Locally advanced/inflammatory breast cancers treated with intensive epirubicin-based neoadjuvant chemotherapy: are there molecular markers in the primary tumour that predict for 5-year clinical outcome?
Locally advanced/inflammatory breast cancers treated with intensive epirubicin-based neoadjuvant chemotherapy: are there molecular markers in the primary tumour that predict for 5-year clinical outcome?
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DOI：
10.1093/annonc/mdg108
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发表时间：
2003-03-01
影响因子：
50.5
通讯作者：
Piccart, M
中科院分区：
文献类型：
--
作者：
Bonnefoi, H;Diebold-Berger, S;Piccart, M
背景：局部晚期和/或炎性乳腺癌（LABC）是一种异质性疾病。分子标记可能有助于理解这种异质性。本文报道了一项研究的结果，该研究通过免疫组化评估了HER-2、p53、cyclinD1、MIB1、ER和PgR表达在eortc - nsic - sakk试验中的潜在预后或预测价值。患者和方法：共有448名细胞学或组织学诊断为LABC的患者被随机分组，比较两种基于蒽环类药物的新辅助治疗方案。化疗后进行标准的局部治疗。两组的生存率相当。我们收集并分析了258例经组织学诊断的患者中187例（72.5%）的中心石蜡包埋肿瘤标本。结果：参与分子标记研究的患者中，114例复发，91例死亡。在多变量分析中，p53阳性与较短的无进展生存期相关[风险比(HR) = 1.96；95% CI 1.33-2.91: P = 0.0008)，总生存期较短（HR = 1.98; 95% CI 1.28-3.06; P = 0.002）。PgR阳性预示着更长的总生存期（HR = 0.54; 95% CI 0.35-0.83; P = 0.0045）。结论：p53是预测患者生存的独立因素。为了明确p53是否是一个纯粹的预后和/或预测因素，正在进行一项III期试验（EORTC 10994/BIG 00-01研究），使用冷冻肿瘤样本中的酵母进行功能测定。
Background: Locally advanced and/or inflammatory breast cancer (LABC) is a heterogeneous disease. Molecular markers may help to understand this heterogeneity. This paper reports the results of a study assessing the potential prognostic or predictive value of HER-2, p53, cyclinD1, MIB1, ER and PgR expression by immunohistochemistry from patients included in an EORTC-NCIC-SAKK trial.Patients and methods: A total of 448 patients with a cytological or histological diagnosis of LABC were randomised into a trial comparing two anthracycline-based neoadjuvant regimens. Chemotherapy was followed by standard locoregional therapy. Survival was comparable in both arms. We collected and analysed centrally paraffin-embedded tumour specimens from 187 (72.5%) of 258 patients that had a histological diagnosis.Results: Of the patients included in this molecular marker study 114 relapsed and 91 died. In the multivariate analysis p53 positivity was associated with a shorter progression-free survival [hazard ratio (HR) = 1.96; 95% CI 1.33-2.91: P = 0.0008) and a shorter overall survival (HR = 1.98; 95% CI 1.28-3.06; P = 0.002). PgR positivity predicted for a longer overall survival (HR = 0.54; 95% CI 0.35-0.83; P = 0.0045).Conclusions: p53 was an independent factor predicting for survival. In order to clarify whether p53 is a pure prognostic and/or a predictive factor, a phase III trial is being conducted (EORTC 10994/BIG 00-01 study) using functional assay in yeast from frozen tumour samples.