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PREDICTIVE MARKERS FOR BREAST CANCER NEOADJUVANT CHEMOTHERAPY
Author(s) -
Syed S.,
Rogers P. A. W.,
Ganju V.,
Hart S.,
Susil B.,
Cann L.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04114_12.x
Subject(s) - medicine , taxane , anthracycline , breast cancer , docetaxel , regimen , oncology , chemotherapy , neoadjuvant therapy , estrogen receptor , cancer , chemotherapy regimen , predictive marker , immunohistochemistry
Purpose Although neoadjuvant chemotherapy (NACT) is routinely used in the management of breast cancer, there is no definitive way of predicting which patients are more likely to respond to a particular therapy. The aim of this study was to identify markers that can be used to predict tumor response to chemotherapy in breast cancer. Methodology We used immunohistochemistry to evaluate blood microvessel density (MVD) (CD31), tumor cell proliferation (Ki‐67), anti‐apoptotic marker (Bcl‐2), ER and PR expression, and HER‐2/neu expression in core biopsy samples (taken before chemotherapy) from patients with locally advanced breast cancer (n = 20), receiving neo‐adjuvant chemotherapy {anthracycline‐based regimen (FEC100) (n = 10) vs single agent taxane regimen (docetaxel) (n = 10), and correlated these factors with tumor response (as assessed clinically and by tumor imaging) after 4 cycles of treatment. Results Tumors expressing low levels of Bcl‐2 showed significantly greater reduction in size to both taxane (P < 0.05) and anthracycline‐based (P < 0.01) regimens, compared to tumors expressing high levels of Bcl‐2. Further, HER‐2/neu positive tumors showed significantly greater reduction in size to taxane regimen (P < 0.05), while estrogen receptor (ER) negative tumors showed a trend of greater reduction in size to anthracycline‐based regimen (P = 0.06). Conclusions Bcl‐2 and HER‐2/neu expression may be useful markers to predict response to neoadjuvant chemotherapy in breast cancer. While subject numbers are still too low to draw firm conclusions, the current data indicates that HER‐2/neu may specifically predict a positive tumor response to taxane regimen, and high Bcl‐2 is a marker of chemoresistance.