Elevated expression of polymorphonuclear leukocyte elastase in breast cancer tissue is associated with tamoxifen failure in patients with advanced disease
2003

PMN-Elastase Levels and Tamoxifen Response in Breast Cancer

Sample size: 463 publication 10 minutes Evidence: moderate

Author Information

Author(s): Foekens J A, Ries Ch, Look M P, Gippner-Steppert C, Klijn J G M, Jochum M

Primary Institution: Erasmus MC-Daniel den Hoed

Hypothesis

Tumour-associated PMN-E might be predictive for the type of response to systemic treatment in patients with advanced breast cancer.

Conclusion

High tumour levels of PMN-E are associated with a poor rate of response to tamoxifen therapy in advanced breast cancer patients.

Supporting Evidence

  • 387 patients received tamoxifen as first-line treatment, with 51% responding.
  • High PMN-E levels were associated with a lower response rate to tamoxifen.
  • Patients with low PMN-E levels had a median postrelapse survival of 25 months compared to 15 months for those with high levels.

Takeaway

This study found that patients with high levels of a protein called PMN-elastase in their breast tumors are less likely to respond well to a common breast cancer treatment called tamoxifen.

Methodology

PMN-E levels were measured in cytosols of primary breast tumours and correlated with treatment response to tamoxifen or chemotherapy.

Potential Biases

Potential selection bias due to the exclusion of inoperable T4 tumours and those sampled after neoadjuvant treatment.

Limitations

The study design was not randomized and included only patients with advanced disease.

Participant Demographics

Median age of patients receiving tamoxifen was 62 years, and 80% were postmenopausal.

Statistical Information

P-Value

0.003

Confidence Interval

95% CI, 0.20–0.80

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1038/sj.bjc.6600813

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