A prospective trial on initiation factor 4E (elF4E) overexpression and cancer recurrence in node-positive breast cancer

Derek R. McClusky, Quyen Chu, Herbert Yu, Arrigo DeBenedetti, Lester W. Johnson, Carol Meschonat, Richard Turnage, John C. McDonald, Fleurette Abreo, Benjamin D.L. Li, Nicholas J. Petrelli, Tien C. Ko, Leigh A. Neumayer

Research output: Contribution to journalArticle

46 Scopus citations

Abstract

Objective: A previous study of patients with stage I to III breast cancer showed that those patients whose tumors were in the highest tertile of eIF4E overexpression experienced a higher risk for recurrence. This study was designed to determine whether high eIF4E overexpression predicts cancer recurrence independent of nodal status by specifically targeting patients with node-positive disease. Methods: The prospective trial was designed to accrue 168 patients with node-positive breast cancer to detect a 2.5-fold increase in risk for recurrence. eIF4E level was quantified by Western blots as x-fold elevated compared with breast tissues from noncancer patients. End points measured were disease recurrence and cancer-related death. Statistical analyses performed include survival analysis by the Kaplan-Meier method, log-rank test, and Cox proportional hazard model. Results: One hundred seventy-four patients with node-positive breast cancer were accrued. All patients fulfilled study inclusion and exclusion criteria, treatment protocol, and surveillance requirements, with a compliance rate >95%. The mean eIF4E elevation was 11.0 ± 7.0-fold (range, 1.4-34.3-fold). Based on previously published data, tertile distribution was as follow: 1) lowest tertile (<7.5-fold) = 67 patients, 2) intermediate tertile (7.5-14-fold) = 54 patients, and 3) highest tertile (> 14-fold) = 53 patients. At a median follow up of 32 months, patients with the highest tertile had a statistically significant higher cancer recurrence rate (log-rank test, P = 0.002) and cancer-related death rate (P = 0.036) than the lowest group. Relative risk calculations demonstrated that high eIF4E patients had a 2.4-fold increase in relative risk increase for cancer recurrence (95% confidence interval, 1.2-4.1; P = 0.01). Conclusions: In this prospective study designed to specifically address risk for recurrence in patients with node-positive breast cancer, the patients whose tumors were in the highest tertile of eIF4E overexpression had a 2.4-fold increase in relative risk for cancer recurrence. Therefore, eIF4E overexpression appears to be an independent predictor of a worse outcome in patients with breast cancer independent of nodal status.

Original languageEnglish (US)
Pages (from-to)584-592
Number of pages9
JournalAnnals of surgery
Volume242
Issue number4
DOIs
StatePublished - Oct 1 2005
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'A prospective trial on initiation factor 4E (elF4E) overexpression and cancer recurrence in node-positive breast cancer'. Together they form a unique fingerprint.

  • Cite this

    McClusky, D. R., Chu, Q., Yu, H., DeBenedetti, A., Johnson, L. W., Meschonat, C., Turnage, R., McDonald, J. C., Abreo, F., Li, B. D. L., Petrelli, N. J., Ko, T. C., & Neumayer, L. A. (2005). A prospective trial on initiation factor 4E (elF4E) overexpression and cancer recurrence in node-positive breast cancer. Annals of surgery, 242(4), 584-592. https://doi.org/10.1097/01.sla.0000184224.55949.90