197P - Breast cancer patients resistant to endocrine therapy are immunodeficient and show enhanced transforming growth factor - beta and vascular endotheli...

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Breast Cancer
Translational Research
Basic Principles in the Management and Treatment (of cancer)
Presenter Eva Zavadova
Authors E. Zavadova1, B. Konopasek1, M. Vocka2, T. Fucikova3, L. Petruzelka4
  • 1Oncology, Genreral Hospital and Charles University, 1600,0 - Prague/CZ
  • 2Clinic Od Oncology, Genreral Hospital and Charles University, 1600,0 - Prague/CZ
  • 3Immunology, Genreral Hospital and Charles University, 1600,0 - Prague/CZ
  • 4Clinic Od Oncology, General Faculty Hospital-Charles University, CZ-12808 - Prague/CZ


Although more than 2/3 of treated patients respond to endocrine therapy, most patients with metastatic breast cancer will develop resistance. It appears that another factor contributing to the resistance may be transforming factor-beta (TGF-beta). It is a highly immunosuppressive factor that inhibits the natural and specific immunity against tumors and stimulates production of vascular endothelial growth factor /VEGF. The purpose of the study was to monitor immune responses in patients with hormone receptor positive breast cancer resistant to hormone therapy, particularly the examination of cellular (CD4, CD8, HLA-DR) as well as humoral immunity. TGF-beta, and VEGF production was monitored and we analyzed the changes during hormonal treatment.


80 patients included in the research project were receiving routine cancer treatment with endocrine therapy. Basic parameters (histological type and grade, the degree of expression of ER and PR, HER2,and the proliferative markers) were established. Patients were evaluated by a cancer clinical immunologist to exclude immune disorders, allergic or autoimmune origin. TGF-beta, VEGF were measured by ELISA and anti-tumor cellular immunity (CD4, CD8,) were measured by flow cytometry.


In patients with resistance to endocrine therapy mainly depression in cellular immunity was found. Immunglobulin plasma level was decreased as well (mainly IgG4 subtype). Most patients have shown clinical symptoms of immunodeficiency (frequent infections of respiratory or urinary tract, herpetic infections); TGF-beta as well as VEGF plasma levels were increased.


Correlation of these factors with resistance to hormonal therapy, and the state of anticancer immunity could help in the future with the prediction of resistance to hormonal therapy and contribute to the selection of targeted immune therapy in cancer patients.


This project was supported by grant IGA NT11168-3/2010.


All authors have declared no conflicts of interest.