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Updated: Jul 21, 2026
Optimization of a Multiplex RNA-based Expression Assay Using Breast Cancer Archival Material
Published on: August 1, 2018
Androgen receptor expression and outcome of neoadjuvant chemotherapy in triple-negative breast cancer
A Di Leone1, S M Fragomeni, L Scardina
1Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Multidisciplinary Breast Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. alba.dileone@policlinicogemelli.it.
Objective:
Triple-negative breast cancers (TNBC) include a heterogeneous group of diseases, characterized by the lack of estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2) expression. TNBC that shows an overexpression of the androgen receptor (AR) defines the phenotype known as "luminal androgen receptor" (LAR), while the absence of the AR defines a "quadruple negative breast cancer" (QNBC). Several reports have associated AR positivity with a lower response to neoadjuvant chemotherapy (NAC), while divergent data have been reported about the impact of AR positivity on survival. The aim of this study was to retrospectively review our series of patients with TNBC tested for AR and submitted to NAC and compare pathologic complete response (pCR) rates in patients with a LAR phenotype or with QNBC.
Patients And Methods:
The clinical records of all patients with TNBC tested for AR that underwent NAC at our Institution from January 1, 2015 to June 30, 2019 were reviewed. Histopathological features as well as ER, PgR, Ki67, HER2 values, clinical and pathological stage, and results of BRCA gene expression profiling were registered for all patients.
Results:
Of the 145 TNBC patients treated by NAC, 20 (13.8%) had a LAR phenotype, while 125 (86.2%) had a QNBC. Overall, a pCR was achieved in 52 patients (35.8%). Patients with LAR phenotype had a lower rate of pCR as compared to patients with QNBC phenotype (25% vs. 37.6%). High Ki67 values (>50%) were observed less frequently in patients with a LAR phenotype (50% vs. 76.8% in QNBC).
Conclusions:
Our data seem to confirm that the LAR phenotype is associated to lower rates of pCR after neoadjuvant chemotherapy; routine assessment of AR expression in addition to classical biomarkers in patients with TNBC could help to better personalize treatment.
Insights
Triple-negative breast cancer (TNBC) patients with the luminal androgen receptor (LAR) phenotype show lower pathologic complete response (pCR) rates after neoadjuvant chemotherapy (NAC). Assessing androgen receptor (AR) status may help personalize TNBC treatment strategies.
Area of Science:
- Oncology
- Breast Cancer Research
- Molecular Pathology
Background:
- Triple-negative breast cancer (TNBC) is a heterogeneous disease lacking ER, PgR, and HER2 expression.
- The luminal androgen receptor (LAR) phenotype is defined by AR overexpression in TNBC, distinct from quadruple-negative breast cancer (QNBC).
- Previous studies show conflicting data on AR positivity's impact on neoadjuvant chemotherapy (NAC) response and survival in TNBC.
Purpose of the Study:
- To retrospectively evaluate pathologic complete response (pCR) rates in TNBC patients treated with NAC.
- To compare pCR rates between TNBC patients with the LAR phenotype and those with QNBC.
- To investigate the association between AR status and treatment outcomes in TNBC.
Main Methods:
- Retrospective review of clinical records for TNBC patients tested for AR who underwent NAC between January 2015 and June 2019.
- Collection of histopathological data, including ER, PgR, HER2, Ki67, clinical/pathological stage, and BRCA gene expression.
- Comparison of pCR rates based on LAR phenotype versus QNBC phenotype.
Main Results:
- Out of 145 TNBC patients, 13.8% (20) had the LAR phenotype and 86.2% (125) had QNBC.
- Overall pCR rate was 35.8% (52 patients).
- LAR phenotype patients exhibited a lower pCR rate (25%) compared to QNBC patients (37.6%).
- High Ki67 values (>50%) were less frequent in the LAR phenotype group (50%) versus QNBC (76.8%).
Conclusions:
- The LAR phenotype in TNBC is associated with reduced pCR rates following NAC.
- Routine assessment of AR expression in TNBC is recommended for personalized treatment strategies.
- Androgen receptor status is a potential biomarker for predicting NAC response in TNBC.
