Journal of Clinical Oncology, 2004 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 22, No 14S (July 15 Supplement), 2004: 524
© 2004 American Society of Clinical Oncology

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Abstract

Adverse association of expressed vascular endothelial growth factor (VEGF) with long-term outcome of stage I-III breast cancer (BrCa), with co-expression data of VEGF and Her2, Cox2, uPA and ER. Results from the British Columbia Tissue Microarray Project

McGill University, Montreal, PQ, Canada; Indiana University Medical Centre, Indianapolis, IN; BCCA/Vancouver Hospital, University of British Columbia, Vancouver, BC, Canada; University of Maryland, Baltimore, MD

524

Background. Several prior studies have shown association of VEGF with inferior outcome of BrCa. However, only a few past studies had a large number of patients, or availability of multiple markers and prognostic factors.Methods. In this study, impact of VEGF was correlated with the outcome in a large cohort of Breast Cancer (BrCa) patients, enrolled between 1978–1990 in phase II-III British Columbia trials, who had tissue microarrays (TMA) built from paraffin, with 877 pts having VEGF expression tested by Immunohistochemistry (IHC, Biogenix polyclonal anti-VEGF Ab, Dako). For detection, the LSAB2 kit with the DAB as the chromogen, was used. Event at 15 years was any death (expressed as OS%), with the median survival and 95% confidence intervals (CI) expressed for 4 groups according to the stain intensity. Other markers (Her2, Cox2, uPA, ER, etc.) were tested for co-expression. Results. At a median follow up of 17.4 years (ranges 9.8, 28.7 years), 586 patients died (any death), and 502 had BrCa recurrence. Expression of VEGF showed progressively worse outcome according to intensity of expression. VEGF expression showed a positive coexpression with Her2 (49 vs 61% for Her2-ve vs +ve, p=0.006); Cox2 (47 vs 57%, for –ve vs +ve, p=0.004); uPA (43 vs 59%, for –ve vs +ve, p<0.001) and a negative coexpression with ER (55 vs 47%, for –ve vs +ve).Conclusion: Expression of VEGF, and its intensity, are associated with a significantly inferior outcome of early BrCa, and with co-expression of several markers of relevance in BrCa biology. VEGF, Her2, Cox2 and other markers can be successfully tested on TMA permitting interactive testing of multiple markers. These data indicate that diagnostic and therapeutic trials exploiting VEGF expression interacting with other markers are indicated for early BrCa.

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Abstract presentation from the 2004 ASCO Annual Meeting