The Prognostic Role of Androgen Receptor in Patients with Early-Stage Breast Cancer: A Meta-analysis of Clinical and Gene Expression Data.
Purpose:Androgen receptor (AR) expression has been observed in about 70% of patients with breast cancer, but its prognostic role remains uncertain.Experimental Design:To assess the prognostic role of AR expression in early-stage breast cancer, we performed a meta-analysis of studies that evaluated the impact of AR at the protein and gene expression level on disease-free survival (DFS) and/or overall survival (OS). Eligible studies were identified by systematic review of electronic databases using the MeSH-terms "breast neoplasm" and "androgen receptor" and were selected after a qualitative assessment based on the REMARK criteria. A pooled gene expression analysis of 35 publicly available microarray data sets was also performed from patients with early-stage breast cancer with available gene expression and clinical outcome data.Results:Twenty-two of 33 eligible studies for the clinical meta-analysis, including 10,004 patients, were considered as evaluable for the current study after the qualitative assessment. AR positivity defined by IHC was associated with improved DFS in all patients with breast cancer [multivariate (M) analysis, HR 0.46; 95% confidence interval (CI) 0.37-0.58,P< 0.001] and better OS [M-HR 0.53; 95% CI, 0.38-0.73,P< 0.001]. Thirty-five datasets including 7,220 patients were eligible for the pooled gene expression analysis. HighARmRNA levels were found to confer positive prognosis overall in terms of DFS (HR 0.82; 95% CI 0.72-0.92;P= 0.0007) and OS (HR 0.84; 95% CI, 0.75-0.94;P= 0.02) only in univariate analysis.Conclusions:Our analysis, conducted among more than 17,000 women with early-stage breast cancer included in clinical and gene expression analysis, demonstrates that AR positivity is associated with favorable clinical outcome.Clin Cancer Res; 23(11); 2702-12. ©2016 AACR.
Breast Data Centre, Medical Oncology Department, Institut Jules Bordet, Université Libre de Bruxelles, Brusells, Belgium.|Institute for Oncology and Radiology of Serbia, National Cancer Research Centre, Belgrade, Republic of Serbia.
Ivana
I
Bozovic-Spasojevic
Breast International Group, Brussels, Belgium.
Dimitrios
D
Zardavas
Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brusells, Belgium.
Sylvain
S
Brohée
Data Centre, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Lieveke
L
Ameye
Breast International Group, Brussels, Belgium.
Debora
D
Fumagalli
Breast Data Centre, Medical Oncology Department, Institut Jules Bordet, Université Libre de Bruxelles, Brusells, Belgium.|Hospital Albert Einstein, São Paulo, Brazil.
Felipe
F
Ades
Breast Data Centre, Medical Oncology Department, Institut Jules Bordet, Université Libre de Bruxelles, Brusells, Belgium.
Evandro
E
de Azambuja
Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brusells, Belgium.
Yacine
Y
Bareche
Medical Oncology Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Martine
M
Piccart
Data Centre, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Marianne
M
Paesmans
Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brusells, Belgium. christos.sotiriou@bordet.be.
Christos
C
Sotiriou
D014408:Biomarkers, Tumor / Q000235:genetics*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D009367:Neoplasm Staging; D011379:Prognosis; D011944:Receptors, Androgen / Q000235:genetics*; D011960:Receptors, Estrogen / Q000235:genetics
C410798:AR protein, human; D014408:Biomarkers, Tumor; D011944:Receptors, Androgen; D011960:Receptors, Estrogen