Prognostic Effect of Epithelial Cell Adhesion Molecule Overexpression in Untreated Node-Negative Breast Cancer

• Published in: Clinical cancer research 2008-09, Vol.14 (18), p.5849-5855
• Main Authors: SCHMIDT, Marcus, HASENCLEVER, Dirk, GEBHARD, Susanne, PILCH, Henryk, GEHRMANN, Mathias, LEHR, Hans-Anton, KOELBL, Heinz, HENGSTLER, Jan G, SCHULER, Martin, SCHAEFFER, Mitra, BOEHM, Daniel, COTARELO, Cristina, STEINER, Eric, LEBRECHT, Antje, SIGGELKOW, Wulf, WEIKEL, Wolfgang, SCHIFFER-PETRY, Ilka
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antigens, Neoplasm - metabolism; Antineoplastic agents; Biological and medical sciences; Biomarkers, Tumor; Breast Neoplasms - metabolism; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Cell Adhesion Molecules - metabolism; Drug Delivery Systems; Ep-CAM; Epithelial Cell Adhesion Molecule; Female; Gynecology. Andrology. Obstetrics; HER-2; Humans; Lymphatic Metastasis; Mammary gland diseases; Medical sciences; Middle Aged; Neoplasms, Hormone-Dependent; node negative; Pharmacology. Drug treatments; Prognosis; triple negative; Tumors
• ISSN: 1078-0432; 1557-3265
• DOI: 10.1158/1078-0432.CCR-08-0669

Purpose: Epithelial cell adhesion molecule (Ep-CAM) recently received increased attention not only as a prognostic factor in breast cancer but also as a potential target for immunotherapy. We examined Ep-CAM expression in 402 consecutive node-negative breast cancer patients with long-term follow-up not treated in the adjuvant setting. Experimental Design: Ep-CAM expression was evaluated by immunostaining. Its prognostic effect was estimated relative to overexpression/amplification of HER-2, histologic grade, tumor size, age, and hormone receptor expression. Results: Ep-CAM status was positive in 106 (26.4%) patients. In multivariate analysis, Ep-CAM status was associated with disease-free survival independent of age, pT stage, histologic grade, estrogen receptor (ER), progesterone receptor (PR), as well as HER2 status ( P = 0.028; hazard ratio, 1.60; 95% confidence interval, 1.05-2.44). Recently, so-called triple-negative (HER-2, ER, and PR) breast cancer has received increased attention. We noticed a similar association of Ep-CAM with disease-free survival in the triple-negative group as for the entire cohort. Conclusion: In this study of untreated breast cancer patients, Ep-CAM overexpression was associated with poor survival in the entire cohort and in the subgroup of triple-negative breast cancer. This suggests that Ep-CAM may be a well-suited target for specific therapies particularly in HER-2–, ER-, and PR-negative tumors.