Premium
Serum EGFR and serum HER‐2/ neu are useful predictive and prognostic markers in metastatic breast cancer patients treated with metronomic chemotherapy
Author(s) -
Sandri Maria Teresa,
Johansson Harriet Ann,
Zorzino Laura,
Salvatici Michela,
Passerini Rita,
Maisonneuve Patrick,
Rocca Andrea,
Peruzzotti Giulia,
Colleoni Marco
Publication year - 2007
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.22825
Subject(s) - medicine , chemotherapy , breast cancer , oncology , her2/neu , metastatic breast cancer , predictive marker , cancer , gastroenterology
BACKGROUND. Metronomic chemotherapy has been demonstrated to be of value in patients with advanced breast cancer. No reliable markers of response are available. In breast tumor, HER‐2/ neu is a prognostic factor, whereas no definite data exist for EGFR. The aim of the study was to evaluate the prognostic and predictive role of serum HER‐2/ neu and serum EGFR in breast cancer patients treated with low‐dose chemotherapy. METHODS. Serum levels of HER‐2/ neu (n = 135) and of EGFR (n = 113) were prospectively determined before the start of chemotherapy, after 2 months of treatment, and when progressive disease was diagnosed. RESULTS. Elevated (>15 ng/mL) serum HER‐2/ neu before the start of chemotherapy was not associated with response rate, whereas elevated serum HER‐2/ neu at 2 months was significantly associated with reduced long‐term clinical benefit (24weeks) ( P < .001), as well as changes in HER‐2/ neu levels between baseline and 2 months ( P < .0001). Multivariate analysis identified a ≥20% increase of serum HER‐2/ neu as an independent factor for progression‐free survival (PFS). Kinetics of serum HER‐2/ neu were significantly associated with PFS ( P < .0001) and overall survival (OS) ( P = .015). Low baseline serum levels of EGFR (<45 ng/mL) were predictive of reduced response rate both at 2 months ( P = .031) and after 24 weeks ( P = .022). Moreover, they were significantly associated with reduced PFS ( P = .016) and OS ( P = .015). CONCLUSIONS. Serum HER‐2/ neu and EGFR may represent useful markers for early prediction of probability of response, PFS, and OS in patients with advanced breast cancer treated with metronomic chemotherapy. Cancer 2007. © 2007 American Cancer Society.