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Breast Cancer
Published in: Breast Cancer 5/2019

01-09-2019 | Breast Cancer | Original Article

Diabetes as a prognostic factor in HER-2 positive breast cancer patients treated with targeted therapy

Authors: Anbok Lee, Sunmi Jo, Changhu Lee, Hyun-Hee Shin, Tae Hyun Kim, Ki Jung Ahn, Sung-Kwang Park, Heunglae Cho, Hye-Kyoung Yoon, Woo Gyeong Kim, Jiyoung Park, Yunseon Choi

Published in: Breast Cancer | Issue 5/2019

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Abstract

Purpose

Recent studies revealed that metabolic stress influences the outcomes of breast cancer treatment. We sought to evaluate the prognostic effect of type 2 diabetes and find the molecular mechanism of relapses in postoperative HER-2+ breast cancer patients treated with HER-2 targeted therapy.

Materials and methods

We evaluated 190 HER-2+ breast cancer patients (pT1-4N0-2M0) who were treated with surgical resection and trastuzumab (HER-2 targeted therapy) between 2006 and 2015. Survival outcomes and failure patterns were compared between such patients with (n = 12) and without (n = 178) type 2 diabetes.

Results

The median follow-up period was 42.4 months (range 12.0–124.7 months). Twenty-one patients (11.1%) showed relapse (including nine patients with locoregional failure), and three patients (1.6%) died as a result of cancer relapse. One-third of the patients with diabetes experienced relapse (4/12, 33.3%). The 3-year disease-free survival (DFS) and overall survival (OS) rates were 90.7% and 98.6%, respectively. Diabetic patients showed shorter DFS compared with non-diabetic patients (p = 0.006, 74.1% vs. 91.9%). OS was also shorter in diabetic patients compared with non-diabetic patients (p = 0.017, 91.7% vs. 99.1%). Of our interest, the levels of HER-3 and its ligand neuregulin-1 were significantly increased in the tumor specimen in HER-2+ breast cancer patients suffering with type 2 diabetes than that in the euglycemic control group.

Conclusions

Type 2 diabetes was associated with detrimental effects on survival in postoperative HER-2+ breast cancer patients who were treated with trastuzumab. The poor prognostic effect of diabetes in HER-2+ breast cancer patients could be associated with the high levels of HER-3 and neuregulin 1, thus it should be considered and evaluated more.
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Metadata
Title
Diabetes as a prognostic factor in HER-2 positive breast cancer patients treated with targeted therapy
Authors
Anbok Lee
Sunmi Jo
Changhu Lee
Hyun-Hee Shin
Tae Hyun Kim
Ki Jung Ahn
Sung-Kwang Park
Heunglae Cho
Hye-Kyoung Yoon
Woo Gyeong Kim
Jiyoung Park
Yunseon Choi
Publication date
01-09-2019
Publisher
Springer Japan
Published in
Breast Cancer / Issue 5/2019
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-019-00967-2

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