Lv Minhao, Li Beibei, Li Yongfeng, Mao Xiaoyun, Yao Fan, Jin Feng
Department of Surgical Oncology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.
Asian Pac J Cancer Prev. 2011;12(9):2411-7.
Breast cancer is increasingly regarded as a heterogeneous disease which can be classified into distinct molecular subtypes with prognostic significance.
ER, PR, HER2 and ki-67 were used to divided 102 breast cancers treated with neoadjuvant chemotherapy (NCT) into 4 subtypes: luminal A (ER+, PR+, HER2-, and ki-67≤14%), luminal B (ER+, PR+, HER2- and ki-67>14% ; ER+ and/or PR+, HER2+), HER2-overexpression (ER-, PR- and HER2+) and triple-negative (ER-, PR-, and HER2-).
Among 102 patients, a pCR was seen in 16 (15.7%) patients. The pathologic complete remission (pC) rates according to different subtypes are as follows: luminal A, 0 of 20 (0.0%), luminal B, 2 of 23 (8.7%), HER2-overexpression 4 of 18 (22.2%), and triple-negative, 10 of 41 (24.4%) (p=0.041). In triple-negative subtype patients, the rates of pCR differed significantly among the 3 chemotherapy regimens with 5.6% (1/18) for CEF (cyclophosphamide, epirubicin and flurouracil), 20.0% (1/5) for TE (docetaxel and epirubicin) and 44.4% (8/18) for TCb (docetaxel and carboplatin) (p=0.024). In locally advanced breast cancer patients, the rates of pCR seem to differ among the 3 chemotherapy regimens with 6.7% (2/30) for CEF, 0.0% (0/8) for TE and 23.1% (6/26) for TCb, but this did not attain statistical significance (p>0.05).
Molecular subtypes are good predictors for response to NCT in breast cancer patients in Northeast China. Compared with luminal A tumors, HER2-overexpression and triple-negative subtypes are more sensitive to NCT. For triple-negative breast cancer, we concluded that the TCb combination is a promising NCT regimen. Our results also indicated that the TCb combination is promising for the treatment of locally advanced breast cancer.
乳腺癌日益被视为一种异质性疾病，可分为具有预后意义的不同分子亚型。
采用雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER2）和Ki-67将102例接受新辅助化疗（NCT）的乳腺癌患者分为4种亚型：腔面A型（ER阳性、PR阳性、HER2阴性且Ki-67≤14%）、腔面B型（ER阳性、PR阳性、HER2阴性且Ki-67>14%；ER阳性和/或PR阳性、HER2阳性）、HER2过表达型（ER阴性、PR阴性、HER2阳性）和三阴性（ER阴性、PR阴性、HER2阴性）。
102例患者中，16例（15.7%）达到病理完全缓解（pCR）。不同亚型的病理完全缓解（pC）率如下：腔面A型，20例中0例（0.0%）；腔面B型，23例中2例（8.7%）；HER2过表达型，18例中4例（22.2%）；三阴性，41例中10例（24.4%）（p=0.041）。在三阴性亚型患者中，3种化疗方案的pCR率差异显著，环磷酰胺、表柔比星和氟尿嘧啶（CEF）方案为5.6%（1/18），多西他赛和表柔比星（TE）方案为20.0%（1/5），多西他赛和卡铂（TCb）方案为44.4%（8/18）（p=0.024）。在局部晚期乳腺癌患者中，3种化疗方案的pCR率似乎有所不同，CEF方案为6.7%（2/30），TE方案为0.0%（0/8），TCb方案为23.1%（6/26），但未达到统计学显著性（p>0.05）。
分子亚型是中国东北地区乳腺癌患者对NCT反应的良好预测指标。与腔面A型肿瘤相比，HER2过表达型和三阴性亚型对NCT更敏感。对于三阴性乳腺癌，我们得出结论，TCb联合方案是一种有前景的NCT方案。我们的结果还表明，TCb联合方案对局部晚期乳腺癌的治疗有前景。
