Impact of FOXA1 expression on the prognosis of patients with hormone receptor-positive breast cancer.

Abstract

BACKGROUND:

Assessing indications for adjuvant chemotherapy (CT) in patients with hormone receptor (HR)-positive/human epidermal receptor 2 (HER2)-negative breast cancer remains a challenge for oncologists. In this study, we evaluated whether forkhead-box protein A1 (FOXA1) expression was a prognostic and predictive marker for HR-positive breast cancer.

METHODS:

FOXA1 expression was analyzed immunohistochemically in 239 primary breast cancers. Associations between FOXA1 expression and clinicopathological characteristics and prognosis were evaluated.

RESULTS:

FOXA1 expression was positively correlated with estrogen receptor (ER) (P<0.0001) and progesterone receptor (PR) expression (P=0.0011), and inversely correlated with nuclear grade (P=0.0048) and Ki67 index (P=0.0112). High FOXA1 was associated with longer recurrence-free survival (RFS) in all cases (P<0.0001) and in ER-positive cases (P<0.0001), but not in ER-negative cases. In addition, FOXA1 expression was associated with good prognosis, regardless of the Ki67 index, in HR-positive cases. FOXA1 was an independent prognostic factor on multivariate analysis in all cases and in ER-positive cases. Among HR-positive/HER2-negative cases with high FOXA1 expression, there was no difference in RFS between those given hormone therapy (HT) alone and those given CT plus HT.

CONCLUSIONS:

In HR-positive breast cancer, FOXA1 expression was significantly associated with good prognosis. FOXA1 expression may be a useful marker for HR-positive/HER2-negative breast cancer to identify patients with good prognosis who may not require CT.

• Authors: Yuichi Hisamatsu, Eriko Tokunaga, Nami Yamashita, Sayuri Akiyoshi, Satoko Okada, Yuichiro Nakashima, Shinichi Aishima, Masaru Morita, Yoshihiro Kakeji, Yoshihiko Maehara
• Journal: Annals of surgical oncology (Ann Surg Oncol) Vol. 19 Issue 4 Pg. 1145-52 (Apr 2012) ISSN: 1534-4681 [Electronic] United States
• PMID: 21984487 (Publication Type: Journal Article)

Chemical References

• Biomarkers, Tumor
• FOXA1 protein, human
• Hepatocyte Nuclear Factor 3-alpha
• Receptors, Estrogen
• Receptors, Progesterone
• Receptor, ErbB-2
• Phenobarbital

Topics

• Biomarkers, Tumor (metabolism)
• Breast Neoplasms (metabolism, mortality, pathology, therapy)
• Chemoradiotherapy, Adjuvant
• Disease-Free Survival
• Female
• Hepatocyte Nuclear Factor 3-alpha (metabolism)
• Humans
• Immunohistochemistry
• Lymphatic Metastasis
• Middle Aged
• Multivariate Analysis
• Neoplasm Grading
• Neoplasm Staging
• Phenobarbital (classification, metabolism)
• Prognosis
• Receptor, ErbB-2 (metabolism)
• Receptors, Estrogen (metabolism)
• Receptors, Progesterone (metabolism)
• Survival Analysis