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Comparative Study
. 2007 Feb 26:7:36.
doi: 10.1186/1471-2407-7-36.

HER-2, p53, p21 and hormonal receptors proteins expression as predictive factors of response and prognosis in locally advanced breast cancer treated with neoadjuvant docetaxel plus epirubicin combination

Daniel G Tiezzi  1 , Jurandyr M Andrade, Alfredo Ribeiro-Silva, Fábio E Zola, Heitor R C Marana, Marcelo G Tiezzi
Affiliations
Comparative Study

HER-2, p53, p21 and hormonal receptors proteins expression as predictive factors of response and prognosis in locally advanced breast cancer treated with neoadjuvant docetaxel plus epirubicin combination

Daniel G Tiezzi et al. BMC Cancer. .

Abstract

Background: Neoadjuvant chemotherapy has been considered the standard care in locally advanced breast cancer. However, about 20% of the patients do not benefit from this clinical treatment and, predictive factors of response were not defined yet. This study was designed to evaluate the importance of biological markers to predict response and prognosis in stage II and III breast cancer patients treated with taxane and anthracycline combination as neoadjuvant setting.

Methods: Sixty patients received preoperative docetaxel (75 mg/m2) in combination with epirubicin (50 mg/m2) in i.v. infusion in D1 every 3 weeks after incisional biopsy. They received adjuvant chemotherapy with CMF or FEC, attaining axillary status following definitive breast surgery. Clinical and pathologic response rates were measured after preoperative therapy. We evaluated the response rate to neoadjuvant chemotherapy and the prognostic significance of clinicopathological and immunohistochemical parameters (ER, PR, p51, p21 and HER-2 protein expression). The median patient age was 50.5 years with a median follow up time 48 months after the time of diagnosis.

Results: Preoperative treatment achieved clinical response in 76.6% of patients and complete pathologic response in 5%. The clinical, pathological and immunohistochemical parameters were not able to predict response to therapy and, only HER2 protein overexpression was associated with a decrease in disease free and overall survival (P = 0.0007 and P = 0.003) as shown by multivariate analysis.

Conclusion: Immunohistochemical phenotypes were not able to predict response to neoadjuvant chemotherapy. Clinical response is inversely correlated with a risk of death in patients submitted to neoadjuvant chemotherapy and HER2 overexpression is the major prognostic factor in stage II and III breast cancer patients treated with a neoadjuvant docetaxel and epirubicin combination.

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Figures

Figure 1
Figure 1
Kaplan-Meyer curve for DFS in sixty patients subjected to Neoadjuvant chemotherapy with docetaxel and epirubicin according to HER-2 protein expression.
Figure 2
Figure 2
Kaplan-Meyer curve for OS in sixty patients subjected to neoadjuvant chemotherapy with docetaxel and epirubicin according to HER-2 protein expression.
See this image and copyright information in PMC

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