Overall Survival in Advanced Breast Cancer: Relevance of Progesterone Receptor Expression and DNA Ploidy in Fine-Needle Aspirates of 392 Patients

Fine-needle aspiration cytology (FNAC) is essential for making a diagnosis in advanced breast cancer. The determination of hormone receptors in the material obtained is useful for predicting patient response to endocrine therapy, but the prognostic value of hormone receptor expression as well as the clinical utility of DNA flow cytometry are controversial. The aim of this prospective study with long-term follow-up (median: 81 months) was to evaluate these biomarkers in relation to overall survival in a series of 392 patients with advanced breast cancer (stage IIB, n=106; IIIA, n=66; IIIB, n=174; and IV, n=46) using FNAC. Estrogen and progesterone receptor expression was found in 65.1% and 46.1% of the tumors, respectively. Hormone receptors were not found to be associated with clinical staging. DNA aneuploidy was present in 70.9% of the cases and the median S-phase fraction (SPF) was 9.4%. There was a significant correlation of aneuploidy and high SPF with lack of hormone receptors. In univariate analysis, advanced disease stage, absence of hormone receptors, DNA aneuploidy and high SPF showed a statistically significant correlation with poor clinical outcome. In multivariate analysis, disease stage, progesterone receptors and DNA ploidy retained independent prognostic significance in relation to overall survival. These data indicate that progesterone receptor expression and DNA ploidy are independent prognostic factors in advanced breast cancer.

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Overall survival in advanced breast cancer: Relevance of progesterone receptor expression and DNA ploidy in fine-needle aspirates of 392 patients

The International Journal of Biological Markers ◽

10.5301/jbm.2008.512 ◽

2003 ◽

Vol 18 (1) ◽

pp. 7-12 ◽

Cited By ~ 8

Author(s):

A.E. Pinto ◽

S. Andre` ◽

E. Mendona ◽

G. Silva ◽

J. Soares

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Progesterone Receptor ◽

Advanced Breast Cancer ◽

Dna Ploidy ◽

Receptor Expression ◽

Advanced Breast ◽

Progesterone Receptor Expression ◽

Fine Needle ◽

Fine Needle Aspirates

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Abemaciclib as initial therapy for advanced breast cancer: MONARCH 3 updated results in prognostic subgroups

npj Breast Cancer ◽

10.1038/s41523-021-00289-7 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Stephen Johnston ◽

Joyce O’Shaughnessy ◽

Miguel Martin ◽

Jens Huober ◽

Masakazu Toi ◽

...

Keyword(s):

Breast Cancer ◽

Progesterone Receptor ◽

Liver Metastases ◽

Advanced Breast Cancer ◽

Performance Status ◽

Objective Response ◽

Advanced Breast ◽

Treatment Benefit ◽

Significant Treatment

AbstractIn MONARCH 3, continuous dosing of abemaciclib with an aromatase inhibitor (AI) conferred significant clinical benefit to postmenopausal women with HR+, HER2− advanced breast cancer. We report data for clinically prognostic subgroups: liver metastases, progesterone receptor status, tumor grade, bone-only disease, ECOG performance status, and treatment-free interval (TFI) from an additional 12-month follow-up (after final progression-free survival [PFS] readout). In the intent-to-treat population, after median follow-up of approximately 39 months, the updated PFS was 28.2 versus 14.8 months (hazard ratio [HR], 0.525; 95% confidence interval, 0.415–0.665) in abemaciclib versus placebo arms, respectively. Time to chemotherapy (HR, 0.513), time to second disease progression (HR, 0.637), and duration of response (HR, 0.466) were also statistically significantly prolonged with the addition of abemaciclib to AI. Treatment benefit was observed across all subgroups, as evidenced by objective response rate change from the addition of abemaciclib to AI, with the largest effects observed in patients with liver metastases, progesterone receptor-negative tumors, high-grade tumors, or TFI < 36 months. Extended follow-up in the MONARCH 3 trial further confirmed that the addition of abemaciclib to AI conferred significant treatment benefit to all subgroups, including those with poorer prognosis.

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