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Inactivation of FBXW7/hCDC4-β expression by promoter hypermethylation is associated with favorable prognosis in primary breast cancer

Shahab Akhoondi12, Linda Lindström2, Martin Widschwendter4, Martin Corcoran2, Jonas Bergh23, Charles Spruck5, Dan Grandér2 and Olle Sangfelt12*

Author Affiliations

1 Departments of Cell and Molecular Biology, Karolinska Institute, Berzelius väg 35, Box 285 S-17177, Stockholm, Sweden

2 Departments of Oncology-Pathology, Cancer Center Karolinska, Radiumhemmet, Karolinska Institute and Hospital, S-17176, Stockholm, Sweden

3 Department of Medical Oncology, Christie Hospital, Manchester University and Christie Hospital, Wilmslow Road, Manchester, M20 4BX, UK

4 Department of Gynecological Oncology, Institute for Women's Health, University College London, EGA Hospital, 2nd Floor Huntley Street, London, WC1E 6DH, UK

5 Sanford-Burnham Medical Research Institute, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA

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Breast Cancer Research 2010, 12:R105  doi:10.1186/bcr2788

Published: 1 December 2010



Mutational inactivation of the FBXW7/hCDC4 tumor suppressor gene (TSG) is common in many cancer types, but infrequent in breast cancers. This study investigates the presence and impact of FBXW7/hCDC4 promoter methylation in breast cancer.


FBXW7/hCDC4-β expression and promoter methylation was assessed in 161 tumors from two independent breast cancer cohorts. Associations between methylation status and clinicopathologic characteristics were assessed by Fisher's exact test. Survival was analyzed using the Kaplan-Meier method in addition to modeling the risk by use of a multivariate proportional hazard (Cox) model adjusting for possible confounders of survival.


Methylation of the promoter and loss of mRNA expression was found both in cell lines and primary tumors (43% and 51%, respectively). Using Cox modeling, a trend was found towards decreased hazard ratio (HR) for death in women with methylation of FBXW7/hCDC4-β in both cohorts (HR 0.53 (95% CI 0.23 to 1.23) and HR 0.50 (95% CI 0.23 to 1.08), respectively), despite an association between methylation and high-grade tumors (P = 0.017). Interestingly, in subgroups of patients whose tumors are p53 mutated or lymph-node positive, promoter methylation identified patients with significantly improved survival (P = 0.048 and P = 0.017, respectively).


We demonstrate an alternative mechanism for inactivation of the TSG FBXW7/hCDC4, namely promoter specific methylation. Importantly, in breast cancer, methylation of FBXW7/hCDC4-β is related to favorable prognosis despite its association with poorly differentiated tumors. Future work may define whether FBXW7/hCDC4 methylation is a biomarker of the response to chemotherapy and a target for epigenetic modulation therapy.