title: Prognostic value of HMGB1 in early breast cancer patients under neoadjuvant chemotherapy.
abstract: The response to neoadjuvant chemotherapy in breast cancer patients is usually assessed by pCR and RCB score. However, the prognostic value of these parameters is still in discussion. We showed recently that an epirubicin/docetaxel therapy is associated with an increase in the cell death marker high-mobility group box 1 protein (HMGB1) in the circulation. Here, we investigate whether this increase correlates with the long-term outcome. Thirty-six early breast cancer patients under neoadjuvant epirubicin/docetaxel combination chemotherapy were included in this study. To determine the immediate effect of this treatment on HMGB1, we collected blood samples before and 24-96 h after the initial dose. This time course was then compared to the 5-year follow-up of the patients. HMGB1 levels varied before chemotherapy between 4.1 and 11.3 ng/mL and reacted differently in response to therapy. Some patients showed an increase while others did not show any changes. Therefore, we subdivided the patient collective into two groups: patients with an at least 1.1 ng/mL increase in HMGB1 and patients with smaller changes. The disease-free survival was longer in the HMGB1 increase group (56.2 months vs. 46.6 months), but this difference did not reach significance. The overall survival (OS) was significantly better in patients with an increase in HMGB1 (log rank P = 0.021). These data suggest that an immediate increase in HMGB1 levels correlates with improved outcome in early breast cancer patients receiving neoadjuvant chemotherapy, and may be a valuable complementary biomarker for early estimation of prognosis.
authors.affiliation: Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, A-1090, Austria.
authors.forename: Ruth
authors.initials: R
authors.lastname: Exner
authors.affiliation: Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, A-1090, Austria.
authors.forename: Monika
authors.initials: M
authors.lastname: Sachet
authors.affiliation: Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, A-1090, Austria.
authors.forename: Tobias
authors.initials: T
authors.lastname: Arnold
authors.affiliation: Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, A-1090, Austria.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Zinn-Zinnenburg
authors.affiliation: Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, A-1090, Austria.
authors.forename: Anna
authors.initials: A
authors.lastname: Michlmayr
authors.affiliation: Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, A-1090, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Dubsky
authors.affiliation: Department of Internal Medicine I and Comprehensive Cancer Center, Medical University of Vienna, Vienna, A-1090, Austria.
authors.forename: Rupert
authors.initials: R
authors.lastname: Bartsch
authors.affiliation: Department of Internal Medicine I and Comprehensive Cancer Center, Medical University of Vienna, Vienna, A-1090, Austria.
authors.forename: Guenther
authors.initials: G
authors.lastname: Steger
authors.affiliation: Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, A-1090, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Gnant
authors.affiliation: Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, A-1090, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Bergmann
authors.affiliation: Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, A-1090, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bachleitner-Hofmann
authors.affiliation: Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, A-1090, Austria. rudolf.oehler@meduniwien.ac.at.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Oehler
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000401:mortality*; D005260:Female; D024243:HMGB1 Protein / Q000097:blood*; D006801:Humans; D053208:Kaplan-Meier Estimate; D045022:Lactate Dehydrogenases / Q000378:metabolism; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D024243:HMGB1 Protein; D045022:Lactate Dehydrogenases
keywords: Breast cancer; chemotherapy; high-mobility group box 1 protein; immunogenic cell death; prognostic marker