Although we detected only borderline significant improved recurrence-free survival upon tamoxifen in high pERK subgroup (Hazard Ratio [HR] = 0.444, 95% confidence interval [CI] = 0.197 to 1.004, Univariate Cox regression: P = 0.051), the low pERK in CAFs displayed no difference in survival between treatment arms (Hazard Ratio [HR] = 1.204, 95% confidence interval [CI] = 0.436 to 3.327, Univariate Cox regression: P = 0.720) confirming our finding of an impaired tamoxifen response in patients with low ERK phosphorylation in CAFs.
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Low ERK phosphorylation in cancer-associated fibroblasts is associated with tamoxifen resistance in pre-menopausal breast cancer.
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