Breast Cancer Research and Treatment

, Volume 165, Issue 3, pp 611–621 | Cite as

Prognostic impact of the inclusion of uPA/PAI-1 for adjuvant treatment decision-making in ER+/Her2− pN0 early breast cancers

  • Marie VialaEmail author
  • Marie Alexandre
  • Simon Thezenas
  • Pierre-Jean Lamy
  • Aurélie Maran-Gonzalez
  • Marian Gutowski
  • Pierre-Emmanuel Colombo
  • Gilles Romieu
  • William Jacot
  • Severine Guiu
Clinical trial



Intermediate-risk early breast cancer (EBC) is a heterogeneous group in which adjuvant chemotherapy decision proves to be difficult. Clinical and pathological criteria are sometimes insufficient to determine the best therapeutic options, and validated biomarkers such as uPA/PAI-1, are needed to contribute to the decision-making. The objective of this study was to evaluate the clinical outcome of an unselected ER+/HER2− pN0 EBC cohort of patients in whom the routine clinical decision process included a prospective uPA/PAI-1 determination.


This monocentric retrospective study included 520 patients who underwent curative surgery in our institute between 2006 and 2011. Adjuvant therapeutic strategy was decided based on clinical–pathological data, altogether with a routine prospective determination of uPA/PAI-1 tumor levels using fresh, extemporaneously sampled tissue. We evaluated the correlation between uPA/PAI-1 levels, clinical-pathological variables, and the patient’s outcome (relapse-free survival, RFS, and overall survival, OS).


Median follow-up was 5.4 years. The 5- and 10-year RFS rates were ,respectively, 95 and 89%, and the five-year OS rate was 96.3%. Forty percent of tumors had low uPA/PAI-1 levels. Seventy-five percent of patients with low uPA/PAI-1 levels did not receive chemotherapy, when 25% did. Sixty percent of patients with high uPA and/or PAI-1 levels received chemotherapy, while 40% did not. No statistical significant correlation was found between the uPA/PAI-1 levels and RFS or OS.


The personalization of the patients’ treatment using uPA/PAI-1 tumor levels allows the reversion of the well-known poor prognostic impact of high uPA/PAI-1 levels and strongly supports the use of this biomarker in clinical practice.


uPA/PAI-Adjuvant chemotherapy Breast cancer Tailoring 



The authors thank Hélène de Forges, Ph.D., for editorial assistance.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10549_2017_4373_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 19 kb)


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Marie Viala
    • 1
    Email author
  • Marie Alexandre
    • 1
  • Simon Thezenas
    • 1
  • Pierre-Jean Lamy
    • 2
  • Aurélie Maran-Gonzalez
    • 1
  • Marian Gutowski
    • 1
  • Pierre-Emmanuel Colombo
    • 1
    • 3
  • Gilles Romieu
    • 1
  • William Jacot
    • 1
    • 3
  • Severine Guiu
    • 1
    • 3
  1. 1.Institut Régional du Cancer de Montpellier - Val d’AurelleMontpellierFrance
  2. 2.Institut Médical d’Analyse Génomique, Labosud et Unité de Recherche Clinique, Clinique Beau SoleilMontpellierFrance
  3. 3.INSERM U1194–IRCM (Institut de Recherche en Cancérologie de Montpellier)MontpellierFrance

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