Can patients' likelihood of benefiting from primary chemotherapy for breast cancer be predicted before commencement of treatment?

Keith Nicholas Ogston, Iain D Miller, Andrew Craig Schofield, A. Spyrantis, E. Pavlidou, T. K. Sarkar, A. W. Hutcheon, S. Payne, Steven Darryll Heys

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Purpose. Primary chemotherapy is commonly used in patients with breast cancer to downstage the primary tumour prior to surgery. There is a need to establish, prior to commencement of chemotherapy, predictors of clinical and pathological response, which may then be surrogate markers for patient survival and thus allow identification of patients who are most likely to benefit from such treatment.

Patients and methods. A total of 104 patients with large and locally advanced breast cancers received an anthracycline/docetaxel-based regimen prior to surgery. Immunohistochemistry was carried out on pretreatment core biopsies of the tumour to detect hormone receptors (oestrogen-ER; progesterone-PR), a proliferation marker (MIB-1), the oncoprotein Bcl-2, an extracellular matrix degradation enzyme ( cathepsin D), p53, and an oestrogen associated protein (pS2). Both clinical and pathological response were assessed following completion of chemotherapy.

Results. Patients whose tumours did not express oestrogen receptor ( p = 0.02) or did not express Bcl-2 (p< 0.01) had a better pathological response in a univariate analysis. However, in a multivariate model, it was only the absence of detectable Bcl-2 protein that predicted a better pathological response ( p = 0.001).

Conclusions. This study has identified that patients whose breast cancers are most likely to experience the greatest degree of tumour destruction by primary chemotherapy do not express either oestrogen receptors or Bcl-2. This may have important implications in the selection of patients with breast cancer for primary chemotherapy who are most likely to gain a survival benefit.

Original languageEnglish
Pages (from-to)181-189
Number of pages8
JournalBreast Cancer Research and Treatment
Volume86
Issue number2
DOIs
Publication statusPublished - Jul 2004

Keywords

  • breast cancer
  • primary chemotheraphy
  • NEOADJUVANT CHEMOENDOCRINE THERAPY
  • RANDOMIZED-TRIAL
  • PREOPERATIVE CHEMOTHERAPY
  • ADJUVANT CHEMOTHERAPY
  • PROGNOSTIC-FACTORS
  • P53
  • MARKERS
  • EXPRESSION
  • DOCETAXEL
  • CARCINOMA

Cite this

Can patients' likelihood of benefiting from primary chemotherapy for breast cancer be predicted before commencement of treatment? / Ogston, Keith Nicholas; Miller, Iain D; Schofield, Andrew Craig; Spyrantis, A.; Pavlidou, E.; Sarkar, T. K.; Hutcheon, A. W.; Payne, S.; Heys, Steven Darryll.

In: Breast Cancer Research and Treatment, Vol. 86, No. 2, 07.2004, p. 181-189.

Research output: Contribution to journalArticle

Ogston, KN, Miller, ID, Schofield, AC, Spyrantis, A, Pavlidou, E, Sarkar, TK, Hutcheon, AW, Payne, S & Heys, SD 2004, 'Can patients' likelihood of benefiting from primary chemotherapy for breast cancer be predicted before commencement of treatment?', Breast Cancer Research and Treatment, vol. 86, no. 2, pp. 181-189. https://doi.org/10.1023/B:BREA.0000032986.00879.d7
Ogston, Keith Nicholas ; Miller, Iain D ; Schofield, Andrew Craig ; Spyrantis, A. ; Pavlidou, E. ; Sarkar, T. K. ; Hutcheon, A. W. ; Payne, S. ; Heys, Steven Darryll. / Can patients' likelihood of benefiting from primary chemotherapy for breast cancer be predicted before commencement of treatment?. In: Breast Cancer Research and Treatment. 2004 ; Vol. 86, No. 2. pp. 181-189.
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abstract = "Purpose. Primary chemotherapy is commonly used in patients with breast cancer to downstage the primary tumour prior to surgery. There is a need to establish, prior to commencement of chemotherapy, predictors of clinical and pathological response, which may then be surrogate markers for patient survival and thus allow identification of patients who are most likely to benefit from such treatment.Patients and methods. A total of 104 patients with large and locally advanced breast cancers received an anthracycline/docetaxel-based regimen prior to surgery. Immunohistochemistry was carried out on pretreatment core biopsies of the tumour to detect hormone receptors (oestrogen-ER; progesterone-PR), a proliferation marker (MIB-1), the oncoprotein Bcl-2, an extracellular matrix degradation enzyme ( cathepsin D), p53, and an oestrogen associated protein (pS2). Both clinical and pathological response were assessed following completion of chemotherapy.Results. Patients whose tumours did not express oestrogen receptor ( p = 0.02) or did not express Bcl-2 (p< 0.01) had a better pathological response in a univariate analysis. However, in a multivariate model, it was only the absence of detectable Bcl-2 protein that predicted a better pathological response ( p = 0.001).Conclusions. This study has identified that patients whose breast cancers are most likely to experience the greatest degree of tumour destruction by primary chemotherapy do not express either oestrogen receptors or Bcl-2. This may have important implications in the selection of patients with breast cancer for primary chemotherapy who are most likely to gain a survival benefit.",
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T1 - Can patients' likelihood of benefiting from primary chemotherapy for breast cancer be predicted before commencement of treatment?

AU - Ogston, Keith Nicholas

AU - Miller, Iain D

AU - Schofield, Andrew Craig

AU - Spyrantis, A.

AU - Pavlidou, E.

AU - Sarkar, T. K.

AU - Hutcheon, A. W.

AU - Payne, S.

AU - Heys, Steven Darryll

PY - 2004/7

Y1 - 2004/7

N2 - Purpose. Primary chemotherapy is commonly used in patients with breast cancer to downstage the primary tumour prior to surgery. There is a need to establish, prior to commencement of chemotherapy, predictors of clinical and pathological response, which may then be surrogate markers for patient survival and thus allow identification of patients who are most likely to benefit from such treatment.Patients and methods. A total of 104 patients with large and locally advanced breast cancers received an anthracycline/docetaxel-based regimen prior to surgery. Immunohistochemistry was carried out on pretreatment core biopsies of the tumour to detect hormone receptors (oestrogen-ER; progesterone-PR), a proliferation marker (MIB-1), the oncoprotein Bcl-2, an extracellular matrix degradation enzyme ( cathepsin D), p53, and an oestrogen associated protein (pS2). Both clinical and pathological response were assessed following completion of chemotherapy.Results. Patients whose tumours did not express oestrogen receptor ( p = 0.02) or did not express Bcl-2 (p< 0.01) had a better pathological response in a univariate analysis. However, in a multivariate model, it was only the absence of detectable Bcl-2 protein that predicted a better pathological response ( p = 0.001).Conclusions. This study has identified that patients whose breast cancers are most likely to experience the greatest degree of tumour destruction by primary chemotherapy do not express either oestrogen receptors or Bcl-2. This may have important implications in the selection of patients with breast cancer for primary chemotherapy who are most likely to gain a survival benefit.

AB - Purpose. Primary chemotherapy is commonly used in patients with breast cancer to downstage the primary tumour prior to surgery. There is a need to establish, prior to commencement of chemotherapy, predictors of clinical and pathological response, which may then be surrogate markers for patient survival and thus allow identification of patients who are most likely to benefit from such treatment.Patients and methods. A total of 104 patients with large and locally advanced breast cancers received an anthracycline/docetaxel-based regimen prior to surgery. Immunohistochemistry was carried out on pretreatment core biopsies of the tumour to detect hormone receptors (oestrogen-ER; progesterone-PR), a proliferation marker (MIB-1), the oncoprotein Bcl-2, an extracellular matrix degradation enzyme ( cathepsin D), p53, and an oestrogen associated protein (pS2). Both clinical and pathological response were assessed following completion of chemotherapy.Results. Patients whose tumours did not express oestrogen receptor ( p = 0.02) or did not express Bcl-2 (p< 0.01) had a better pathological response in a univariate analysis. However, in a multivariate model, it was only the absence of detectable Bcl-2 protein that predicted a better pathological response ( p = 0.001).Conclusions. This study has identified that patients whose breast cancers are most likely to experience the greatest degree of tumour destruction by primary chemotherapy do not express either oestrogen receptors or Bcl-2. This may have important implications in the selection of patients with breast cancer for primary chemotherapy who are most likely to gain a survival benefit.

KW - breast cancer

KW - primary chemotheraphy

KW - NEOADJUVANT CHEMOENDOCRINE THERAPY

KW - RANDOMIZED-TRIAL

KW - PREOPERATIVE CHEMOTHERAPY

KW - ADJUVANT CHEMOTHERAPY

KW - PROGNOSTIC-FACTORS

KW - P53

KW - MARKERS

KW - EXPRESSION

KW - DOCETAXEL

KW - CARCINOMA

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DO - 10.1023/B:BREA.0000032986.00879.d7

M3 - Article

VL - 86

SP - 181

EP - 189

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 2

ER -