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PI3KCA mutations and/or PTEN loss in Her2-positive breast carcinomas treated with trastuzumab are not related to resistance to anti-Her2 therapy

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Abstract

The purpose of this study is to evaluate whether activating mutations of the p110α catalytic subunit of class A phosphoinositide 3-kinases (PI3KCA) or complete loss of phosphatase and tensin homolog (PTEN) is associated with response to anti-human epidermal growth factor receptor 2 (Her2) treatment in breast cancer (BC). We analysed PI3KCA hot-spot mutations and PTEN immunohistochemical expression in 129 Her2-positive infiltrating BC treated with trastuzumab, including 26 cases treated with neoadjuvant therapy, 48 metastatic infiltrating breast cancer (IBC; MBC) and 55 early-stage IBC, with complete clinical information (mean follow-up 37, 66 and 32 months, respectively). PI3KCA hot-spot mutations were observed in 25 cases (19 %): 12 (9 %) in exon 9 and 13 (10 %) in exon 20. No correlations were observed between mutations and pathological and biological parameters. In patients treated with neoadjuvant therapy and in MBC, we did not observe any relationship with response to trastuzumab-based therapy. PTEN loss was observed in 24 out of 86 informative cases (28 %), 3 (13 %) of which were also mutated for PI3KCA. PI3K pathway activation, defined as PI3KCA mutation and/or PTEN loss, was not associated with response to treatment or clinical outcome in MBC. PI3KCA mutation and/or PTEN loss should not exclude patients from potentially beneficial anti-Her2 therapy.

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Acknowledgments

This study has been supported by grants of the Provincia Autonoma di Trento, Italy and of the Fondazione Cassa di Risparmio di Trento e Rovereto, Italy.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Unit of Surgical Pathology, Laboratory of Molecular Pathology, Trentino Biobank, S. Chiara Hospital, Trento, Italy

    Mattia Barbareschi, Lucia Veronica Cuorvo, Salvatore Girlando, Emma Bragantini, Elena Leonardi, Chiara Cantaloni, Nicola Decarli & Paolo Dalla Palma

  2. Bruno Kessler Foundation, Trento, Italy

    Claudio Eccher

  3. Unit of Medical Oncolgy, S. Chiara Hospital, Trento, Italy

    Antonella Ferro, Alessia Caldara, Renza Triolo & Enzo Galligioni

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  1. Mattia Barbareschi
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  2. Lucia Veronica Cuorvo
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  3. Salvatore Girlando
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  4. Emma Bragantini
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Correspondence to Mattia Barbareschi.

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Barbareschi, M., Cuorvo, L.V., Girlando, S. et al. PI3KCA mutations and/or PTEN loss in Her2-positive breast carcinomas treated with trastuzumab are not related to resistance to anti-Her2 therapy. Virchows Arch 461, 129–139 (2012). https://doi.org/10.1007/s00428-012-1267-2

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  • DOI: https://doi.org/10.1007/s00428-012-1267-2

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