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Endothelin-1 genetic polymorphism as predictive marker for bevacizumab in metastatic breast cancer

The Pharmacogenomics Journal volume 17, pages 344–350 (2017)Cite this article

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Abstract

Biomarkers for bevacizumab efficacy in metastatic breast cancer (MBC) are of urgent need. The genetic variability of genes involved in angiogenesis could explain the interpatient variability of drug effects. For this biomarker study DNA was extracted from tumor blocks or blood samples of patients with human epidermal growth factor receptor 2 (HER2)-negative MBC treated with bevacizumab in combination with chemotherapy (bevacizumab cohort, 163 patients) or chemotherapy only (control cohort, 105 patients). We assessed the correlation of 10 single-nucleotide polymorphisms (SNPs) in genes modulating angiogenesis (vascular endothelial growth factor-A (VEGF-A), VEGF receptor 1 (VEGFR-1), serine threonine kinase 39 (STK39)) or hypertension (endothelin-1 and uromodulin) with outcome and toxicity. In the bevacizumab cohort, the SNP rs5370-TT in endothelin-1 (EDN1) showed a significantly shorter median overall survival (OS, 6.3 vs 21.3 months; hazard ratio (HR) 2.89, 95% confidence interval (CI) 1.34–6.26; log-rank P=0.0069) and a trend toward worse median progression-free survival (3.5 vs 7.9 months; HR 2.05, 95% CI 0.96–4.39; log-rank P=0.065) compared with the alternate genotypes combined. Similarly, patients harboring the VEGF-936 (rs3025039) TT alleles showed a significantly shorter median OS than patients with VEGF-936 CC or CT (14.9 vs 21.3 months; HR 2.37, 95% CI 1.09–5.13; P=0.0286). In multivariate analysis including important clinical parameters like disease-free survival (DFS), adjuvant chemotherapy, ECOG (Eastern Cooperative Oncology Group) performance score, histologic subtype, grade, hormone receptor status, visceral metastases and treatment line, only the association of rs5370 (EDN1) with OS was still statistically significant (P=0.012). In the control cohort, no association of the EDN1 genotype with outcome was seen, suggesting a predictive value for bevacizumab. In conclusion, the SNP rs5370 in endothelin-1 could help identifying patients who unlikely gain any benefit from bevacizumab.

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Acknowledgements

This research project was partially supported by ROCHE Austria GmbH.

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Authors and Affiliations

  1. IIIrd Medical Department with Hematology and Medical Oncology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria

    S P Gampenrieder, C Hufnagl, S Brechelmacher, F Huemer, G Rinnerthaler, F Romeder, C Monzo Fuentes, P Morre, B Mlineritsch & R Greil

  2. Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Salzburg, Austria

    S P Gampenrieder, C Hufnagl, S Brechelmacher, F Huemer, G Rinnerthaler, F Romeder, C Monzo Fuentes, P Morre, B Mlineritsch & R Greil

  3. Cancer Cluster Salzburg, Salzburg, Austria

    S P Gampenrieder, C Hufnagl, S Brechelmacher, F Huemer, G Rinnerthaler, F Romeder, C Monzo Fuentes, P Morre, B Mlineritsch & R Greil

  4. Division of Bioinformatics, Biocenter, Medical University of Innsbruck, Innsbruck, Austria

    H Hackl

  5. Department of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria

    C Hauser-Kronberger

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Employment or leadership position: none; consultant or advisory role: SPG, GR, BM and RG; stock ownership: none; speakers honoraria: BM and RG; travel grants: SPG, GR, CH, FR, CMF, CH-K, BM and RG; research funding: SPG, GR, FH, CH, BM and RG.

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Gampenrieder, S., Hufnagl, C., Brechelmacher, S. et al. Endothelin-1 genetic polymorphism as predictive marker for bevacizumab in metastatic breast cancer. Pharmacogenomics J 17, 344–350 (2017). https://doi.org/10.1038/tpj.2016.25

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