基于免疫组织化学的分子亚型对西班牙裔乳腺癌患者新辅助化疗后化疗敏感性和生存的影响。
Impact of immunohistochemistry-based molecular subtype on chemosensitivity and survival in Hispanic breast cancer patients following neoadjuvant chemotherapy.
作者信息
Gómez Rodolfo, Ossa Carlos Andrés, Montoya María Elvira, Echeverri Carolina, Ángel Gonzalo, Ascuntar Johana, Borrero Mauricio, Gil Mónica, Herrera Sabrina, Gutiérrez Eduardo, Herazo Fernando, Jiménez Alejo, Madrid Jorge, Reyes Pedro Alejandro, Zuluaga Lina, García Héctor
机构信息
Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia ; School of Medicine, Universidad de Antioquia, Medellín, Colombia ; Cancer Research Group, Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia ; Cancer Research Group, Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
出版信息
Ecancermedicalscience. 2015 Aug 6;9:562. doi: 10.3332/ecancer.2015.562. eCollection 2015.
BACKGROUND
Neoadjuvant chemotherapy (NAC) is the standard treatment for patients with locally advanced breast cancer, showing improvement in disease-free survival (DFS) and overall survival (OS) rates in patients achieving pathological complete response (pCR). The relationship between immunohistochemistry-based molecular subtyping (IMS), chemo sensitivity and survival is currently a matter of interest. We explore this relationship in a Hispanic cohort of breast cancer patients treated with NAC.
METHODS
A retrospective survival analysis was performed on Colombian females with breast cancer treated at Instituto de Cancerología-Clinica Las Américas between January 2009 and December 2011. Patients were classified according to immunohistochemistry-based subtyping into the following five groups: Luminal A, Luminal B, Luminal B/HER 2+, HER2-enriched, and triple-negative breast cancer. Demographic characteristics, recurrence pattern, and survival rate were reviewed by bivariate and multivariate analysis.
RESULTS
A total of 328 patients fulfilled the study's inclusion parameters and the distribution of subtypes were as follows: Luminal A: 73 (22.3%), Luminal B/HER2-: 110 (33.5%), Luminal B/HER2+: 75 (22.9%), HER2-enriched: 30 (9.1%), and triple-negative: 40 (12.2%). The median follow-up was 41 months (interquartile range: 31-52). Pathological response to NAC was as follows: complete pathological response (pCR) in 28 (8.5%) patients, partial 247 (75.3%); stable disease 47 (14.3%), and progression 6 (1.8%) patients. The presence of pCR had a significant DFS and OS in the entire group (p = 0.01) but subtypes had different DFS in Luminal B (p = 0.01) and triple negative (p = 0.02) and also OS in Luminal B (p = 0.01) and triple negative (p = 0.01).
CONCLUSIONS
pCR is associated with an improved overall survival and disease-free survival rates in this group of Hispanics patients. Advanced stages, Luminal B subtypes, triple-negative tumours and non-pCR showed lower DFS.
背景
新辅助化疗（NAC）是局部晚期乳腺癌患者的标准治疗方法，在达到病理完全缓解（pCR）的患者中，无病生存期（DFS）和总生存期（OS）有所改善。基于免疫组织化学的分子亚型（IMS）、化疗敏感性和生存率之间的关系目前备受关注。我们在接受NAC治疗的西班牙裔乳腺癌患者队列中探讨这种关系。
方法
对2009年1月至2011年12月在拉丁美洲癌症研究所-临床癌症中心接受治疗的哥伦比亚乳腺癌女性患者进行回顾性生存分析。根据基于免疫组织化学的亚型将患者分为以下五组：腔面A型、腔面B型、腔面B/HER2+型、HER2富集型和三阴性乳腺癌。通过双变量和多变量分析回顾人口统计学特征、复发模式和生存率。
结果
共有328例患者符合研究纳入标准，亚型分布如下：腔面A型：73例（22.3%），腔面B/HER2-型：110例（33.5%），腔面B/HER2+型：75例（22.9%），HER2富集型：30例（9.1%），三阴性：40例（12.2%）。中位随访时间为41个月（四分位间距：31 - 52个月）。对NAC的病理反应如下：28例（8.5%）患者达到完全病理缓解（pCR），247例（75.3%）部分缓解；疾病稳定47例（14.3%），疾病进展6例（1.8%）。pCR的存在在整个组中对DFS和OS有显著影响（p = 0.01），但不同亚型在腔面B型（p = 0.01）和三阴性（p = 0.02）中的DFS以及腔面B型（p = 0.01）和三阴性（p = 0.01）中的OS有所不同。
结论
在这组西班牙裔患者中，pCR与总体生存率和无病生存率的提高相关。晚期、腔面B亚型、三阴性肿瘤和非pCR患者的DFS较低。
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