Fiegl Heidi, Jones Allison, Hauser-Kronberger Cornelia, Hutarew Georg, Reitsamer Roland, Jones Robin L, Dowsett Mitch, Mueller-Holzner Elisabeth, Windbichler Gudrun, Daxenbichler Günter, Goebel Georg, Ensinger Christian, Jacobs Ian, Widschwendter Martin
Department of Gynecological Oncology, UCL Institute for Women's Health, University College London, London, United Kingdom.
Clin Cancer Res. 2008 Jun 1;14(11):3494-502. doi: 10.1158/1078-0432.CCR-07-4557.
Chemotherapy can be an integral component of the adjuvant management strategy for women with early stage breast cancer. To date, no tool is available to predict or monitor the efficacy of these therapies. The aim of this proof-of-principle study was to assess whether NEUROD1 DNA methylation is able to predict the response to neoadjuvant and adjuvant chemotherapy.
Recently, we showed that NEUROD1 DNA is differentially methylated in neoplastic versus nonneoplastic breast tissue samples. In this study, we used MethyLight and analyzed NEUROD1 methylation in (a) 74 breast cancer tissue samples, (b) two independent sets of pretreatment core biopsies of 23 (training set) and 21 (test set) neoadjuvantly treated breast cancer patients, and (c) pretherapeutic and posttherapeutic serum samples from 107 breast cancer patients treated with adjuvant chemotherapy.
High-grade tumors showed higher NEUROD1 methylation levels. Estrogen receptor-negative breast cancers with high NEUROD1 methylation were 10.8-fold more likely to respond with a complete pathologic response following neoadjuvant chemotherapy. Patients with positive serum pretreatment NEUROD1 methylation, which persisted after chemotherapy, indicated poor relapse-free and overall survival in univariate and multivariate analyses (relative risk for relapse, 6.2; 95% confidence interval, 1.6-24; P = 0.008, and relative risk for death, 14; 95% confidence interval, 1.6-120; P = 0.02).
These data support the view that NEUROD1 methylation is a chemosensitivity marker in estrogen receptor-negative breast cancer.
化疗可以成为早期乳腺癌女性辅助治疗策略的一个重要组成部分。迄今为止,尚无工具可用于预测或监测这些疗法的疗效。本原理验证研究的目的是评估NEUROD1 DNA甲基化是否能够预测新辅助化疗和辅助化疗的反应。
最近,我们发现NEUROD1 DNA在肿瘤性与非肿瘤性乳腺组织样本中的甲基化存在差异。在本研究中,我们使用甲基化荧光定量法,分析了以下样本中的NEUROD1甲基化情况:(a) 74例乳腺癌组织样本;(b) 两组分别为23例(训练集)和21例(测试集)接受新辅助治疗的乳腺癌患者的预处理核心活检样本;(c) 107例接受辅助化疗的乳腺癌患者的治疗前和治疗后的血清样本。
高级别肿瘤显示出更高的NEUROD1甲基化水平。新辅助化疗后,NEUROD1甲基化水平高的雌激素受体阴性乳腺癌患者出现完全病理缓解的可能性高10.8倍。血清预处理NEUROD1甲基化呈阳性且化疗后持续存在的患者,在单因素和多因素分析中显示无复发生存期和总生存期较差(复发相对风险为6.2;95%置信区间为1.6 - 24;P = 0.008,死亡相对风险为14;95%置信区间为1.6 - 120;P = 0.02)。
这些数据支持以下观点,即NEUROD1甲基化是雌激素受体阴性乳腺癌中的一种化疗敏感性标志物。