Department of Medical Oncology, Institut Bergonié Unicancer, University of Bordeaux, INSERM U1218, INSERM CIC1401, Bordeaux, France.
Department of BioPathology, Institut Bergonié Unicancer, INSERM U1218, Bordeaux, France.
Br J Cancer. 2019 Apr;120(9):913-921. doi: 10.1038/s41416-019-0420-y. Epub 2019 Mar 22.
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.
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.
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.
Irrespective of their HER2 status, the prognosis for MA tumours remains poor and adjuvant trials evaluating anti-androgens should be considered.
我们在 EORTC10994 研究中探索了分子大汗腺癌（MA）患者的结局，并将免疫组织化学（IHC）定义为雄激素受体（AR）阳性、雌激素（ER）和孕激素（PR）阴性。我们还评估了 IHC 与基因表达谱（GEA）在识别 MA 癌症中的一致性。
通过 IHC 对 AR、ER、PR、HER2 和 Ki67 进行中央评估的活检被分为六种亚型：MA、三阴性（TN）基底样、管腔 A、管腔 B HER2 阴性、管腔 B HER2 阳性和“其他”。两个主要目标是总体 MA 亚型（并进一步按 HER2 状态）和其余五种亚型的 pCR 率和生存结局。
IHC 亚分型在 846 名合格患者中获得。93 例（11%）肿瘤被归类为 MA 亚型。IHC 和 GEA 数据均可用于 64 名患者。在这个亚组中，与 GEA 相比，IHC 在识别 MA 肿瘤方面的一致性为 88.3%。在 MA 亚型中，观察到 33.3%的患者达到 pCR（95%CI：29.4-43.9），5 年无复发生存率为 59.2%（95%CI：48.2-68.6）。具有 MA 和 TN 基底样肿瘤的患者生存结局较差。
无论其 HER2 状态如何，MA 肿瘤的预后仍然较差，应考虑评估抗雄激素的辅助试验。
