Association of Breast Cancer Stem Cells Identified by Aldehyde Dehydrogenase-1A1 Expression with Poor Prognosis in the Conventional Cytotoxic Neoadjuvant Chemotherapy.
Thaer Khoury, Ademuyiwa Foluso, Rameela Chandraseekhar, Wilding Gregory, Albert B DeLeo, Soldano Ferrone, Yangyang Wang, LaKeta Monhollen, Dongfeng Tan, Xinhui Wang. Roswell Park Cancer Institute, Buffalo; University of Pittsburgh Medical Center, PA; MD-Anderson Cancer Center, Houston
Background: In vitro studies have shown that breast cancer stem cells are associated with resistance to chemotherapy. However, their clinical significance remains to be clarified. The purposes of this study were to investigate the clinicopathologic characteristics of breast cancers with ALDH1A1+ cancer stem cells and whether the presence of cancer stem cells in these tumors is clinically significant for resistance to conventional chemotherapy in breast cancer.
Design: Primary breast cancer patients (n =513) of various types were included in this study. Tissue microarrays of the studied cases were stained with ALDH-1A1. The clinicopathologic information were recorded including patients age, menopausal status, race, tumor size, SBR grade, histologic type, node status, stage, biomarkers status (Hormonal receptors and HER2), therapy modality (adjuvant and neoadjuvant), hormonal, systemic, and radiation, and survival data including disease free (DFS) and overall survival (OS). Fisher's exact test and Kaplan-Meier test were used for statistical analysis.
Results: ALDH-1A1 expression was detected in 53 of 513 (10.3%) cases. It was significantly correlated with triple negative tumors (basal type), larger tumor size, and advanced tumor stage in the univariate and multivariate analyses. Moreover, it was significantly correlated with worse DFS (p=0.01) and OS (p=0.005) in patients who were treated with cytotoxic neoadjuvant chemotherapy (Adriamycin and cyclophosphamide with or without Taxane) (n=38).
Conclusions: ALDH-1A1 is more frequently expressed in basal type breast cancer. It could be a useful marker to predict worse clinical outcome after system chemotherapy in the neoadjuvant setting.
Tuesday, March 1, 2011 1:00 PM
Poster Session IV # 5, Tuesday Afternoon