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PIK3CA Exon 20 Mutation is Independently Associated with a Poor Prognosis in Breast Cancer Patients

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Prognostic factors that could select breast cancer patients with poor survival, and influence clinical trials of targeted therapy, are needed. However, the reported observations regarding the impact of PI3KCA mutation on breast cancers are controversial.

Methods

We analyzed exons 4, 7, 9, and 20 of PI3KCA on a series of 158 patients. Clinicopathological characteristics were correlated with the mutation data.

Results

Among 152 patients who were available for follow-up (median follow-up time, 6.57 years), 26% had PIK3CA mutations, more than half of which occurred in exon 20. The five-year survival rate of patients with exon 20 mutations (46%) was significantly lower than that of patients without (75%) (p = 0.0054). Multivariate analysis showed that PIK3CA exon 20 mutations and nodal involvement were independent risk factors for overall survival. The relative risk of death in patients with PIK3CA exon 20 mutations was 2.881 (95% CI, 1.406–5.900; p = 0.0038).

Conclusions

PIK3CA mutations are common in invasive ductal carcinomas of the breast. Our result suggests that PIK3CA exon 20 mutation is an independent risk factor for poor prognosis in breast cancer patients, indicating that differences in patient numbers with PIK3CA exon 20 mutations in study and control arms should be avoided in clinical trials of PI3K inhibitors.

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Acknowledgments

This study is supported in part by Grant NSC 94-2320-B-195-001 from the National Science Council, Taiwan, and MMH-E-95002 from Mackay Memorial Hospital, Taipei, Taiwan. The authors thank Jui-Hung Chu for statistical analysis and Chun-Yu Kuo for reviewing this manuscript from a statistician’s point of view.

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Authors and Affiliations

  1. Hospice Palliative Care Center, Mackay Memorial Hospital, 45 Minsheng Road, Danshui, Taipei, 251, Taiwan

    Yuen-Liang Lai MD

  2. Center for General Education, National Yang-Ming University, 155 Sec. 2, Linong Street, Beitou, Taipei, 112, Taiwan

    Yuen-Liang Lai MD

  3. School of Medicine, Taipei Medical University, 250 Wuxin Street, Xinyi, Taipei, 110, Taiwan

    Yuen-Liang Lai MD

  4. Division of General Internal Medicine, Sun Yat-Sen Cancer Center, 125 Lihder Road, Beitou, Taipei, 112, Taiwan

    Bey-Liing Mau MD PhD

  5. Department of Pathology, Mackay Memorial Hospital, 45 Minsheng Road, Danshui, Taipei, 251, Taiwan

    Wen-Hsuan Cheng MS & Chin-Yuan Tzen MD PhD

  6. Department of Surgery, Ten-Chan General Hospital, 155 Yanping Road, Chungli, Taoyuan, 320, Taiwan

    Han-Ming Chen MD

  7. Department of Surgery, Cheng-Ching Hospital, 118 Sec. 3, Chungkang Road, Taichung, 407, Taiwan

    Hsi-Hsiung Chiu MD

  8. Mackay Medicine, Nursing and Management College, 92 Shengjing Road, Beitou, Taipei , 112, Taiwan

    Chin-Yuan Tzen MD PhD

  9. National Taipei College of Nursing, 365 Minte Road, Beitou, Taipei, 112, Taiwan

    Chin-Yuan Tzen MD PhD

Authors
  1. Yuen-Liang Lai MD
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  2. Bey-Liing Mau MD PhD
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  3. Wen-Hsuan Cheng MS
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  4. Han-Ming Chen MD
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  5. Hsi-Hsiung Chiu MD
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  6. Chin-Yuan Tzen MD PhD
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Corresponding author

Correspondence to Chin-Yuan Tzen MD PhD.

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Lai, YL., Mau, BL., Cheng, WH. et al. PIK3CA Exon 20 Mutation is Independently Associated with a Poor Prognosis in Breast Cancer Patients. Ann Surg Oncol 15, 1064–1069 (2008). https://doi.org/10.1245/s10434-007-9751-7

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  • DOI: https://doi.org/10.1245/s10434-007-9751-7

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