Long-term maintenance of prognostic value of survivin protein expression in T4 breast cancer patients: 10-year results from a single institution

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22124 Background: Survivin, a member of the inhibitor of apoptosis protein family, is overexpressed in many tumors, including breast cancer and is considered a promising molecular target for emerging therapies. Survivin's overexpression is associated with poor clinical prognosis and chemo- resistance in some tumors. Survivin seems to be a strong predictor of poor survival in early-stage breast cancer patients (pts),nevertheless its role in predicting prognosis in Locally Advanced Breast Cancer (LABC) pts is still unknown. Aim of the present study was to investigate the prognostic relevance of survivin on terms of survival in LABC T4 breast cancer. Methods: Survival was estimated by Kaplan-Meier method and differences between groups were tested by log-rank test. Survivin protein was measured in primary tumor, by IHC method (samples with more than 10% of cells stained were considered to be positive); 53 out of 126 consecutive LABC T4 breast cancer pts observed between 1991 and 2001, were evaluable. Survivin protein was positive in 21 (40%), negative in 32 (60%) cases; median age was 51 years (32–67), clinical T4abc 38 pts (72%), T4d 15 pts (28%); N+ 50 pts (94%); ERneg 25 pts (47%), PRneg 36 pts (68%); HER2 status by IHC was neg in 43 pts (81%), pos in 10 pts (19%). All pts received anthracycline-based primary chemotherapy, surgery, radiation, adjuvant chemotherapy and Hormone when indicated. Results: At a median follow up of 125 months (70–182), 10y DFS and OS were 32,1% and 43,4% for the entire population, respectively. Patients with low survivin expression showed significantly better OS and a trend of improving DFS than patients with high survivin expression. Conclusions: Our data show that the overexpression of survivin protein is a negative prognostic factor in LABC pts, maintening its relevance even at long term. Survivin protein should be considered a new marker for treatment decision making and a promising target for innovative therapies. Overall (53) 5 y-10 y Survivin neg (32) 5 y-10 y Survivin pos (21) 5 y-10 y p value DFS 45% 32,1% 59,4% 37,5% 23,8% 23,8% 0.095 OS 60,4% 43,4% 75% 56,3% 38% 23,8% 0.009 No significant financial relationships to disclose.