Predictive and prognostic value of classification by immunohistochemical phenotypes in localised breast cancer treated with dose-dense adriamycin/cyclophosphamide
Journal Title: Journal of Cancer Research & Therapy - Year 2015, Vol 3, Issue 11
Abstract
Introduction: Histopathologic subtyping according to the St. Gallen classification is predictive of response in women with breast cancer treated with neoadjuvant chemotherapy (NCT). Our aim was to confirm its predictive role when dose-dense (DD) chemotherapy is administered. Methods: A prospective study was performed in stage II-III breast cancer treated with four cycles of doxorubicin-cyclophosphamide every two weeks, followed by 4 cycles of docetaxel every 3weeks. Tumours were grouped into 4 subtypes. Simple and multivariate logistic regression analysis was performed to determine the association between pathologic complete response (pCR), according to the Miller & Payne classification and tumour subtype. In addition survival analysis was performed. Results: 71 patients were included. By phenotypic classification, 11.3% were Luminal A, 59.2% Luminal B, 8.5% pure HER2 and 21.1% TN. Following the administration of DD NCT, a pCR rate of 25.4% was achieved. There was a significant association between the pCR rate and the different immune phenotypes (p=0.05). The pCR rate was 46.7% for the TN patients and 19.6% for the others (p=0.046). At 30 months’ followup, the rate of disease-free survival (DFS) was 71.8% for the TN patients and 93.3% for all others. The difference was also significant for overall survival (p=0.006), with 100% of the non-TN patients alive vs 85.7% of the TN patients. Within the TN subtype, the patients who achieved pCR had a better DFS (p=0.04) and a better rate of overall survival. Conclusions: Tumour classification according to the St. Gallen phenotypes is useful in predicting response and survival in breast cancer patients treated with DD neoadjuvant chemotherapy.
Authors and Affiliations
Pedrinaci IZ, Maximino R, Ángel C, Francisco RR, Luis JP, Antonio R
Predictive and prognostic value of classification by immunohistochemical phenotypes in localised breast cancer treated with dose-dense adriamycin/cyclophosphamide
Introduction: Histopathologic subtyping according to the St. Gallen classification is predictive of response in women with breast cancer treated with neoadjuvant chemotherapy (NCT). Our aim was to confirm its predictive...
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