© 2000 by Oxford University Press
Journal of the National Cancer Institute, Vol. 92, No. 2, 120-127,
January 19, 2000
© 2000 Oxford University Press
Bcar1/p130Cas Protein and Primary Breast Cancer: Prognosis and Response to Tamoxifen Treatment
Affiliations of authors: S. van der Flier, A. Brinkman, E. M. Kok, L. C. J. Dorssers (Department of Pathology/Division of Molecular Biology), M. P. Look, M. E. Meijer-van Gelder, J. G. M. Klijn, J. A. Foekens (Department of Medical Oncology/Division of Endocrine Oncology), Josephine Nefkens Institute, University Hospital Rotterdam, The Netherlands.
Correspondence to: Lambert C. J. Dorssers, Ph.D., Department of Pathology/Division of Molecular Biology, Josephine Nefkens Institute, University Hospital Rotterdam, Rm. Be 432, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands (e-mail: dorssers{at}bidh.azr.nl).
BACKGROUND: The product of the Bcar1/p130Cas (breast cancer resistance/p130Crk-associated substrate) gene causes resistance to antiestrogen drugs in human breast cancer cells in vitro. To investigate its role in clinical breast cancer, we determined the levels of Bcar1/p130Cas protein in a large series of primary breast carcinomas. METHODS: We measured Bcar1/p130Cas protein in cytosol extracts from 937 primary breast carcinomas by western blot analysis. The levels of Bcar1/p130Cas protein were tested for associations and trends against clinicopathologic and patient characteristics, the lengths of relapse-free survival and overall survival (n = 775), and the efficacy of first-line treatment with tamoxifen for recurrent or metastatic disease (n = 268). RESULTS: Bcar1/p130Cas levels in primary tumors were associated with age/menopausal status and the levels of estrogen receptor and progesterone receptor. In univariate survival analysis, higher Bcar1/p130Cas levels were associated with poor relapse-free survival and overall survival (both two-sided P = .04; log-rank test for trend). In multivariate analysis, a high level of Bcar1/p130Cas was independently associated with poor relapse-free survival and overall survival. The response to tamoxifen therapy in patients with recurrent disease was reduced in patients with primary tumors that expressed high levels of Bcar1/p130Cas. In multivariate analysis for response, Bcar1/p130Cas was independent of classical predictive factors, such as estrogen receptor status, age/menopausal status, disease-free interval, and dominant site of relapse. CONCLUSION: Patients with primary breast tumors expressing a high level of Bcar1/p130Cas protein appear to experience more rapid disease recurrence and have a greater risk of (intrinsic) resistance to tamoxifen therapy. Thus, measurement of Bcar1/p130Cas may provide useful prognostic information for patients with primary or metastatic breast cancer.
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