Genomic aberrations and late recurrence in postmenopausal women with hormone receptor⇓positive early breast cancer: results from the SOLE trial

Elena Guerini-Rocco, Kathryn P. Gray, Caterina Fumagalli, Marta Rita Reforgiato, Isabella Leone, Paola Rafaniello Raviele, Elisabetta Munzone, Roswitha Kammler, Patrick Neven, Erika Hitre, Guy Jerusalem, Edda Simoncini, Andrea Gombos, Ines Deleu, Per Karlsson, Stefan Aebi, Jacquie Chirgwin, Vincenzo Di Lauro, Alastair Thompson, Marie Pascale GraasMatthew Barber, Christel Fontaine, Sibylle Loibl, Joaquín Gavila, Katsumasa Kuroi, Bettina Muller, Seamus O’Reilly, Angelo Di Leo, Aron Goldhirsch, Giuseppe Viale, Massimo Barberis, Meredith M. Regan, Marco Colleoni

Research output: Contribution to journalArticlepeer-review


Purpose: Women with hormone receptor–positive early breast cancers have a persistent risk of relapse and biomarkers for late recurrence are needed. We sought to identify tumor genomic aberrations associated with increased late-recurrence risk. Experimental Design: In a secondary analysis of Study of Letrozole Extension trial, a case-cohort–like sampling selected 598 primary breast cancers for targeted next-generation sequencing analysis of gene mutations and copy-number gains (CNGs). Correlations of genomic aberrations with clinicopathologic factors and breast and distant recurrence-free intervals (BCFIs and DRFIs) were analyzed using weighted Cox models. Results: Analysis of mutations and CNGs was successfully performed for 403 and 350 samples, including 148 and 134 patients with breast cancer recurrences (median follow-up time, 5.2 years), respectively. The most frequent alterations were PIK3CA mutations (42%) and CNGs of CCND1 (15%), ERBB2 (10%), FGFR1 (8%), and MYC (8%). PIK3CA mutations and MYC CNGs were associated with lower (P ¼ 0.03) and higher (P ¼ 0.004) tumor grade, respectively; a higher Ki-67 was seen in tumor with CCND1, ERBB2, and MYC CNGs (P ¼ 0.01, P < 0.001, and P ¼ 0.03, respectively). FGFR1 CNG was associated with an increased risk of late events in univariate analyses [17/29 patients; BCFI: HR, 3.2; 95% confidence interval (CI), 1.48–6.92; P ¼ 0.003 and DRFI: HR, 3.5; 95% CI, 1.61–7.75; P ¼ 0.002) and in multivariable models adjusted for clinicopathologic factors. Conclusions: Postmenopausal women with hormone receptor–positive early breast cancer harboring FGFR1 CNG had an increased risk of late recurrence despite extended therapy. FGFR1 CNG may represent a useful prognostic biomarker for late recurrence and a therapeutic target.

Original languageEnglish
Pages (from-to)504-512
Number of pages9
JournalClinical Cancer Research
Issue number2
Publication statusPublished - Jan 15 2021

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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