Department of Senology, University of Cologne, Cologne, Germany.
Anticancer Res. 2010 Oct;30(10):4251-9.
The central objective of this study was to determine the predictive impact of several established tumor biological factors (PgR, ER, HER2 and Ki-67) on response to pre-operative chemotherapy in primary breast cancer.
59 primary M0 breast cancer patients received pre-operative sequential dose-dense epirubicin and cyclophosphamide followed by docetaxel (19 patients at dosage 100 mg/m(2), 40 patients at 75 mg/m(2)).
Pathological complete remission (pCR) occurred in 17 patients (29%) and at least partial remission in 42 (71%). Higher proliferation (Ki-67) and lack of hormone receptors (either or both) were significant predictive factors for pCR; moreover, 8/11 (73%) patients with triple-negative tumors (HER2(-)/ER(-)/PgR(-)) had pCR (p=0.001). Breast conserving surgery was achieved in 46/59 patients (78%). Hand-foot syndrome occurred in 12/19 patients treated at the higher docetaxel dosage but only 1/40 of the remaining patients. Higher docetaxel dosage was associated with improved pCR in the non-triple-negative subgroup.
The tumor biology of hormone receptor-negative, especially triple-negative, and highly proliferating breast cancer is associated with strongly positive response to dose-dense, pre-operative epirubicin/cyclophosphamide/docetaxel chemotherapy.
本研究的主要目的是确定几种已确立的肿瘤生物学因素（PgR、ER、HER2 和 Ki-67）对原发性乳腺癌术前化疗反应的预测影响。
59 例 M0 期原发性乳腺癌患者接受术前序贯密集表阿霉素和环磷酰胺，然后是多西紫杉醇（19 例患者剂量为 100mg/m²，40 例患者剂量为 75mg/m²）。
17 例（29%）患者发生病理完全缓解（pCR），42 例（71%）患者至少部分缓解。较高的增殖（Ki-67）和缺乏激素受体（或两者均无）是 pCR 的显著预测因素；此外，11 例三阴性肿瘤（HER2(-)/ER(-)/PgR(-)）患者中有 8 例（73%）发生 pCR（p=0.001）。59 例患者中有 46 例（78%）接受了保乳手术。19 例接受较高剂量多西紫杉醇治疗的患者中有 12 例出现手足综合征，但其余 40 例患者中只有 1 例出现。非三阴性亚组中，较高的多西紫杉醇剂量与 pCR 改善相关。
激素受体阴性、尤其是三阴性和高增殖性乳腺癌的肿瘤生物学与密集的术前表阿霉素/环磷酰胺/多西紫杉醇化疗的强烈阳性反应相关。
