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MCM-2 Levels as a Potential Biomarker for Predicting High-Risk Breast Cancer Patients According to TAILORx

Çağlar Ünal1, Tolga Özmen2,3, Ahmet Serkan İlgün4

  • 1Division of Medical Oncology, Department of Internal Medicine, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey.

Breast Cancer (Dove Medical Press)
|September 7, 2023
PubMed
Summary

Minichromosome maintenance protein-2 (MCM-2) is a sensitive proliferation marker. Elevated MCM-2 levels correlate with higher Oncotype DX recurrence scores in early breast cancer, suggesting MCM-2 as an independent risk factor.

Keywords:
MCM-2Oncotype DX recurrence scoreTAILORx risk categorizationbreast cancer

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Area of Science:

  • Oncology
  • Biomarkers
  • Breast Cancer Research

Background:

  • Minichromosome maintenance protein-2 (MCM-2) demonstrates superior sensitivity as a proliferation marker compared to Ki-67.
  • Hormone receptor (HR)-positive, HER-2-negative early-stage breast cancer patients are often assessed using the Oncotype DX recurrence score (ODX-RS).

Purpose of the Study:

  • To investigate the correlation between MCM-2 expression and ODX-RS in HR-positive, HER-2-negative early breast cancer.
  • To establish a predictive MCM-2 cutoff value for identifying high-risk patients within the TAILORx risk stratification framework.

Main Methods:

  • Retrospective analysis of formalin-fixed, paraffin-embedded tissues from HR-positive, HER-2-negative early breast cancer patients.
  • Immunohistochemical staining for MCM-2 on 3 µm tissue sections.
  • Receiver Operating Characteristic (ROC) curve analysis to determine MCM-2 cutoff for high-risk ODX-RS (≥26).

Main Results:

  • Mean MCM-2 levels were significantly higher in the high-risk ODX-RS group (60.2 ± 11.2) compared to the low-risk group (34.4 ± 13.8).
  • MCM-2 expression and low progesterone receptor (PR) levels (≤10%) were identified as independent predictors of high-risk status.
  • The optimal MCM-2 cutoff value was determined to be 50, with high sensitivity (86.7%) and specificity (96.0%) for identifying high-risk patients.

Conclusions:

  • MCM-2 serves as an independent risk factor for stratifying high-risk patients in HR-positive, HER-2-negative early breast cancer based on TAILORx criteria.
  • The established MCM-2 cutoff of 50 offers a potential alternative for assessing adjuvant chemotherapy decisions in cases where Oncotype DX testing is unavailable.