TY - JOUR TI - Impact of tumor angiogenic profile on the outcome of patients with metastatic breast carcinoma treated with weekly docetaxel. A Hellenic Cooperative Oncology Group (HeCOG) study AU - Kourea, Helen P. AU - Kotoula, Vassiliki AU - Koutras, Angelos and AU - Alexopoulou, Zoi AU - Papaspirou, Irene AU - Skarlos, Dimosthenis V. and AU - Efstratiou, Ioannis AU - Bobos, Mattheos AU - Zagouri, Flora and AU - Papakostas, Pavlos AU - Pectasides, Dimitrios AU - Chrisafi, Sofia and AU - Varthalitis, Ioannis AU - Aravantinos, Gerasimos AU - Kosmidis, Paris and AU - Bafaloukos, Dimitrios AU - Scopa, Chrisoula D. AU - Fountzilas, George JO - HISTOLOGY AND HISTOPATHOLOGY PY - 2015 VL - 30 TODO - 9 SP - 1129-1141 PB - F HERNANDEZ SN - 0213-3911 TODO - 10.14670/HH-11-612 TODO - Metastatic breast cancer; Docetaxel; VEGF-A; VEGFR-1; VEGFR-2 TODO - Background: Metronomic taxane administration has putative antiangiogenic properties. Herein, we examined the baseline tumor angiogenic profile of patients with metastatic breast carcinoma (MBC) in a prospective-retrospective translational research study. The interplay between the angiogenic factors expressed in the tumors and their prognostic value in MBC were investigated. Patients and Methods: Tumor tissues from patients with MBC treated with weekly docetaxel (n=159) were examined by immunohistochemistry for VEGF-A, VEGF-C, VEGFR-1, VEGFR-2, VEGFR-3 and osteopontin (OPN) and by mRNA analysis for expression of VEGF-A, VEGFxxxa, VEGFxxxb, VEGF-C, thrombospondin-1 (THBS-1), hypoxia-inducible factor-1 alpha (HIF-1 alpha) and von Hippel-Lindau (VHL) genes. Associations between these parameters and outcome were statistically analyzed. Results: Statistically significant correlations were identified between almost all biomarkers examined in continuous form, particularly at the mRNA level: VEGF-A with VEGFxxxa (rho=0.70); VEGF-C with VEGFxxxa, VEGFxxxb and VHL (rho=0.51, 0.60 and 0.44 respectively); HIF-1 alpha with VEGF-C and THBS1 (rho=0.48 and 0.45). High VEGF-A mRNA was associated with worse survival (p=0.0279) and marginally with progression free survival (PFS). Intratumoral co-expression of VEGFR-1 and VEGFR-2 proteins was associated with more favorable survival (p=0.0337). In multivariate analysis, only high VEGF-A mRNA levels retained their prognostic role for worse PFS and survival (PFS: HR=2.34, 95% CI=1.25-4.40, p=0.0080; survival: HR=3.15, 95% CI=1.48-6.72, p=0.0029). Conclusions: In MBC, this study confirms the adverse prognostic effect of high intratumoral VEGF-A mRNA and reveals the combined VEGFR-1/VEGFR-2 ER -