Gonzalez-Angulo Ana M, Krishnamurthy Savitri, Yamamura Yuko, Broglio Kristine R, Pusztai Lajos, Buzdar Aman U, Hortobagyi Gabriel N, Esteva Francisco J
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer. 2004 Jul 15;101(2):258-63. doi: 10.1002/cncr.20348.
The objective of the current study was to determine whether her-2 amplification was associated with a pathologic response to preoperative chemotherapy with taxanes in patients with early-stage breast carcinoma.
The authors evaluated 71 patients treated for AJCC Stage II and III breast carcinoma with preoperative taxanes whose tissue specimens were still available. Fifty-seven patients (80%) had received paclitaxel and 14 (20%) had received docetaxel (4 cycles of either drug). Amplification of the her-2 gene was determined using fluorescence in situ hybridization.
The median patient age was 49 years (range, 21-70 years). Forty-eight patients (68%) had Stage II breast carcinoma and 23 (32%) had Stage III disease. her-2 gene amplification was detected in 19 tumor specimens (28%). Hormone receptors (estrogen and/or progesterone) were detected in 11 her-2-positive tumor specimens (58%) and in 31 her-2-negative tumor specimens (85%). Eight pathologic complete responses (pCR; breast and axillary lymph nodes) occurred, 3 (16%) in patients with her-2-positive tumor specimens and five (10%) in patients with her-2-negative tumor specimens (P = 0.68). Twelve patients achieved pCR in the breast, 5 (26%) in patients with her-2-positive tumors and 7 (15%) in patients with her-2-negative tumors (P = 0.3). At a median follow-up of 61 months, none of the patients with a pCR developed recurrent disease, regardless of their her-2 status. The progression-free and overall survival rates were similar in both HER-2-positive and her-2-negative groups (P = 0.45 and P = 0.14, respectively).
her-2 gene amplification was not found to be predictive of a pathologic response to preoperative taxanes in patients with early-stage breast carcinoma.
本研究的目的是确定在早期乳腺癌患者中,her-2基因扩增是否与紫杉类药物术前化疗的病理反应相关。
作者评估了71例接受术前紫杉类药物治疗的AJCC II期和III期乳腺癌患者,其组织标本仍然可用。57例患者(80%)接受了紫杉醇治疗,14例(20%)接受了多西他赛治疗(两种药物均为4个周期)。使用荧光原位杂交法测定her-2基因的扩增情况。
患者的中位年龄为49岁(范围21 - 70岁)。48例患者(68%)患有II期乳腺癌,23例(32%)患有III期疾病。在19个肿瘤标本(28%)中检测到her-2基因扩增。在11个her-2阳性肿瘤标本(58%)和31个her-2阴性肿瘤标本(85%)中检测到激素受体(雌激素和/或孕激素)。出现了8例病理完全缓解(pCR;乳腺和腋窝淋巴结),her-2阳性肿瘤标本患者中有3例(16%),her-2阴性肿瘤标本患者中有5例(10%)(P = 0.68)。12例患者乳腺达到pCR,her-2阳性肿瘤患者中有5例(26%),her-2阴性肿瘤患者中有7例(15%)(P = 0.3)。中位随访61个月时,无论her-2状态如何,pCR患者均未出现复发性疾病。HER-2阳性和her-2阴性组的无进展生存率和总生存率相似(分别为P = 0.45和P = 0.14)。
在早期乳腺癌患者中,未发现her-2基因扩增可预测术前紫杉类药物的病理反应。