Gene expression profiling of sequential metastatic biopsies for biomarker discovery in breast cancer

The feasibility of longitudinal metastatic biopsies for gene expression profiling in breast cancer is unexplored. Dynamic changes in gene expression can potentially predict efficacy of targeted cancer drugs. Patients enrolled in a phase III trial of metastatic breast cancer with docetaxel monotherap...

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Main Authors: Theodoros Foukakis, John Lövrot, Patricia Sandqvist, Hanjing Xie, Linda S. Lindström, Carla Giorgetti, Hans Jacobsson, Elham Hedayati, Jonas Bergh
Format: Article
Language:English
Published: Wiley 2015-08-01
Series:Molecular Oncology
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Online Access:https://doi.org/10.1016/j.molonc.2015.03.011
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author Theodoros Foukakis
John Lövrot
Patricia Sandqvist
Hanjing Xie
Linda S. Lindström
Carla Giorgetti
Hans Jacobsson
Elham Hedayati
Jonas Bergh
author_facet Theodoros Foukakis
John Lövrot
Patricia Sandqvist
Hanjing Xie
Linda S. Lindström
Carla Giorgetti
Hans Jacobsson
Elham Hedayati
Jonas Bergh
author_sort Theodoros Foukakis
collection DOAJ
description The feasibility of longitudinal metastatic biopsies for gene expression profiling in breast cancer is unexplored. Dynamic changes in gene expression can potentially predict efficacy of targeted cancer drugs. Patients enrolled in a phase III trial of metastatic breast cancer with docetaxel monotherapy versus combination of docetaxel + sunitinib were offered to participate in a translational substudy comprising longitudinal fine needle aspiration biopsies and Positron Emission Tomography imaging before (T1) and two weeks after start of treatment (T2). Aspirated tumor material was used for microarray analysis, and treatment‐induced changes (T2 versus T1) in gene expression and standardized uptake values (SUV) were investigated and correlated to clinical outcome measures. Gene expression profiling yielded high‐quality data at both time points in 14/18 patients. Unsupervised clustering revealed specific patterns of changes caused by monotherapy vs. combination therapy (p = 0.021, Fisher's exact test). A therapy‐induced reduction of known proliferation and hypoxia metagene scores was prominent in the combination arm. Changes in a previously reported hypoxia metagene score were strongly correlated to the objective responses seen by conventional radiology assessments after 6 weeks in the combination arm, Spearman's ρ = 1 (p = 0.017) but not in monotherapy, ρ = −0.029 (p = 1). Similarly, the Predictor Analysis of Microarrays 50 (PAM50) proliferation metagene correlated to tumor changes merely in the combination arm at 6 and 12 weeks (ρ = 0.900, p = 0.083 and ρ = 1, p = 0.017 respectively). Reductions in mean SUV were a reliable early predictor of objective response in monotherapy, ρ = 0.833 (p = 0.008), but not in the combination arm ρ = −0.029 (p = 1). Gene expression profiling of longitudinal metastatic aspiration biopsies was feasible, demonstrated biological validity and provided predictive information.
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spelling doaj-art-89c2141cc3f44e8897ebac1036b4b4822024-11-28T05:26:00ZengWileyMolecular Oncology1574-78911878-02612015-08-01971384139110.1016/j.molonc.2015.03.011Gene expression profiling of sequential metastatic biopsies for biomarker discovery in breast cancerTheodoros Foukakis0John Lövrot1Patricia Sandqvist2Hanjing Xie3Linda S. Lindström4Carla Giorgetti5Hans Jacobsson6Elham Hedayati7Jonas Bergh8Department of Oncology-Pathology, Cancer Center Karolinska, Karolinska Institutet and University Hospital, Stockholm, SwedenDepartment of Oncology-Pathology, Cancer Center Karolinska, Karolinska Institutet and University Hospital, Stockholm, SwedenDepartment of Radiology and Nuclear Medicine, Karolinska Institutet and University Hospital, Stockholm, SwedenDepartment of Oncology-Pathology, Cancer Center Karolinska, Karolinska Institutet and University Hospital, Stockholm, SwedenDepartment of Oncology-Pathology, Cancer Center Karolinska, Karolinska Institutet and University Hospital, Stockholm, SwedenPfizer Oncology, Milan, ItalyDepartment of Radiology and Nuclear Medicine, Karolinska Institutet and University Hospital, Stockholm, SwedenDepartment of Oncology-Pathology, Cancer Center Karolinska, Karolinska Institutet and University Hospital, Stockholm, SwedenDepartment of Oncology-Pathology, Cancer Center Karolinska, Karolinska Institutet and University Hospital, Stockholm, SwedenThe feasibility of longitudinal metastatic biopsies for gene expression profiling in breast cancer is unexplored. Dynamic changes in gene expression can potentially predict efficacy of targeted cancer drugs. Patients enrolled in a phase III trial of metastatic breast cancer with docetaxel monotherapy versus combination of docetaxel + sunitinib were offered to participate in a translational substudy comprising longitudinal fine needle aspiration biopsies and Positron Emission Tomography imaging before (T1) and two weeks after start of treatment (T2). Aspirated tumor material was used for microarray analysis, and treatment‐induced changes (T2 versus T1) in gene expression and standardized uptake values (SUV) were investigated and correlated to clinical outcome measures. Gene expression profiling yielded high‐quality data at both time points in 14/18 patients. Unsupervised clustering revealed specific patterns of changes caused by monotherapy vs. combination therapy (p = 0.021, Fisher's exact test). A therapy‐induced reduction of known proliferation and hypoxia metagene scores was prominent in the combination arm. Changes in a previously reported hypoxia metagene score were strongly correlated to the objective responses seen by conventional radiology assessments after 6 weeks in the combination arm, Spearman's ρ = 1 (p = 0.017) but not in monotherapy, ρ = −0.029 (p = 1). Similarly, the Predictor Analysis of Microarrays 50 (PAM50) proliferation metagene correlated to tumor changes merely in the combination arm at 6 and 12 weeks (ρ = 0.900, p = 0.083 and ρ = 1, p = 0.017 respectively). Reductions in mean SUV were a reliable early predictor of objective response in monotherapy, ρ = 0.833 (p = 0.008), but not in the combination arm ρ = −0.029 (p = 1). Gene expression profiling of longitudinal metastatic aspiration biopsies was feasible, demonstrated biological validity and provided predictive information.https://doi.org/10.1016/j.molonc.2015.03.011Breast cancerRelapse biopsyPositron emission tomographyHypoxiaSunitinib
spellingShingle Theodoros Foukakis
John Lövrot
Patricia Sandqvist
Hanjing Xie
Linda S. Lindström
Carla Giorgetti
Hans Jacobsson
Elham Hedayati
Jonas Bergh
Gene expression profiling of sequential metastatic biopsies for biomarker discovery in breast cancer
Molecular Oncology
Breast cancer
Relapse biopsy
Positron emission tomography
Hypoxia
Sunitinib
title Gene expression profiling of sequential metastatic biopsies for biomarker discovery in breast cancer
title_full Gene expression profiling of sequential metastatic biopsies for biomarker discovery in breast cancer
title_fullStr Gene expression profiling of sequential metastatic biopsies for biomarker discovery in breast cancer
title_full_unstemmed Gene expression profiling of sequential metastatic biopsies for biomarker discovery in breast cancer
title_short Gene expression profiling of sequential metastatic biopsies for biomarker discovery in breast cancer
title_sort gene expression profiling of sequential metastatic biopsies for biomarker discovery in breast cancer
topic Breast cancer
Relapse biopsy
Positron emission tomography
Hypoxia
Sunitinib
url https://doi.org/10.1016/j.molonc.2015.03.011
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