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Epidermal growth factor receptor expression correlates with poor survival in patients who have breast carcinoma treated with doxorubicin‐based neoadjuvant chemotherapy
Author(s) -
Buchholz Thomas A.,
Tu Xiaoyu,
Ang K. Kian,
Esteva Francisco J.,
Kuerer Henry M.,
Pusztai Lajos,
Cristofanilli Massimo,
Singletary S. Eva,
Hortobagyi Gabriel N.,
Sahin Aysegul A.
Publication year - 2005
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21217
Subject(s) - medicine , chemotherapy , epidermal growth factor receptor , anthracycline , oncology , immunohistochemistry , breast carcinoma , breast cancer , doxorubicin , estrogen receptor , carcinoma , pathology , cancer
BACKGROUND To the authors' knowledge there are few data that correlate the expression of the epidermal growth factor receptor (EGFR) with the outcome of patients who have breast carcinoma and are treated with anthracycline chemotherapy. METHODS Pretreatment tumor tissue samples were available from 82 patients who had locally advanced breast carcinoma and were treated on 2 protocols investigating neoadjuvant 5‐fluorouracil, doxorubicin, and cyclophosphamide chemotherapy. Immunohistochemical staining for EGFR (diluted 1:50) was performed, and the staining results were interpreted without knowledge of outcome. RESULTS Fourteen tumors (17%) were EGFR‐positive, and 68 tumors (83%) were EGFR‐negative. EGFR expression did not correlate with clinical stage ( P = 0.361), HER‐2/ neu overexpression ( P = 0.503), estrogen or progesterone receptor status ( P = 0.631 and P = 0.838, respectively), nuclear grade ( P = 0.448), or proliferative index ( P = 0.769). Patients who had EGFR‐positive tumors had a worse 5‐year disease‐free survival (DFS) rate (46% vs. 76%; P = 0.026) and overall survival (OS) rate (46% vs. 76%; P = 0.037) compared with patients who had EGFR‐negative tumors. The pathologic complete response rate did not differ between the 2 groups ( P = 0.389), although patients with EGFR‐positive disease more commonly had ≥ 4 positive lymph nodes after chemotherapy (64% vs. 29%; P = 0.028). EGFR expression continued to show a significant correlation with poorer DFS and OS in a Cox regression analysis model that included the presence or absence of four or more lymph nodes and EGFR status. CONCLUSIONS EGFR expression may have prognostic significance in patients with locally advanced breast carcinoma who are treated with anthracycline chemotherapy. These data warrant further studies aimed at correlating EGFR expression and outcome in patients who have breast carcinoma treated with doxorubicin‐based chemotherapy. Cancer 2005. © 2005 American Cancer Society.