Predictive Role of EGFR, IGF-1R, VEGFR2 and HIF-1alfa Expression on Survival of Patients with Triple-negative Breast Cancer

Triple-negative breast cancer (TNBC) carries a poor prognosis and therapeutic options are limited to date. The aim of this study was to investigate to what extent the epidermal growth factor receptor (EGFR), vascular endothelial growth factor receptor 2 (VEGFR2), hypoxia inducible factor-1 alpha (HIF-1a) and insulin-like growth factor-1 receptor (IGF-1R) are expressed in TNBC and to determine if these expressions have a predictive role. Of 923 breast cancer patients who were treated and followed in Academic Center for Education, Culture and Research (ACECR) from 2006-2010, 104 of them had TNBC. Immunohistochemistry analyses were performed on tissue microarray blocks with antibodies for EGFR, VEGFR2, HIF-1a and IGF-1R. We analyzed tumor samples from 104 patients with classic primary invasive ductal carcinoma (IDC). Fifteen patients (14%) were in stage I, 46.6% in stage II, 30.1% in stage III and 5.8% in a metastatic stage (stage IV). The median overall survival (OS) was 48 months. EGFR was expressed in 15 (14%), VEGFR2 in 63 (61%), IGF-1R in 81 (78%) and HIF-1a in 57 (55%) samples. EGFR expression was significantly associated with poor outcome in terms of OS (P = 0.021, OR = 3.9). Among the four investigated tumor markers, only EGFR was significantly associated with survival of patients with TNBC.