Immunomodulation of FOXP3+ regulatory T cells by the aromatase inhibitor letrozole in breast cancer patients.

PURPOSE: We have shown previously that tumor infiltration by FOXP3+ regulatory T cells (Treg) is associated with increased relapse and shorter survival of patients with both in situ and invasive breast cancer. Because estrogen regulates Treg numbers in mice and promotes the proliferation of human T...

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Egile Nagusiak: Generali, D, Bates, G, Berruti, A, Brizzi, M, Campo, L, Bonardi, S, Bersiga, A, Allevi, G, Milani, M, Aguggini, S, Dogliotti, L, Banham, A, Harris, A, Bottini, A, Fox, S
Formatua: Journal article
Hizkuntza:English
Argitaratua: 2009
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author Generali, D
Bates, G
Berruti, A
Brizzi, M
Campo, L
Bonardi, S
Bersiga, A
Allevi, G
Milani, M
Aguggini, S
Dogliotti, L
Banham, A
Harris, A
Bottini, A
Fox, S
author_facet Generali, D
Bates, G
Berruti, A
Brizzi, M
Campo, L
Bonardi, S
Bersiga, A
Allevi, G
Milani, M
Aguggini, S
Dogliotti, L
Banham, A
Harris, A
Bottini, A
Fox, S
author_sort Generali, D
collection OXFORD
description PURPOSE: We have shown previously that tumor infiltration by FOXP3+ regulatory T cells (Treg) is associated with increased relapse and shorter survival of patients with both in situ and invasive breast cancer. Because estrogen regulates Treg numbers in mice and promotes the proliferation of human Tregs, we hypothesized that blocking estrogen receptor-alpha signaling would abrogate Tregs and be associated with response to hormonal therapy and increased survival. EXPERIMENTAL DESIGN: FOXP3+ Tregs were quantified in tumor samples collected at baseline by incisional biopsy and after 6 months at definitive surgery in 83 elderly breast cancer patients (T2-4 N0-1) enrolled in a randomized phase II trial based on 6 months of primary letrozole (2.5 mg/d) or 6 months of letrozole plus oral "metronomic" cyclophosphamide (50 mg/d). RESULTS: Treg number ranged from 0 to 380 (median, 30) before treatment and from 0 to 300 (median, 8) after treatment. There was a significant reduction in Tregs in letrozole and letrozole-cyclophosphamide patients (P < 0.0001 and P < 0.002, respectively) after treatment. Treg number at residual histology was inversely related with response (P < 0.03 and P = 0.50, respectively) and a greater Treg reduction was observed in responding patients (P < 0.03). CONCLUSION: This study suggests that aromatase inhibitors may have an indirect antitumor mechanism of action through reducing Tregs in breast tumors and may be of use in estrogen receptor-alpha-negative tumors in combination with immunotherapy approaches.
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spelling oxford-uuid:5d4cc906-9789-4150-ab0d-1fb5fddf2dd12022-03-26T17:33:36ZImmunomodulation of FOXP3+ regulatory T cells by the aromatase inhibitor letrozole in breast cancer patients.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5d4cc906-9789-4150-ab0d-1fb5fddf2dd1EnglishSymplectic Elements at Oxford2009Generali, DBates, GBerruti, ABrizzi, MCampo, LBonardi, SBersiga, AAllevi, GMilani, MAguggini, SDogliotti, LBanham, AHarris, ABottini, AFox, S PURPOSE: We have shown previously that tumor infiltration by FOXP3+ regulatory T cells (Treg) is associated with increased relapse and shorter survival of patients with both in situ and invasive breast cancer. Because estrogen regulates Treg numbers in mice and promotes the proliferation of human Tregs, we hypothesized that blocking estrogen receptor-alpha signaling would abrogate Tregs and be associated with response to hormonal therapy and increased survival. EXPERIMENTAL DESIGN: FOXP3+ Tregs were quantified in tumor samples collected at baseline by incisional biopsy and after 6 months at definitive surgery in 83 elderly breast cancer patients (T2-4 N0-1) enrolled in a randomized phase II trial based on 6 months of primary letrozole (2.5 mg/d) or 6 months of letrozole plus oral "metronomic" cyclophosphamide (50 mg/d). RESULTS: Treg number ranged from 0 to 380 (median, 30) before treatment and from 0 to 300 (median, 8) after treatment. There was a significant reduction in Tregs in letrozole and letrozole-cyclophosphamide patients (P < 0.0001 and P < 0.002, respectively) after treatment. Treg number at residual histology was inversely related with response (P < 0.03 and P = 0.50, respectively) and a greater Treg reduction was observed in responding patients (P < 0.03). CONCLUSION: This study suggests that aromatase inhibitors may have an indirect antitumor mechanism of action through reducing Tregs in breast tumors and may be of use in estrogen receptor-alpha-negative tumors in combination with immunotherapy approaches.
spellingShingle Generali, D
Bates, G
Berruti, A
Brizzi, M
Campo, L
Bonardi, S
Bersiga, A
Allevi, G
Milani, M
Aguggini, S
Dogliotti, L
Banham, A
Harris, A
Bottini, A
Fox, S
Immunomodulation of FOXP3+ regulatory T cells by the aromatase inhibitor letrozole in breast cancer patients.
title Immunomodulation of FOXP3+ regulatory T cells by the aromatase inhibitor letrozole in breast cancer patients.
title_full Immunomodulation of FOXP3+ regulatory T cells by the aromatase inhibitor letrozole in breast cancer patients.
title_fullStr Immunomodulation of FOXP3+ regulatory T cells by the aromatase inhibitor letrozole in breast cancer patients.
title_full_unstemmed Immunomodulation of FOXP3+ regulatory T cells by the aromatase inhibitor letrozole in breast cancer patients.
title_short Immunomodulation of FOXP3+ regulatory T cells by the aromatase inhibitor letrozole in breast cancer patients.
title_sort immunomodulation of foxp3 regulatory t cells by the aromatase inhibitor letrozole in breast cancer patients
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