Journal Article

Systematic Evaluation of HLA-G 3’Untranslated Region Variants in Locally Advanced, Non-Metastatic Breast Cancer Patients: UTR-1, 2 or UTR-4 are Predictors for Therapy and Disease Outcome

Kimmig, Rainer, Michita, Rafael Tomoya, Rohn, Hana, Rebmann, Vera, Grüntkemeier, Lisa, Bittner, Ann-Kathrin, Hoffmann, Oliver, Kasimir-Bauer, Sabine, Schwich, Esther, Horn, Peter A.

2022

Overview

Despite major improvements in diagnostics and therapy in early as well as in locally advanced breast cancer (LABC), metastatic relapse occurs in about 20% of patients, often explained by early micro-metastatic spread into bone marrow by disseminated tumor cells (DTC). Although neoadjuvant chemotherapy (NACT) has been a successful tool to improve overall survival (OS), there is growing evidence that various environmental factors like the non-classical human leukocyte antigen-G (HLA-G) promotes cancer invasiveness and metastatic progression. HLA-G expression is associated with regulatory elements targeting certain single-nucleotide polymorphisms (SNP) in the HLA-G 3’ untranslated region (UTR), which arrange as haplotypes. Here, we systematically evaluated the impact of HLA-G 3’UTR polymorphisms on disease status, on the presence of DTC, on soluble HLA-G levels, and on therapy and disease outcome in non-metastatic LABC patients. Although haplotype frequencies were similar in patients ( n  = 142) and controls ( n = 204), univariate analysis revealed that the UTR-7 haplotype was related to patients with low tumor burden, whereas UTR-4 was associated with tumor sizes >T1. Furthermore, UTR-4 was associated with the presence of DTC, but UTR-3 and UTR-7 were related to absence of DTC. Additionally, increased levels of soluble HLA-G molecules were found in patients carrying UTR-7. Regarding therapy and disease outcome, univariate and multivariate analysis highlighted UTR-1 or UTR-2 as a prognostic parameter indicative for a beneficial course of disease in terms of complete response towards NACT or progression-free survival (PFS). At variance, UTR-4 was an independent risk factor for a reduced OS besides already known parameters. Taken into account the most common HLA-G 3’UTR haplotypes (UTR-1–UTR-7, UTR-18), deduction of the UTR-1/2/4 haplotypes to specific SNPs revealed that the +3003C variant, unique for UTR-4, seemed to favor a detrimental disease outcome, while the +3187G and +3196G variants, unique for UTR-1 or UTR-2, were prognostic parameters for a beneficial course of disease. In conclusion, these data suggest that the HLA-G 3’UTR variants +3003C, +3187G, and +3196G are promising candidates for the prediction of therapy and disease outcome in LABC patients.

• Publisher: Frontiers Media SA,Frontiers Media S.A
• Subject: 3' Untranslated Regions / Adolescent / Adult / Aged / Aged, 80 and over / Alleles / Biomarkers, Tumor / Breast cancer / Breast Neoplasms - diagnosis / Breast Neoplasms - genetics / Breast Neoplasms - mortality / Breast Neoplasms - therapy / Cancer therapies / Chemotherapy / Environmental factors / Estrogens / Extracellular vesicles / Female / Genetic Association Studies / Genetic Predisposition to Disease / Genetic Variation / Genotype / Haplotypes / Histocompatibility antigen HLA / HLA-G / HLA-G 3’UTR polymorphism / HLA-G Antigens - genetics / HLA-G UTR-1 / HLA-G UTR-2 / HLA-G UTR-4 / Humans / Immunology / Invasiveness / Medical prognosis / Metastases / Metastasis / MicroRNAs / Middle Aged / Multivariate analysis / Patients / Polymorphism / Polymorphism, Single Nucleotide / Prognosis / Protein expression / Regulatory sequences / Risk factors / Single-nucleotide polymorphism / Tumor Burden / Tumor cells / Tumors / Young Adult