Consideration of breast cancer subtype in targeting the androgen receptor
Clasina M Venema1, Rico D Bense1, Tessa G Steenbruggen1
1Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Abstract:
The androgen receptor (AR) is a drug target in breast cancer, and AR-targeted therapies have induced tumor responses in breast cancer patients. In this review, we summarized the role of AR in breast cancer based on preclinical and clinical data. Response to AR-targeted therapies in unselected breast cancer populations is relatively low. Preclinical and clinical data show that AR antagonists might have a role in estrogen receptor (ER)-negative/AR-positive tumors. The prognostic value of AR for patients remains uncertain due to the use of various antibodies and cut-off values for immunohistochemical assessment. To get more insight into the role of AR in breast cancer, we additionally performed a retrospective pooled analysis to determine the prognostic value of the AR using mRNA profiles of 7270 primary breast tumors. Our analysis shows that a higher AR mRNA level is associated with improved disease outcome in patients with ER-positive/human epidermal growth factor receptor 2 (HER2)-negative tumors, but with worse disease outcome in HER2-positive subgroups. In conclusion, next to AR expression, incorporation of additional tumor characteristics will potentially make AR targeting a more valuable therapeutic strategy in breast cancer.
Insights
Androgen receptor (AR) targeted therapies show limited response in breast cancer. Higher AR mRNA levels improve outcomes in ER-positive/HER2-negative tumors but worsen them in HER2-positive subtypes.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Androgen receptor (AR) is a therapeutic target in breast cancer.
- AR-targeted therapies have shown some efficacy but response rates are low in unselected populations.
- AR's prognostic value is unclear due to inconsistent assessment methods.
Purpose of the Study:
- To review the role of AR in breast cancer using preclinical and clinical data.
- To investigate the prognostic value of AR mRNA levels in a large cohort of primary breast tumors.
Main Methods:
- Retrospective pooled analysis of AR mRNA profiles from 7270 primary breast tumors.
- Review of existing preclinical and clinical data on AR-targeted therapies.
Main Results:
- AR antagonists may benefit estrogen receptor (ER)-negative/AR-positive tumors.
- Higher AR mRNA levels correlate with better outcomes in ER-positive/HER2-negative breast cancer.
- Higher AR mRNA levels correlate with worse outcomes in HER2-positive breast cancer subgroups.
Conclusions:
- AR expression alone has uncertain prognostic value.
- Combining AR expression with other tumor characteristics may enhance AR-targeted therapy efficacy.
- Further research is needed to refine AR-targeted therapeutic strategies in breast cancer.
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