Bozzetti Cecilia, Musolino Antonino, Camisa Roberta, Bisagni Giancarlo, Flora Marcella, Bassano Cristina, Martella Eugenia, Lagrasta Costanza, Nizzoli Rita, Personeni Nicola, Leonardi Francesco, Cocconi Giorgio, Ardizzoni Andrea
Deparment of Medical Oncology, University Hospital, Parma, Italy.
Am J Clin Oncol. 2006 Apr;29(2):171-7. doi: 10.1097/01.coc.0000204405.96572.f9.
The value of HER-2/neu status as a predictor of response to anthracycline-based chemotherapy is still a matter of debate. We evaluated the contribution of HER-2/neu gene amplification and other biologic markers in predicting response to different doses of neoadjuvant anthracycline-based chemotherapy.
Clinical and pathologic records of 115 primary breast cancer patients were reviewed. Forty-eight and 67 patients received high (doxorubicin > or =20 mg/m2/wk; epirubicin > or =30 mg/m2/wk) and moderate-low anthracycline dose intensity regimens, respectively. Pathologic diagnosis, hormonal receptor status (HR), Ki67, and HER-2/neu status were assessed on tumor samples before neoadjuvant chemotherapy. HER-2/neu was determined by fluorescence in situ hybridization (FISH).
HER-2/neu amplification was observed in 29/115 (25%) tumors, 18 from moderate-low-dose and 11 from high-dose group. In the univariate analysis, a high Ki67 index (> or =20%) and positive clinical axillary nodes were predictive of an objective tumor response (P = 0.033 and 0.001, respectively). In the multivariate analysis, Ki67 was the only factor predictive of response (OR = 3.08, 95% CI = 1.1-8.5, P = 0.03). HER-2/neu status was not a factor in predicting objective response to different anthracycline dose intensities. The same finding was observed with regards to HR and Ki67.
In our series, no significant dose-response relationship was found according to HER-2/neu status.
HER-2/neu状态作为基于蒽环类化疗反应预测指标的价值仍存在争议。我们评估了HER-2/neu基因扩增及其他生物学标志物在预测不同剂量基于蒽环类新辅助化疗反应中的作用。
回顾了115例原发性乳腺癌患者的临床和病理记录。48例和67例患者分别接受了高剂量（多柔比星≥20mg/m²/周；表柔比星≥30mg/m²/周）和中低剂量蒽环类药物剂量强度方案。在新辅助化疗前对肿瘤样本进行病理诊断、激素受体状态（HR）、Ki67和HER-2/neu状态评估。HER-2/neu通过荧光原位杂交（FISH）测定。
115例肿瘤中有29例（25%）观察到HER-2/neu扩增，其中18例来自中低剂量组，11例来自高剂量组。单因素分析中，高Ki67指数（≥20%）和临床腋窝淋巴结阳性可预测客观肿瘤反应（分别为P = 0.033和0.001）。多因素分析中，Ki67是唯一预测反应的因素（OR = 3.08，95%CI = 1.1 - 8.5，P = 0.03）。HER-2/neu状态不是预测不同蒽环类药物剂量强度客观反应的因素。关于HR和Ki67也观察到相同结果。
在我们的研究系列中，未发现根据HER-
