三阴性乳腺癌中 HER3-EGFR 联合评分优于单个生物标志物,具有预后和预测意义。
Combined HER3-EGFR score in triple-negative breast cancer provides prognostic and predictive significance superior to individual biomarkers.
机构信息
Department of Biology, Georgia State University, Atlanta, GA, USA.
Faculty of Medicine and Health Science, School of Veterinary Medicine and Science, University of Nottingham, Nottingham, LE12 5RD, UK.
出版信息
Sci Rep. 2020 Feb 20;10(1):3009. doi: 10.1038/s41598-020-59514-1.
Epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 3 (HER3) have been investigated as triple-negative breast cancer (TNBC) biomarkers. Reduced EGFR levels can be compensated by increases in HER3; thus, assaying EGFR and HER3 together may improve prognostic value. In a multi-institutional cohort of 510 TNBC patients, we analyzed the impact of HER3, EGFR, or combined HER3-EGFR protein expression in pre-treatment samples on breast cancer-specific and distant metastasis-free survival (BCSS and DMFS, respectively). A subset of 60 TNBC samples were RNA-sequenced using massive parallel sequencing. The combined HER3-EGFR score outperformed individual HER3 and EGFR scores, with high HER3-EGFR score independently predicting worse BCSS (Hazard Ratio [HR] = 2.30, p = 0.006) and DMFS (HR = 1.78, p = 0.041, respectively). TNBCs with high HER3-EGFR scores exhibited significantly suppressed ATM signaling and differential expression of a network predicted to be controlled by low TXN activity, resulting in activation of EGFR, PARP1, and caspases and inhibition of p53 and NFκB. Nuclear PARP1 protein levels were higher in HER3-EGFR-high TNBCs based on immunohistochemistry (p = 0.036). Assessing HER3 and EGFR protein expression in combination may identify which adjuvant chemotherapy-treated TNBC patients have a higher risk of treatment resistance and may benefit from a dual HER3-EGFR inhibitor and a PARP1 inhibitor.
表皮生长因子受体 (EGFR) 和人表皮生长因子受体 3 (HER3) 已被研究作为三阴性乳腺癌 (TNBC) 的生物标志物。EGFR 水平的降低可以通过 HER3 的增加来补偿;因此,同时检测 EGFR 和 HER3 可能会提高预后价值。在一个由 510 例 TNBC 患者组成的多机构队列中,我们分析了预处理样本中 HER3、EGFR 或联合 HER3-EGFR 蛋白表达对乳腺癌特异性和远处无转移生存 (BCSS 和 DMFS) 的影响。使用大规模平行测序对 60 例 TNBC 样本进行了 RNA 测序。HER3-EGFR 联合评分优于单独的 HER3 和 EGFR 评分,高 HER3-EGFR 评分独立预测 BCSS 更差 (风险比 [HR] = 2.30,p = 0.006) 和 DMFS (HR = 1.78,p = 0.041)。HER3-EGFR 评分高的 TNBCs 表现出明显受抑制的 ATM 信号和预测由低 TXN 活性控制的网络的差异表达,导致 EGFR、PARP1 和半胱天冬酶的激活以及 p53 和 NFκB 的抑制。基于免疫组化,HER3-EGFR 高 TNBCs 中核 PARP1 蛋白水平更高 (p = 0.036)。联合评估 HER3 和 EGFR 蛋白表达可能会识别出哪些接受辅助化疗的 TNBC 患者有更高的治疗耐药风险,并可能受益于双重 HER3-EGFR 抑制剂和 PARP1 抑制剂。