Relation Between Molecular Subtypes and Neoadjuvant Chemotherapy Efficacy in Breast Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIANGYue-yang , TANGPeng , WANGShu-shu ,  ZHANGYi

Department of Breast Surgery, Southwest Hospital Affiliated to The Third Military Medical University, Chongqing 400038, China;

Corresponding author：

ZHANGYi, Email: zy53810@163.com

Keywords：

Breast cancer; Molecular subtype; Neoadjuvant chemotherapy

DOI：

10.7507/1007-9424.20140136

Video：

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Objective To explore the relation between the molecular subtypes and efficacy of neoadjuvant chemotherapy with docetaxel together with epirubicin(TE) in breast cancer. Methods According to the inclusion and exclusion criteria, 239 patients with breast cancer who at least received 3 cycles of TE-based neoadjuvant chemotherapy from May 2011 to December 2012 in this hospital were included. Molecular subtypes were categorized into luminal A, luminal B, human epidermal growth factor receptor 2(HER-2) positive, and triple negative by the immunohistochemical results of estrogen receptor(ER), progesterone receptor(PR), HER-2, and Ki-67 status. The relevant indicators of the different molecular subtypes of breast cancer patients, such as pathological complete response(pCR) rate, age, and menstruation, etc. were analyzed. Results There were 67(28.03%) patients with luminal A, 84(35.15%) luminal B, 21(8.79%) HER-2, and 67(28.03%) triple negative in these 239 patients with breast cancer. The differences of age, menstruation, axillary lymph node status etc. among the four molecular subtypes were not statistically significant(P > 0.05). The pCR rate of triple negative breast cancer(14.93%) was the highest among four subtypes, followed by luminal B(7.14%), HER-2 positive(4.76%) and luminal A(1.49%), there was a significant difference(P=0.027). Conclusions Comparing with luminal A, luminal B, and HER-2 positive breast cancers, triple negative breast cancer is the most sensitive to TE neoadjuvant chemotherapy, and it has the highest pCR rate. Therefore, different treatment should be selected according to molecular subtypes of breast cancer.

Citation： LIANGYue-yang, TANGPeng, WANGShu-shu, ZHANGYi. Relation Between Molecular Subtypes and Neoadjuvant Chemotherapy Efficacy in Breast Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(5): 562-566. doi: 10.7507/1007-9424.20140136 Copy

1.	吴阶平, 裘法祖.黄家泗外科学[M].北京:人民卫生出版社, 1992:895.
2.	许良中.乳腺病理学[M].上海:上海医科大学出版社, 1999:95.
3.	Trudeau M, Sinclair SE, Clemons M, et al.Neoadjuvant taxanes in the treatment of non-metastatic breast cancer:a systematic review[J].Cancer Treat Rev, 2005, 31(4):283-302.
4.	沈镇宙, 柳光宇, 苏逢锡, 等.多西紫杉醇加表柔比星治疗局部晚期乳腺癌的多中心Ⅱ期临床研究[J].中华肿瘤杂志, 2005, 27(2):126-128.
5.	Wolmark N, Wang J, Mamounas E, et al.Preoperative chemotherapy in patients with operable breast cancer:nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18[J].J Natl Cancer Inst Monogr, 2001, (30):96-102.
6.	Bear HD, Anderson S, Brow A, et al.The effect on tumor response of adding sequential preoperative docetaxel to preoperative doxorubicin and cyclophosphamide:preliminary results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27[J].J Clin Oncol, 2003, 21(22):4165-4174.
7.	Rastogi P, Anderson SJ, Bear HD, et al.Preoperative chemotherapy:updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27[J].J Clin Oncol, 2008, 26(5):778-785.
8.	Perou CM, Sørlie T, Eisen MB, et al.Molecular portraits of human breast tumours[J].Nature, 2000, 406(6797):747-752.
9.	Cheang MC, Chia SK, Voduc D, et al.Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer[J].J Natl Cancer Inst, 2009, 101(10):736-750.
10.	Goldhirsch A, Wood WC, Coates AS, et al.Strategies for subtypes-dealing with the diversity of breast cancer:highlights of the St.Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011[J].Ann Oncol, 2011, 22(8):1736-1747.
11.	NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines):Breast Cancer[EB/OL].Version 2.2013.www.nccn.com.http://infoonco.es/wp-content/uploads/2011/10/breast_cancer_2.2013.pdf.
12.	Prisack HB, Karreman C, Modlich O, et al.Predictive biological markers for response of invasive breast cancer to anthracycline/cyclophosphamide-based primary (radio-) chemotherapy[J].Anticancer Res, 2005, 25(6C):4615-4621.
13.	Therasse P, Arbuck SG, Eisenhauer EA, et al.new guidelines to evaluate the response to treatment in solid tumors[J].j natl cancer inst, 2000, 92(3):205-216.
14.	Mazouni C, Peintinger F, Wan-Kau S, et al.Residual ductal carcinoma in situ in patients with complete eradication of invasive breast cancer after neoadjuvant chemotherapy does not adversely affect patient outcome[J].J Clin Oncol, 2007, 25(19):2650-2655.
15.	Carey LA, Dees EC, Sawyer L, et al.The triple negative paradox:primary tumor chemosensitivity of breast cancer subtypes[J].Clin Cancer Res, 2007, 13(8):2329-2334.
16.	龚丽, 邹天宁.乳腺癌分子分型与新辅助化疗疗效关系的研究[J].中国医药导报, 2013, 10(13):42-44.
17.	郝卓芳, 章乐虹, 杨基鹏, 等.乳腺癌分子分型在浸润性导管癌的生存分析[J].中国现代医学杂志, 2011, 21(32):4080-4084.
18.	Fernández-Morales LA, Seguí MA, Andreu X, et al.Analysis of the pathologic response to primary chemotherapy in patients with locally advanced breast cancer grouped according to estrogen receptor, progesterone receptor, and HER2 status[J].Clin Breast Cancer, 2007, 7(7):559-564.
19.	Rouzier R, Perou CM, Symmans WF, et al.Breast cancer molecular subtypes respond differently to preoperative chemotherapy[J].Clin Cancer Res, 2005, 11(16):5678-5685.
20.	Smith IC, Heys SD, Hutcheon AW, et al.Neoadjuvant chemotherapy in breast cancer:significantly enhanced response with docetaxel[J].J Clin Oncol, 2002, 20(6):1456-1466.
21.	Bear HD, Anderson S, Brown A, et al.The effect on tumor response of adding sequential preoperative docetaxel to preoperative doxorubicin and cyclophosphamide:preliminary results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27[J].J Clin Oncol, 2003, 21(22):4165-4174.
22.	Guarneri V, Broglio K, Kau SW, et al.Prognostic value of pathologic complete response after primary chemotherapy in relation to hormone receptor status and other factors[J].J Clin Oncol, 2006, 24(7):1037-1044.
23.	DiGiovanna MP, Stern DF, Edgerton S, et al.Influence of activation state of ErbB-2(HER-2) on response to adjuvant cyclophosphamide, doxorubicin, and fluorouracil for stageⅡ, node-positive breast cancer:study 8541 from the cancer and Leukemia Group B[J].J Clin Oncol, 2008, 26(14):2364-2372.
24.	Jahanzeb M, Brufsky A, Erban J, et al.Dose-dense neoadjuvant treatment of women with breast cancer utilizing docetaxel, vinorelbine and trastuzumab with growth factor support[J].J Clin Oncol, 2005, 23(No 16S):591.
25.	Yerushalmi R, Woods R, Ravdin PM, et al.Ki67 in breast cancer:prognostic and predictive potential[J].Lancet Oncol, 2010, 11(2):174-183.

1. 吴阶平, 裘法祖.黄家泗外科学[M].北京:人民卫生出版社, 1992:895.
2. 许良中.乳腺病理学[M].上海:上海医科大学出版社, 1999:95.
3. Trudeau M, Sinclair SE, Clemons M, et al.Neoadjuvant taxanes in the treatment of non-metastatic breast cancer:a systematic review[J].Cancer Treat Rev, 2005, 31(4):283-302.
4. 沈镇宙, 柳光宇, 苏逢锡, 等.多西紫杉醇加表柔比星治疗局部晚期乳腺癌的多中心Ⅱ期临床研究[J].中华肿瘤杂志, 2005, 27(2):126-128.
5. Wolmark N, Wang J, Mamounas E, et al.Preoperative chemotherapy in patients with operable breast cancer:nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18[J].J Natl Cancer Inst Monogr, 2001, (30):96-102.
6. Bear HD, Anderson S, Brow A, et al.The effect on tumor response of adding sequential preoperative docetaxel to preoperative doxorubicin and cyclophosphamide:preliminary results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27[J].J Clin Oncol, 2003, 21(22):4165-4174.
7. Rastogi P, Anderson SJ, Bear HD, et al.Preoperative chemotherapy:updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27[J].J Clin Oncol, 2008, 26(5):778-785.
8. Perou CM, Sørlie T, Eisen MB, et al.Molecular portraits of human breast tumours[J].Nature, 2000, 406(6797):747-752.
9. Cheang MC, Chia SK, Voduc D, et al.Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer[J].J Natl Cancer Inst, 2009, 101(10):736-750.
10. Goldhirsch A, Wood WC, Coates AS, et al.Strategies for subtypes-dealing with the diversity of breast cancer:highlights of the St.Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011[J].Ann Oncol, 2011, 22(8):1736-1747.
11. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines):Breast Cancer[EB/OL].Version 2.2013.www.nccn.com.http://infoonco.es/wp-content/uploads/2011/10/breast_cancer_2.2013.pdf.
12. Prisack HB, Karreman C, Modlich O, et al.Predictive biological markers for response of invasive breast cancer to anthracycline/cyclophosphamide-based primary (radio-) chemotherapy[J].Anticancer Res, 2005, 25(6C):4615-4621.
13. Therasse P, Arbuck SG, Eisenhauer EA, et al.new guidelines to evaluate the response to treatment in solid tumors[J].j natl cancer inst, 2000, 92(3):205-216.
14. Mazouni C, Peintinger F, Wan-Kau S, et al.Residual ductal carcinoma in situ in patients with complete eradication of invasive breast cancer after neoadjuvant chemotherapy does not adversely affect patient outcome[J].J Clin Oncol, 2007, 25(19):2650-2655.
15. Carey LA, Dees EC, Sawyer L, et al.The triple negative paradox:primary tumor chemosensitivity of breast cancer subtypes[J].Clin Cancer Res, 2007, 13(8):2329-2334.
16. 龚丽, 邹天宁.乳腺癌分子分型与新辅助化疗疗效关系的研究[J].中国医药导报, 2013, 10(13):42-44.
17. 郝卓芳, 章乐虹, 杨基鹏, 等.乳腺癌分子分型在浸润性导管癌的生存分析[J].中国现代医学杂志, 2011, 21(32):4080-4084.
18. Fernández-Morales LA, Seguí MA, Andreu X, et al.Analysis of the pathologic response to primary chemotherapy in patients with locally advanced breast cancer grouped according to estrogen receptor, progesterone receptor, and HER2 status[J].Clin Breast Cancer, 2007, 7(7):559-564.
19. Rouzier R, Perou CM, Symmans WF, et al.Breast cancer molecular subtypes respond differently to preoperative chemotherapy[J].Clin Cancer Res, 2005, 11(16):5678-5685.
20. Smith IC, Heys SD, Hutcheon AW, et al.Neoadjuvant chemotherapy in breast cancer:significantly enhanced response with docetaxel[J].J Clin Oncol, 2002, 20(6):1456-1466.
21. Bear HD, Anderson S, Brown A, et al.The effect on tumor response of adding sequential preoperative docetaxel to preoperative doxorubicin and cyclophosphamide:preliminary results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27[J].J Clin Oncol, 2003, 21(22):4165-4174.
22. Guarneri V, Broglio K, Kau SW, et al.Prognostic value of pathologic complete response after primary chemotherapy in relation to hormone receptor status and other factors[J].J Clin Oncol, 2006, 24(7):1037-1044.
23. DiGiovanna MP, Stern DF, Edgerton S, et al.Influence of activation state of ErbB-2(HER-2) on response to adjuvant cyclophosphamide, doxorubicin, and fluorouracil for stageⅡ, node-positive breast cancer:study 8541 from the cancer and Leukemia Group B[J].J Clin Oncol, 2008, 26(14):2364-2372.
24. Jahanzeb M, Brufsky A, Erban J, et al.Dose-dense neoadjuvant treatment of women with breast cancer utilizing docetaxel, vinorelbine and trastuzumab with growth factor support[J].J Clin Oncol, 2005, 23(No 16S):591.
25. Yerushalmi R, Woods R, Ravdin PM, et al.Ki67 in breast cancer:prognostic and predictive potential[J].Lancet Oncol, 2010, 11(2):174-183.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Relation Between Molecular Subtypes and Neoadjuvant Chemotherapy Efficacy in Breast Cancer

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