Prediction of response to neoadjuvant chemoendocrine therapy in primary breast carcinomas

Our aim was to determine whether biological molecular markers can predict response to neoadjuvant chemoendocrine therapy in patients with early breast cancer. Ninety patients (median age 56 years; range, 28-69 years) with primary operable breast carcinoma were studied. They were treated with four 3-...

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Vydáno v:Clinical cancer research Ročník 3; číslo 4; s. 593
Hlavní autoři: Makris, A, Powles, T J, Dowsett, M, Osborne, C K, Trott, P A, Fernando, I N, Ashley, S E, Ormerod, M G, Titley, J C, Gregory, R K, Allred, D C
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.04.1997
Témata:
Adult
Age Factors
Aged
Antineoplastic Agents, Hormonal - administration & dosage
Antineoplastic Agents, Hormonal - therapeutic use
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biopsy, Needle
Breast Neoplasms - drug therapy
Breast Neoplasms - pathology
Breast Neoplasms - radiotherapy
Breast Neoplasms - surgery
Chemotherapy, Adjuvant
Combined Modality Therapy
Disease Progression
Female
Humans
Menopause
Middle Aged
Mitomycin - administration & dosage
Mitoxantrone - administration & dosage
Neoplasm Staging
Ploidies
Predictive Value of Tests
Proto-Oncogene Proteins c-bcl-2 - analysis
Receptors, Estrogen - analysis
Receptors, Progesterone - analysis
S Phase
Tamoxifen - administration & dosage
Tamoxifen - therapeutic use
ISSN:1078-0432
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Shrnutí:Our aim was to determine whether biological molecular markers can predict response to neoadjuvant chemoendocrine therapy in patients with early breast cancer. Ninety patients (median age 56 years; range, 28-69 years) with primary operable breast carcinoma were studied. They were treated with four 3-weekly cycles of chemotherapy with mitozantrone, methotrexate (+/- mitomycin C), and tamoxifen prior to surgery. Fine-needle aspiration was used to obtain samples from patients prior to therapy, and the following parameters were assessed: estrogen receptor (ER), progesterone receptor (PgR), p53, Ki67, Bcl-2, and c-erbB-2 measured by immunocytochemistry, and ploidy and S-phase fraction (SPF) by flow cytometry. The tumors of 78% of the subjects responded (complete response, 9%; partial response, 69%) and 22% did not (no change, 20%; progressive disease, 2%). Response rates according to disease stage and patient age were as follows: T1, 74%; T2, 79%; T3/T4, 78%; age </=50 years, 76%; >50, 79% (P = not significant). Response rates for other parameters were as follows: ER-positive, 82%, and -negative, 70%; PgR-positive, 86%, and -negative, 71%; p53-positive, 74%, and -negative, 81%; Bcl-2-positive, 85%, and -negative 61%; c-erbB-2-positive, 57%, and -negative, 93%; Ki67 high, 77%, and low, 81%; SPF high, 77%, and low, 77%; aneuploid, 71%; and diploid, 85%. Only the difference for c-erbB-2 was statistically significant (P = 0.007). A trend for higher response rates to neoadjuvant chemoendocrine therapy for tumors that were positive for ER, PgR, and Bcl-2 was observed but did not reach statistical significance. Tumors negative for c-erbB-2 had a higher response rate, which was statistically significant. In contrast, Ki67, ploidy, SPF, and p53 failed to predict for response.
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ISSN:1078-0432