Progesterone receptor loss identifies luminal-type local advanced breast cancer with poor survival in patients who fail to achieve a pathological complete response to neoadjuvant chemotherapy.
Progesterone receptor loss identifies luminal-type local advanced breast cancer with poor survival in patients who fail to achieve a pathological complete response to neoadjuvant chemotherapy.
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DOI：
10.18632/oncotarget.4225
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发表时间：
2015-07-20
期刊：
影响因子：
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通讯作者：
Shao ZM
中科院分区：
文献类型：
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作者：
Chen S;Huang L;Chen CM;Shao ZM
本研究的目的是探讨孕激素受体（PgR）作为区分雌激素受体（ER）阳性患者的生物标志物的潜力，这些患者对新辅助化疗（NCT）未能达到病理完全反应，但患有不同的疾病。本研究共纳入327例连续的局部晚期乳腺癌ER阳性患者。根据其HER-2和Ki-67状态，将患者分为Luminal-A或Luminal-B亚型。我们根据不同管腔亚型的PgR状态评估了NCT的临床和病理反应以及随访期间发生的复发或死亡。在Luminal-B亚型中，与PgR+肿瘤相比，PgR-肿瘤患者具有相对较高的病理学完全缓解（pCR）率（29.5%vs.4.7%pCR，P < 0.001）和Miller-Payne分级（45.5%vs.23.5%4 -5级，P = 0.033）。在NCT后有残留肿瘤的Luminal-B患者中，PgR丢失也与不良无复发生存期（P = 0.017; HR = 0.430; PgR-作为参考）和总生存期（P = 0.013; HR = 0.355; PgR-作为参考）独立相关。然而，在Luminal-A亚型中，PgR+和PgR-疾病对NCT的反应或存活率之间没有统计学显著差异。我们的研究结果已经证明了PgR丢失在新辅助治疗环境中的预后价值，表明ER+/PgR- Luminal-B肿瘤由于其在初次治疗后的高复发风险而值得进一步关注。
The aim of this study was to investigate the potential of progesterone receptor (PgR) as a biomarker for differentiating estrogen receptor (ER)-positive patients who fail to achieve a pathological complete response to neoadjuvant chemotherapy (NCT) with different prognoses. A total of 327 consecutive, locally advanced breast cancer patients with ER-positive disease were included in this study. According to their HER-2 and Ki-67 status, the patients were classified into the Luminal-A or Luminal-B subtype. We evaluated the clinical and pathological response to NCT and relapse or death occurring during follow-up according to PgR status in the different luminal subtypes. In the Luminal-B subtype, patients with PgR- tumors had a relatively higher pathological complete response (pCR) rate (29.5% vs. 4.7% pCR, P < 0.001) and Miller-Payne grades (45.5% vs. 23.5% of grade 4-5, P = 0033) compared to PgR+ tumors. In Luminal-B patients with residual tumor after NCT, PgR loss was also independently correlated with poor relapse-free survival (P = 0.017; HR = 0.430; PgR- as a reference) and overall survival (P = 0.013; HR = 0.355; PgR- as a reference). However, in the Luminal-A subtype, there were no statistically significant differences between PgR+ and PgR- disease in response to NCT or survival. Our findings have demonstrated the prognostic value of PgR loss in the neoadjuvant setting, indicating that ER+/PgR- Luminal-B tumors warrant further attention due to their high risk of relapse after primary treatment.