THE PROGNOSTIC-SIGNIFICANCE OF SIALYL-TN ANTIGEN IN WOMEN TREATED WITH BREAST-CARCINOMA TREATED WITH ADJUVANT CHEMOTHERAPY

BACKGROUND. Sialyl-Tn (STn) represents an aberrantly glycosylated muci n epitope that is expressed in breast carcinoma and other adenocarcino mas and is an important factor in the development of novel immunothera peutic approaches. The primary aim of the current study was to investi gate the influence of STn expression on the prognoses of patients with breast carcinoma. METHODS. A cohort of 207 women diagnosed with invas ive breast carcinoma who were treated with anthracycline-containing ad juvant chemotherapy and were enrolled in a randomized clinical trial w ere studied. Expression of STn was determined by an immunohistochemica l procedure in which the B72.3 monoclonal antibody was used. Kaplan-Me ier and Cox proportional regression survival analyses were used to com pare low STn and high STn patients. RESULTS. Forty-eight (23%) of the 207 specimens demonstrated high STn staining (>25% cells were immunore active). During a median follow-up of 5 years, high STn patients had w orse disease free survival than low STn patients (55% vs. 74%, respect ively; P = 0.03). High STn expression was significantly associated wit h age (P = 0.04) but not with other conventional prognostic markers. I n multivariate analysis using the Cox regression model, high STn emerg ed as an independent prognostic indicator for disease free survival (h azard ratio [HR], 2.02; 95% confidence interval [CI], 1.09-3.73) and f or overall survival (HR, 2.16; 95% CI, 0.95-4.92). CONCLUSIONS, The re sults of this study suggest that STn may be a valuable marker for iden tifying women at high risk of developing recurrent breast carcinoma wh o may be candidates for trials investigating new therapies in combinat ion with standard adjuvant therapy. (C) 1997 American Cancer Society.