Cyclin E and Survival in Patients with Breast Cancer
Khandan Keyomarsi, Ph.D., Susan L. Tucker, Ph.D., Thomas A. Buchholz, M.D., Matthew Callister, M.D., Ye Ding, Ph.D., Gabriel N. Hortobagyi, M.D., Isabelle Bedrosian, M.D., Christopher Knickerbocker, M.S., Wendy Toyofuku, B.S., Michael Lowe, B.S., Thaddeus W. Herliczek, M.D., and Sarah S. Bacus, Ph.D.
Background Cyclin E, a regulator of the cell cycle, affectsthe behavior of breast-cancer cells. We investigated whetherlevels of cyclin E in the tumor correlated with survival amongpatients with breast cancer.
Methods Tumor tissue from 395 patients with breast cancer wasassayed for cyclin E, cyclin D1, cyclin D3, and the HER-2/neuoncogene with the use of Western blot analysis. Full-length,low-molecular-weight, and total cyclin E were measured. Immunohistochemicalassessments of cyclin E were also made of 256 tumors. We soughtcorrelations between levels of these molecular markers and disease-specificand overall survival.
Results The median follow-up was 6.4 years. A high level ofthe low-molecular-weight isoforms of cyclin E, as detected byWestern blotting, correlated strongly with disease-specificsurvival whether axillary lymph nodes were negative or positivefor metastases (P<0.001). Among 114 patients with stage Ibreast cancer, none of the 102 patients with low levels of cyclinE in the tumor had died of breast cancer by five years afterdiagnosis, whereas all 12 patients with a high level of low-molecular-weightcyclin E had died of breast cancer within that period. In multivariateanalysis, a high total cyclin E level or high levels of thelow-molecular-weight forms of cyclin E were significantly correlatedwith poor outcome. The hazard ratio for death from breast cancerfor patients with high total cyclin E levels as compared withthose with low total cyclin E levels was 13.3 abouteight times as high as the hazard ratios associated with otherindependent clinical and pathological risk factors.
Conclusions Levels of total cyclin E and low-molecular-weightcyclin E in tumor tissue, as measured by Western blot assay,correlate strongly with survival in patients with breast cancer.
Source Information
From the Department of Experimental Radiation Oncology (K.K.), the Breast Cancer Research Program (K.K., T.A.B., M.C., G.N.H.), the Department of Biomathematics (S.L.T.), the Division of Radiation Oncology (T.A.B., M.C.), the Department of Breast Medical Oncology (G.N.H.), and the Department of Surgical Oncology (I.B.), University of Texas M.D. Anderson Cancer Center, Houston; the Division of Molecular Medicine, Wadsworth Center, Albany, N.Y. (Y.D., C.K., W.T., M.L., T.W.H.); and Quantitative Diagnostic Laboratories, Elmhurst, Ill. (S.S.B.).
Address reprint requests to Dr. Keyomarsi at the Department of Experimental Radiation Oncology, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 66, Houston, TX 77030-4095, or at kkeyomar{at}mdanderson.org.
Cyclin E in Breast Cancer
Kang Y., D'Hondt L., André M., Canon J.-L., Yee D., Rabinowitz I., Bedrosian I., Tucker S. L., Keyomarsi K.
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N Engl J Med 2003;
348:1063-1064, Mar 13, 2003.
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