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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1806767
Original Article

An Observational Study of AR Expression in Indian Women with TNBC and Their Treatment Response and Overall Survival

Tejesh Krishna Chatradi 
1   Department of Medical Oncology, Yenepoya Medical College Hospital, Mangalore, Karnataka, India
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Abstract

Introduction

Triple-negative breast cancer (TNBC) is a heterogeneous subtype of breast cancer with the worst outcome, is not amenable for known target therapies, and has a poor response to chemotherapy. Androgen receptor (AR) was evaluated as a predictive, prognostic, and therapeutic factor in TNBC, but with contradicting results and the cutoff used for positive was also varied among studies. Thus, we studied 104 Indian women with TNBC for proportion showing AR expression and responses and survival outcomes compared over a period of 60 months with standard of care.

Objectives

Primary: To observe the proportion of AR expression in TNBC. Secondary: To compare (1) pathological response to neoadjuvant chemotherapy (NACT) and (2) overall survival (OS) of both groups.

Materials and Methods

This is a prospective descriptive study of 104 female patients with TNBC who visited the medical oncology department at a tertiary hospital in South India over a period of 2 years (June 2018–June 2020). They were diagnosed with TNBC by Immunohistochemistry (IHC); hence, they tested negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) receptors. Patients with HER2 2+ IHC were confirmed negative by fluorescence in situ hybridization testing. They were analyzed with IHC for AR expression using EP140 rabbit monoclonal primary antibody interpreted by a single breast pathologist, and proportion of TNBC expressing AR were identified with a cutoff > 10% nuclear expression. They were managed as per the standard of care necessary for a particular stage. Results were analyzed comparing the baseline characteristic, treatment response, recurrence rate, and survival outcomes over a follow-up period of 60 months.

Results

Percentage of AR expression in TNBC in this study was 35%. Twenty-five percent patients (28/104) were treated with NACT and complete pathological response was seen in 1/13 (7.69%) versus 7/22 (31.8%) in AR-positive compared with AR negative group (p 0.003). The AR-positive group showed significant survival advantage compared with the AR-negative group. Median OS of AR-negative group was reached at 29 months whereas for the AR-positive group it was 49 months (p = 0.58). The AR-positive group showed late recurrences after 24 months in follow-up.

Conclusion

This study showed that the proportion of TNBCs showing AR expression was much higher. Assessment of AR status in patients with TNBC provides additional information on prognosis and also predicts response to chemotherapy. AR-positive TNBC represents a breast cancer subtype with unique features with potential targeted therapies.

Keywords

TNBC - AR - 5-year-follow-up - IHC - prognosis - response - pCR

Note

The author of this research paper has directly participated in the planning, execution, and analysis of this study. The author of this paper has read and approved the final version submitted and believes that the manuscript represents honest work.


Patient Consent

Informed patient consent was obtained for this study.


Supplementary Material



Publikationsverlauf

Artikel online veröffentlicht:
21. März 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 DeSantis CE, Ma J, Gaudet MM. et al. Breast cancer statistics, 2019. CA Cancer J Clin 2019; 69 (06) 438-451
    CrossrefPubMedSuche in Google Scholar
  • 2 Bianchini G, Balko JM, Mayer IA, Sanders ME, Gianni L. Triple-negative breast cancer: challenges and opportunities of a heterogeneous disease. Nat Rev Clin Oncol 2016; 13 (11) 674-690
    CrossrefPubMedSuche in Google Scholar
  • 3 Lehmann BD, Bauer JA, Chen X. et al. Identification of human triple-negative breast cancer subtypes and preclinical models for selection of targeted therapies. J Clin Invest 2011; 121 (07) 2750-2767
    CrossrefPubMedSuche in Google Scholar
  • 4 Zhang L, Fang C, Xu X, Li A, Cai Q, Long X. Androgen receptor, EGFR, and BRCA1 as biomarkers in triple-negative breast cancer: a meta-analysis. BioMed Res Int 2015; 2015: 357485
    PubMedSuche in Google Scholar
  • 5 Xu M, Yuan Y, Yan P. et al. Prognostic significance of androgen receptor expression in triple negative breast cancer: a systematic review and meta-analysis. Clin Breast Cancer 2020; 20 (04) e385-e396
    CrossrefPubMedSuche in Google Scholar
  • 6 Bhattarai S, Klimov S, Mittal K. et al. Prognostic role of androgen receptor in triple negative breast cancer: a multi-institutional study. Cancers (Basel) 2019; 11 (07) 995
    CrossrefPubMedSuche in Google Scholar
  • 7 McGhan LJ, McCullough AE, Protheroe CA. et al. Androgen receptor-positive triple negative breast cancer: a unique breast cancer subtype. Ann Surg Oncol 2014; 21 (02) 361-367
    CrossrefPubMedSuche in Google Scholar
  • 8 Collignon J, Lousberg L, Schroeder H, Jerusalem G. Triple-negative breast cancer: treatment challenges and solutions. Breast Cancer (Dove Med Press) 2016; 8: 93-107
    PubMedSuche in Google Scholar
  • 9 Ricciardi GR, Adamo B, Ieni A. et al. Androgen Receptor (AR), E-Cadherin, and Ki-67 as Emerging Targets and Novel Prognostic Markers in Triple-Negative Breast Cancer (TNBC) Patients. PLoS One. 2015;10(6):e0128368
  • 10 Choi JE, Kang SH, Lee SJ, Bae YK. Androgen receptor expression predicts decreased survival in early stage triple-negative breast cancer. Ann Surg Oncol 2015; 22 (01) 82-89
    CrossrefPubMedSuche in Google Scholar
  • 11 Grogg A, Trippel M, Pfaltz K. et al. Androgen receptor status is highly conserved during tumor progression of breast cancer. BMC Cancer 2015; 15: 872
    CrossrefPubMedSuche in Google Scholar
  • 12 Rampurwala M, Wisinski KB, O'Regan R. Role of the androgen receptor in triple-negative breast cancer. Clin Adv Hematol Oncol 2016; 14 (03) 186-193
    PubMedSuche in Google Scholar
  • 13 Narayanan R, Dalton JT. Androgen receptor: a complex therapeutic target for breast cancer. Cancers (Basel) 2016; 8 (12) 108
    CrossrefPubMedSuche in Google Scholar
  • 14 Patnayak R, Jena A, Bhargavi D, Chowhan AK. Androgen receptor expression in triple negative breast cancer - Study from a tertiary health care center in South India. Indian J Med Paediatr Oncol 2018; 39: 28-31
    Thieme ConnectSuche in Google Scholar
  • 15 Anand A, Singh KR, Kumar S, Husain N, Kushwaha JK, Sonkar AA. Androgen receptor expression in an Indian breast cancer cohort with relation to molecular subtypes and response to neoadjuvant chemotherapy - a prospective clinical study. Breast Care (Basel) 2017; 12 (03) 160-164
    CrossrefPubMedSuche in Google Scholar