HER2 and response to anthracycline-based neoadjuvant chemotherapy in breast cancer.
HER2 and response to anthracycline-based neoadjuvant chemotherapy in breast cancer.
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DOI：
10.1093/annonc/mdq612
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发表时间：
2011-06
期刊：
影响因子：
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通讯作者：
L. Yao;Y. Liu;Z. Li;T. Ouyang;Jiuqiang Li;Tianmiao Wang;Z. Fan;T. Fan;B. Lin;Y. Xie
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文献类型：
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作者：
L. Yao;Y. Liu;Z. Li;T. Ouyang;Jiuqiang Li;Tianmiao Wang;Z. Fan;T. Fan;B. Lin;Y. Xie
人类表皮生长因子受体2（HER 2）对辅助蒽环类药物化疗的预测作用仍存在争议。在这里，我们研究了接受新辅助蒽环类药物治疗方案的乳腺癌患者的HER 2状态和病理学反应之间的关系。患者和方法538例可手术原发性乳腺癌患者接受了以蒽环类药物为基础的新辅助化疗。病理学完全缓解（pCR）定义为新辅助化疗完成后乳腺内无浸润性乳腺肿瘤细胞。在新辅助化疗开始前，通过免疫组织化学和/或荧光原位杂交法测定乳腺癌组织的HER 2状态。结果：在538例患者的队列中，23.9%的患者在乳房中实现了pCR。HER 2阳性肿瘤的pCR率低于HER 2阴性肿瘤（14.7% vs 25.7%，P = 0.013）;在多变量分析中，在校正年龄、雌激素受体、孕激素受体、肿瘤大小、化疗周期和肿瘤分级后，阴性HER 2状态仍然是pCR的独立有利预测因素（比值比= 3.14; 95%置信区间= 1.60-6.16，P = 0.001）。此外，pCR患者的3年无病生存率（DFS）高于无pCR患者（P = 0.007）。结论：以蒽环类抗生素为基础的新辅助化疗对HER 2阴性乳腺癌的疗效优于HER 2阳性乳腺癌。
BACKGROUND The predictive role of human epidermal growth factor receptor 2 (HER2) to adjuvant anthracycline-based chemotherapy remains controversial. Here, we investigated the association between HER2 status and pathological response in breast cancer patients who received neoadjuvant anthracycline-based regimens. PATIENTS AND METHODS Women (n = 538) with operable primary breast cancer received neoadjuvant anthracycline-based chemotherapy. Pathological complete response (pCR) was defined as no invasive breast tumor cells in breast after completion of neoadjuvant chemotherapy. HER2 status was determined by immunohistochemistry and/or by fluorescence in situ hybridization in core biopsy breast cancer tissue obtained before initiation of neoadjuvant chemotherapy. RESULTS In this cohort of 538 patients, 23.9% of patients achieved a pCR in their breast. HER2-positive tumors had a lower rate of pCR than did HER2-negative tumors (14.7% versus 25.7%, P = 0.013); negative HER2 status remained as an independent favorable predictor of pCR after adjusted for age, estrogen receptor, progesterone receptor, tumor size, chemotherapy cycles, and tumor grade in a multivariate analysis (odds ratio = 3.14; 95% confidence interval = 1.60-6.16, P = 0.001). Furthermore, patients with a pCR had a higher 3-year disease-free survival (DFS) rate than did patients without a pCR (P = 0.007). CONCLUSION Women with HER2-negative breast cancers rather than HER2-positive tumors benefit from anthracycline-based neoadjuvant chemotherapy.