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The role of serum thymidine kinase 1 activity in neoadjuvant-treated HER2-positive breast cancer: biomarker analysis from the Swedish phase II randomized PREDIX HER2 trial.


ABSTRACT:

Background

Thymidine kinase 1 (TK1) plays a pivotal role in DNA synthesis and cellular proliferation. TK1 has been studied as a prognostic marker and as an early indicator of treatment response in human epidermal growth factor 2 (HER2)-negative early and metastatic breast cancer (BC). However, the prognostic and predictive value of serial TK1 activity in HER2-positive BC remains unknown.

Methods

In the PREDIX HER2 trial, 197 HER2-positive BC patients were randomized to neoadjuvant trastuzumab, pertuzumab, and docetaxel (DPH) or trastuzumab emtansine (T-DM1), followed by surgery and adjuvant epirubicin and cyclophosphamide. Serum samples were prospectively collected from all participants at multiple timepoints: at baseline, after cycle 1, 2, 4, and 6, at end of adjuvant therapy, annually for a total period of 5 years and/or at the time of recurrence. The associations of sTK1 activity with baseline characteristics, pathologic complete response (pCR), event-free survival (EFS), and disease-free survival (DFS) were evaluated.

Results

No association was detected between baseline sTK1 levels and all the baseline clinicopathologic characteristics. An increase of TK1 activity from baseline to cycle 2 was seen in all cases. sTK1 level at baseline, after 2 and 4 cycles was not associated with pCR status. After a median follow-up of 58 months, 23 patients had EFS events. There was no significant effect between baseline or cycle 2 sTK1 activity and time to event. A non-significant trend was noted among patents with residual disease (non-pCR) and high sTK1 activity at the end of treatment visit, indicating a potentially worse long-term prognosis.

Conclusion

sTK1 activity increased following neoadjuvant therapy for HER2-positive BC but was not associated with patient outcomes or treatment benefit. However, the post-surgery prognostic value in patients that have not attained pCR warrants further investigation.

Trial registration

ClinicalTrials.gov, NCT02568839. Registered on 6 October 2015.

SUBMITTER: Zhu Y 

PROVIDER: S-EPMC10948570 | biostudies-literature | 2024 Apr

REPOSITORIES: biostudies-literature

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The role of serum thymidine kinase 1 activity in neoadjuvant-treated HER2-positive breast cancer: biomarker analysis from the Swedish phase II randomized PREDIX HER2 trial.

Zhu Yajing Y   Zerdes Ioannis I   Matikas Alexios A   Cruz Ivette Raices IR   Bergqvist Mattias M   Elinder Ellinor E   Bosch Ana A   Lindman Henrik H   Einbeigi Zakaria Z   Andersson Anne A   Carlsson Lena L   Dreifaldt Ann Charlotte AC   Isaksson-Friman Erika E   Hellstrom Mats M   Johansson Hemming H   Wang Kang K   Bergh Jonas C S JCS   Hatschek Thomas T   Foukakis Theodoros T  

Breast cancer research and treatment 20240104 2


<h4>Background</h4>Thymidine kinase 1 (TK1) plays a pivotal role in DNA synthesis and cellular proliferation. TK1 has been studied as a prognostic marker and as an early indicator of treatment response in human epidermal growth factor 2 (HER2)-negative early and metastatic breast cancer (BC). However, the prognostic and predictive value of serial TK1 activity in HER2-positive BC remains unknown.<h4>Methods</h4>In the PREDIX HER2 trial, 197 HER2-positive BC patients were randomized to neoadjuvant  ...[more]

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