Circulating small-sized endothelial microparticles as predictors of clinical outcome after chemotherapy for breast cancer: an exploratory analysis

Elisa García Garre, Ginés Luengo Gil, Silvia Montoro García, Enrique Gonzalez Billalabeitia, Marta Zafra Poves, Elena García Martinez, Vanessa Roldán Schilling, Esther Navarro Manzano, Alejandra Ivars Rubio, Gregory Y H Lip, Francisco Ayala de la Peña

Research output: Contribution to journalJournal articleResearchpeer-review

14 Citations (Scopus)

Abstract

PURPOSE: Therapeutic exploitation of angiogenesis in breast cancer has been limited by the lack of reliable biomarkers. Circulating small-sized endothelial microparticles (sEMP) are likely to play a significant role as messengers of angiogenesis. Higher levels of EMP have been observed in cancer patients, but their prognostic value in breast cancer is unknown. Our aim was to determine the value of circulating sEMP as a marker of response to chemotherapy in breast cancer.

METHODS: We included patients with breast cancer treated with neoadjuvant or first-line chemotherapy. Baseline and post-treatment circulating sEMP (CD144+) were quantified using a flow cytometer approach specifically designed for analysis of small-sized particles (0.1-0.5 μm). Small-sized EMP response was defined as a post-treatment decrease of sEMP larger than the median decrease of sEMP after chemotherapy. Baseline and post-chemotherapy VEGFA levels were determined with ELISA.

RESULTS: Forty-four breast cancer patients were included (19 with metastatic and 25 with locally advanced disease). Median levels of sEMP decreased after chemotherapy (P = 0.005). Response to chemotherapy showed a non-significant trend to associate with sEMP response (P = 0.056). A sEMP response was observed in 51% of patients and was associated with better overall survival (HR 0.18; 95% CI 0.04-0.87; P = 0.02) and progression free survival (HR 0.30; 95% CI 0.09-0.99; P = 0.04) in the group of women with metastatic disease. Post-chemotherapy decrease of VEGFA levels was not associated with breast cancer prognosis.

CONCLUSIONS: Our results did not support sEMP as a marker of response to chemotherapy. However, our exploratory analysis suggests that in patients with metastatic breast cancer, the decrease of sEMP levels after chemotherapy is associated with better overall and disease free survival and might be superior to VEGFA levels as an angiogenesis-related prognostic marker.

Original languageEnglish
JournalBreast Cancer Research and Treatment
Volume169
Issue number1
Pages (from-to)83-92
Number of pages10
ISSN0167-6806
DOIs
Publication statusPublished - May 2018
Externally publishedYes

Keywords

  • Breast cancer
  • Chemotherapy
  • Endothelial
  • Small-sized microparticles
  • VEGFA

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