC may be answered by ongoing clinical trials and/or larger dataset analysis.
Entities:
Keywords:
Mass array system; PIK3CA; Prognosis; Somatic mutation; Triple-negative breast cancer