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Annals of Oncology Advance Access published online on April 20, 2006
Annals of Oncology, doi:10.1093/annonc/mdl053
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© 2006 European Society for Medical Oncology
Received October 14, 2005
Revised February 15, 2006
Accepted February 16, 2006

original article

Expression of chemokine receptors predicts the site of metastatic relapse in patients with axillary node positive primary breast cancer

F. Andre 1 * {dagger}, N. Cabioglu 2 {dagger}, H. Assi 1 {dagger}, J. C. Sabourin 1, S. Delaloge 1, A. Sahin 2, K. Broglio 2, J. P. Spano 3, C. Combadiere 4, C. Bucana 2, J. C. Soria 1 {dagger}, and M. Cristofanilli 2 {dagger}

1 Department of Medicine and Translational Research Unit UPRES03535, Institut Gustave Roussy, Villejuif, France
2 Departments of Pathology, Breast Medical Oncology, Biostatistics and Cancer Biology, MD Anderson Cancer Center, Houston, Texas, USA
3 Unité d'Oncologie Médicale, Pitie Salpetriere Hospital, Paris, France
4 Immunology Unit, INSERM U543, Hopital Pitie-Salpetriere, Paris, France

* To whom correspondence should be addressed.
F. Andre, E-mail: fandre{at}igr.fr


  Abstract

Background: Recent studies have suggested that chemokine receptors are involved in development of organ-specific pattern of metastases. In the present study, we evaluated the association between the chemokine receptors expressed in primary tumor cells and the site of metastatic relapse in patients with breast cancer.

Methods: Primary tumors were obtained from 142 patients with axillary node-positive breast cancer and stained for CX3CR1, CXCR4, CCR6, and CCR7 expression. All statistical analyses were adjusted for systemic post-operative treatment.

Results: After a median follow-up of 13 years, none of the chemokine receptors was associated with overall survival or disease free survival. However, expression of chemokine receptors was found to be associated with increased risk of relapse in certain organs. By estimating the Mantel-Haenszel odds ratios (OR), CXCR4 was associated with increased risk of metastasis to the liver (OR = 3.71, P = 0.005), CX3CR1 was associated with metastasis to the brain (OR = 13.18, P = 0.01). Patients with CCR6 positivity were more likely to develop a first metastasis in the pleura (OR = 2.82, P = 0.06). In addition, CCR7 expression was associated with the occurrence of skin metastases (11% versus 0%, P = 0.017).

Interpretation: Expression of chemokine receptors in the primary tumor predicts the site of metastatic relapse in patients with axillary node positive breast cancer. This study, in concordance with the data obtained in animal models, suggests that the chemokine receptors family could be the biological support of the ‘seed and soil’ theory.

Keywords: breast cancer; chemokine receptors; metastases.

{dagger}FA, NC, HA and JCS, MC equally contributed to this work.


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