Department of Molecular Oncology, Institut Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille, UMR891 Inserm, 232, Bd Ste-Marguerite, Marseille, 13009, France.
Breast Cancer Res. 2011;13(6):R109. doi: 10.1186/bcr3051. Epub 2011 Nov 1.
INTRODUCTION: The PACS01 trial has demonstrated that a docetaxel addition to adjuvant anthracycline-based chemotherapy improves disease-free survival (DFS) and overall survival of node-positive early breast cancer (EBC). We searched for prognostic and predictive markers for docetaxel's benefit. METHODS: Tumor samples from 1,099 recruited women were analyzed for the expression of 34 selected proteins using immunohistochemistry. The prognostic and predictive values of each marker and four molecular subtypes (luminal A, luminal B, HER2-overexpressing, and triple-negative) were tested. RESULTS: Progesterone receptor-negativity (HR = 0.66; 95% CI 0.47 to 0.92, P = 0.013), and Ki67-positivity (HR = 1.53; 95% CI 1.12 to 2.08, P = 0.007) were independent adverse prognostic factors. Out of the 34 proteins, only Ki67-positivity was associated with DFS improvement with docetaxel addition (adjusted HR = 0.51, 95% CI 0.33 to 0.79 for Ki67-positive versus HR = 1.10, 95% CI 0.75 to 1.61 for Ki67-negative tumors, P for interaction = 0.012). Molecular subtyping predicted the docetaxel benefit, but without providing additional information to Ki67 status. The luminal A subtype did not benefit from docetaxel (HR = 1.16, 95% CI 0.73 to 1.84); the reduction in the relapse risk was 53% (HR = 0.47, 95% CI 0.22 to 1.01), 34% (HR = 0.66, 95% CI 0.37 to 1.19), and 12% (HR = 0.88, 95% CI 0.49 to 1.57) in the luminal B, HER2-overexpressing, and triple-negative subtypes, respectively. CONCLUSIONS: In patients with node-positive EBC receiving adjuvant anthracycline-based chemotherapy, the most powerful predictor of docetaxel benefit is Ki67-positivity.
简介:PACS01 试验表明,多西他赛联合辅助蒽环类化疗可改善淋巴结阳性早期乳腺癌(EBC)患者的无病生存(DFS)和总生存。我们寻找了预测多西他赛获益的预后和预测标志物。 方法:使用免疫组化法分析了 1099 名入组女性的肿瘤样本,检测了 34 种选定蛋白的表达情况。测试了每个标志物和四个分子亚型(管腔 A、管腔 B、HER2 过表达和三阴性)的预后和预测价值。 结果:孕激素受体阴性(HR = 0.66;95%CI 0.47 至 0.92,P = 0.013)和 Ki67 阳性(HR = 1.53;95%CI 1.12 至 2.08,P = 0.007)是独立的不良预后因素。在 34 种蛋白中,只有 Ki67 阳性与多西他赛加用相关的 DFS 改善有关(调整 HR = 0.51,95%CI 0.33 至 0.79 对于 Ki67 阳性 vs HR = 1.10,95%CI 0.75 至 1.61 对于 Ki67 阴性肿瘤,P 交互= 0.012)。分子分型预测了多西他赛的获益,但没有提供 Ki67 状态以外的信息。管腔 A 型亚组不能从多西他赛中获益(HR = 1.16,95%CI 0.73 至 1.84);复发风险降低 53%(HR = 0.47,95%CI 0.22 至 1.01),34%(HR = 0.66,95%CI 0.37 至 1.19)和 12%(HR = 0.88,95%CI 0.49 至 1.57)分别在管腔 B、HER2 过表达和三阴性亚型中。 结论:在接受辅助蒽环类化疗的淋巴结阳性 EBC 患者中,预测多西他赛获益的最强预测因子是 Ki67 阳性。
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