BRCAness Predicts Resistance to Taxane-Containing Regimens in Triple Negative Breast Cancer During Neoadjuvant Chemotherapy
BRCAness Predicts Resistance to Taxane-Containing Regimens in Triple Negative Breast Cancer During Neoadjuvant Chemotherapy
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DOI：
10.1016/j.clbc.2014.08.003
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发表时间：
2015-02-01
影响因子：
3.1
通讯作者：
Nakamura, Seigo
中科院分区：
文献类型：
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作者：
Akashi-Tanaka, Sadako;Watanabe, Chie;Nakamura, Seigo
我们调查了73例乳腺癌患者在含紫杉烷的新辅助化疗前后的活检和手术标本中的BRCAness。所有在紫杉烷治疗方案下进展的肿瘤预后不良;所有肿瘤均为BRCAness，大多数为三阴性。识别BRCAness可以帮助预测对含紫杉烷的regiments.Background的反应：为了提供异质性三阴性乳腺癌（TNBC）的最佳治疗，我们需要可以预测化疗反应的生物标志物。患者和方法：我们回顾性研究了73例接受紫杉烷和/或蒽环类新辅助化疗（NAC）的乳腺癌患者的BRCAness。使用多重连接依赖性探针扩增对NAC前福尔马林固定的空芯针活检（CNB）标本和NAC后手术标本进行检测。在评估者不了解临床信息的情况下评估BRCAness状态。结果：我们从73名患者中获得了45份CNB和60份手术标本。在45例CNB标本中，17例有BRCAness（占所有亚型的38.6%）。在23例TNBC CNB标本中，14例具有BRCAness（占TNBC病例的61%）。BRCAness肿瘤的临床缓解率显著低于非BRCAness肿瘤，无论是所有肿瘤（58.8% vs. 89.3%，P = 0.03）还是TNBC（50% vs. 100%，P = 0.02）。所有紫杉烷治疗进展的肿瘤都有BRCAness。在TNBC患者中，非BRCAness肿瘤患者的病理完全缓解率显著高于BRCAness肿瘤患者（77.8% vs. 14.3%，P = 0.007）。NAC后，BRCAness的临床反应率在所有亚型（P = 0.002）和TNBC病例（P = 0.008）中均显著低于非BRCAness肿瘤。中位随访26.4个月后，6例BRCAness患者复发。BRCAness患者的无进展生存期短于非BRCAness患者（P = 0.049）。结论：识别BRCAness可以帮助预测对紫杉烷的反应，改变BRCAness TNBC的治疗方案可能会提高患者的生存率。需要更大规模的前瞻性研究来进一步澄清这一问题。
We investigated BRCAness in the biopsy and surgical specimens from 73 patients with breast cancer, taken before and after taxane-containing neoadjuvant chemotherapy. All tumors that progressed on taxanecontaining regimens had a poor prognosis; all had BRCAness and most were triple negative. Identifying BRCAness can help predict the response to taxane-containing regimens.Background: To provide optimal treatment of heterogeneous triple negative breast cancer (TNBC), we need biomarkers that can predict the chemotherapy response. Patients and Methods: We retrospectively investigated BRCAness in 73 patients with breast cancer who had been treated with taxane- and/or anthracycline-based neoadjuvant chemotherapy (NAC). Using multiplex, ligation-dependent probe amplification on formalin-fixed core needle biopsy (CNB) specimens before NAC and surgical specimens after NAC. BRCAness status was assessed with the assessor unaware of the clinical information. Results: We obtained 45 CNB and 60 surgical specimens from the 73 patients. Of the 45 CNB specimens, 17 had BRCAness (38.6% of all subtypes). Of the 23 TNBC CNB specimens, 14 had BRCAness (61% of TNBC cases). The clinical response rates were significantly lower for BRCAness than for non-BRCAness tumors, both for all tumors (58.8% vs. 89.3%, P =.03) and for TNBC (50% vs. 100%, P =.02). All tumors that progressed with taxane therapy had BRCAness. Of the patients with TNBC, those with non-BRCAness cancer had pathologic complete responses significantly more often than did those with BRCAness tumors (77.8% vs. 14.3%, P =.007). After NAC, the clinical response rates were significant lower for BRCAness than for non-BRCAness tumors in all subtypes (P =.002) and in TNBC cases (P =.008). After a median follow-up of 26.4 months, 6 patients all with BRCAness had developed recurrence. Patients with BRCAness had shorter progression-free survival than did those with non- BRCAness (P =.049). Conclusion: Identifying BRCAness can help predict the response to taxane, and changing regimens for BRCAness TNBC might improve patient survival. A larger prospective study is needed to further clarify this issue.