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DOI: 10.1055/s-0038-1651824
Genetic variants in FCGR2A and FCGR3A and disease-free survival in patients with HER2 positive breast cancer treated with trastuzumab in the SUCCESS A trial
Authors
Publication History
Publication Date:
22 May 2018 (online)
Background:
The anti-HER2 antibody trastuzumab acts by different mechanisms, one of which is antibody-dependent cellular cytotoxicity of immune effector cells via Fcγ receptors (FCGRs). Lower affinity to trastuzumab has been described for the minor alleles in FCGR2A (H131R, rs1801274) and in FCGR3A (V158F, rs396991). These genotypes were previously associated with poorer response to trastuzumab in metastatic breast cancer. This study investigates the association of these genetic polymorphisms with disease-free survival (DFS) in HER2 positive breast cancer patients from the adjuvant SUCCESS A trial.
Patients and Methods:
Whole genome SNP genotyping was performed from germline DNA of 654 HER2 positive patients treated with chemotherapy and trastuzumab within the SUCCESS A trial. The influence of rs1801274 (FGR2A, originally on the chip) and rs396991 (FCGR3A, imputed) on DFS was analyzed using two multiple Cox regression models with these predictors: SNP (ordinal, count of minor alleles), age at diagnosis, body mass index, tumor stage, nodal status, ER status, PgR status, and grading.
Results:
rs1801274 in FCGR2A (minor allele frequency (MAF), 0.44) was associated with DFS in HER2 positive patients. The adjusted hazard ratio (HR) was 1.80 (95% confidence interval (CI), 1.25 to 2.60; p < 0.01) per minor allele. rs396991 in FCGR3A was not associated with DFS (adjusted HR, 0.74; 95% CI, 0.44 to 1.26; p = 0.27).
Conclusion:
We demonstrate for the first time that genetic variants in FCGR2A are associated with DFS in HER2 positive breast cancer patients adjuvantly treated with trastuzumab.
