Zhu Teng, Xu Fangping, Zhang Liulu, Zhang Yifang, Yang Ciqiu, Cheng Minyi, Chen Fulong, Wang Kun
Department of Breast Cancer, Cancer Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
Department of Pathology, Cancer Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
Oncotarget. 2017 Jul 28;8(60):101087-101094. doi: 10.18632/oncotarget.19686. eCollection 2017 Nov 24.
The aim of this study was to determine the predictive value of the clinical and histopathological characteristics of estrogen receptor (ER)-positive patients treated with dose-dense paclitaxel/carboplatin neoadjuvant chemotherapy (NCT). Pathological complete response (pCR) and the change in tumor size between pre- and post-NCT were used to evaluate the tumor response.85 ER-positive breast cancer patients who were treated with dose-dense (biweekly) paclitaxel/carboplatin NCT were analyzed with respect to the expression of progesterone receptor (PgR), Tau, Ki67, human epidermal growth factor receptor 2 (HER2), and Bcl-2 by immunohistochemistry (IHC). These data were used to determine whether these biomarkers could predict the tumor response. A univariate analysis showed that the patients who tested positive for HER2 expression (56.00% vs 11.67%, p<0.01), negative for Tau expression (41.94% vs 14.81%, p=0.005), negative for Bcl-2 expression (46.43% vs 14.04%, p<0.01) and had smaller (≤2 cm) tumors (45.00% vs 18.46%, p=0.02) were associated with higher pCR rates. A multivariate analysis showed that a HER2-positive status (OR: 6.244; 95%CI: 1.734-22.487; p=0.005), Bcl-2-negative status (OR: 0.236; 95%CI: 0.064-0.869; p=0.030) and smaller (≤2 cm) tumor sizes (OR: 0.188; 95%CI: 0.046-0.767; p=0.020) are independent predictors of pCRs. The tumor sizes were significantly reduced in patients with HER2-positive, Tau-negative, Bcl-2-negative and high Ki67 index breast cancer. In conclusion, Bcl-2 negative, HER2-positive and smaller (≤2 cm) tumor sizes are independent predictors of pCR in ER-positive patients treated with dose-dense (biweekly) paclitaxel/carboplatin NCT. This study is registered with ClinicalTrials.gov (NCT0205986).
本研究旨在确定接受剂量密集型紫杉醇/卡铂新辅助化疗（NCT）的雌激素受体（ER）阳性患者的临床和组织病理学特征的预测价值。采用病理完全缓解（pCR）以及NCT前后肿瘤大小的变化来评估肿瘤反应。对85例接受剂量密集型（每两周一次）紫杉醇/卡铂NCT治疗的ER阳性乳腺癌患者，通过免疫组织化学（IHC）分析其孕激素受体（PgR）、Tau、Ki67、人表皮生长因子受体2（HER2）和Bcl-2的表达情况。这些数据用于确定这些生物标志物是否能够预测肿瘤反应。单因素分析显示，HER2表达阳性的患者（56.00%对11.67%，p<0.01）、Tau表达阴性的患者（41.94%对14.81%，p=0.005）、Bcl-2表达阴性的患者（46.43%对14.04%，p<0.01）以及肿瘤较小（≤2 cm）的患者（45.00%对18.46%，p=0.02），其pCR率较高。多因素分析显示，HER2阳性状态（OR：6.244；95%CI：1.734 - 22.487；p=0.005）、Bcl-2阴性状态（OR：0.236；95%CI：0.064 - 0.869；p=0.030）以及较小（≤2 cm）的肿瘤大小（OR：0.188；95%CI：0.046 - 0.767；p=0.020）是pCR的独立预测因素。HER2阳性、Tau阴性、Bcl-2阴性且Ki67指数高的乳腺癌患者的肿瘤大小显著减小。总之，在接受剂量密集型（每两周一次）紫杉醇/卡铂NCT治疗的ER阳性患者中，Bcl-2阴性、HER2阳性以及较小（≤2 cm）的肿瘤大小是pCR的独立预测因素。本研究已在ClinicalTrials.gov注册（NCT0205986）。
