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Annals of Oncology Advance Access published online on July 23, 2009
Annals of Oncology, doi:10.1093/annonc/mdp293
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

AIB1 is a predictive factor for tamoxifen response in premenopausal women

S. Alkner1, P.-O. Bendahl1, D. Grabau2, K. Lövgren1, O. Stål3, L. Rydén4, M. Fernö1,* and on behalf of the South Swedish and South-East Swedish Breast Cancer Groups

1 Department of Oncology, Clinical Sciences, Lund University
2 Department of Pathology, Clinical Sciences, Lund University
3 Department of Oncology, Clinical and Experimental Medicine, Linköping University
4 Department of Surgery, Clinical Sciences, Lund University, Sweden

* Correspondence to: Prof. M. Fernö, Department of Oncology, Clinical Sciences, Barngatan 2B:1, Lund University Hospital, SE 221 85 Lund, Sweden. Tel: +46-46177565; Fax: +46-46147327; E-mail: Marten.Ferno{at}med.lu.se

Background: Clinical trials implicate the estrogen receptor (ER) coactivator amplified in breast cancer 1 (AIB1) to be a prognostic and a treatment-predictive factor, although results are not unanimous. We have further investigated this using a controlled randomised trial of tamoxifen versus control.

Materials and methods: A total of 564 premenopausal women were entered into a randomised study independent of ER status. Using a tissue microarray, AIB1 and ER were analysed by immunohistochemistry.

Results: AIB1 scores were obtained from 349 women. High AIB1 correlated to factors of worse prognosis (human epidermal growth factor receptor 2, Nottingham histological grade 3, and lymph node metastases) and to ER negativity. In the control arm, high AIB1 was a negative prognostic factor for recurrence-free survival (RFS) (P = 0.02). However, ER-positive patients with high AIB1 responded significantly to tamoxifen treatment (P = 0.002), increasing RFS to the same level as for systemically untreated patients with low AIB1. Although ER-positive patients with low AIB1 had a better RFS from the beginning, this was not further improved by tamoxifen (P = 0.8).

Conclusions: In the control group, high AIB1 was a negative prognostic factor. However, ER-positive patients with high AIB1 responded significantly to tamoxifen. This implicates high AIB1 to be an independent predictive factor of improved response to tamoxifen and not, as has previously been discussed, a factor predicting tamoxifen resistance.

amplified in breast cancer 1, breast cancer, coactivator, estrogen receptor, prognosis, tamoxifen

Received for publication February 14, 2009. Revision received April 21, 2009. Accepted for publication April 21, 2009.


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