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H A Azim,
S Michiels,
F Zagouri, S Delaloge,
M Filipits,
M Namer,
P Neven,
W F Symmans,
A Thompson,
F André,
S Loi,
C Swanton
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ABSTRACT: Background
We critically evaluated the available evidence on genomic tests in breast cancer to define their prognostic ability and likelihood to determine treatment benefit.DesignIndependent evaluation of six genomic tests [Oncotype Dx™, MammaPrint(®), Genomic Grade Index, PAM50 (ROR-S), Breast Cancer Index, and EndoPredict] was carried out by a panel of experts in three parameters: analytical validity, clinical validity, and clinical utility based on the principles of the EGAPP criteria.Panel statementsThe majority of the working group members found the available evidence on the analytical and clinical validity of Oncotype Dx™ and MammaPrint(®) to be convincing. None of the genomic tests demonstrated robust evidence of clinical utility: it was not clear from the current evidence that modifying treatment decisions based on the results of a given genomic test could result in improving clinical outcome.Conclusions
The IMPAKT 2012 Working Group proposed the following recommendations: (i) a need to develop models that integrate clinicopathologic factors along with genomic tests; (ii) demonstration of clinical utility should be made in the context of a prospective randomized trial; and (iii) the creation of registries for patients who are subjected to genomic testing in the daily practice.
Annals of Oncology 01/2013; · 6.43 Impact Factor
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ABSTRACT: Background
Circulating tumor cells (CTCs) can provide the basis for a liquid biopsy and may guide the use of targeted therapies. We report on unbiased quantification of Her-2 protein expression of CTCs.Patients and methodsHer-2 assessment of CTCs was carried out using the CellSearch(®) system in 103 metastatic (M1) and 88 non-metastatic (M0) breast-cancer patients. Expression of Her-2 on CTCs was determined by a manual review and an automated algorithm using Her-2- fluorescein isothiocyanate (FITC) fluorescence of leukocytes to determine the Her-2-expression threshold in each sample.ResultsHer-2 expression of CTCs varied greatly within and among patients compared with Her-2 expression of leukocytes. In M1 patients, a threshold of 75% of Her-2 positive CTCs in patients with ≥5 CTCs was set. Applying this threshold, 9% of M1 patients with Her-2-negative primary tumors had Her-2-positive CTC status and 29% of M1 patients with Her-2-positive primary tumors had Her-2-negative CTC status. No Her-2 discrepancy was observed between CTCs and primary tumors in M0 patients.Conclusions
Our findings demonstrate that Her-2 expression is heterogeneous among CTCs within each patient. We show the feasibility of unbiased quantitative and reproducible assessment of treatment targets on CTCs, opening a path towards personalized treatment.
Annals of Oncology 12/2012; · 6.43 Impact Factor
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ABSTRACT: J. Cyrta, F. Andreiuolo, S. Azoulay, C. Balleyguier, C. Bourgier, C. Mazouni, M.-C. Mathieu, S. Delaloge and P. Vielh Pure and mixed mucinous carcinoma of the breast: fine needle aspiration cytology findings and review of the literature Objective: Mucinous (colloid) breast carcinoma accounts for 1-6% of all breast cancer. It comprises pure mucinous tumours and mixed infiltrating ductal carcinomas with a mucinous component. As this latter mixed form has a worse prognosis than pure colloid carcinoma, making this diagnosis on fine needle aspiration cytology (FNAC) might influence the choice of treatment. Methods: We report a consecutive series of 22 cases consisting of 17 mixed and five pure mucinous carcinomas diagnosed by cytology and verified on histopathology. Patients underwent FNAC at the one-stop clinic of our institution during a 7-year period of time. Cytological findings were evaluated by a semi-quantitative method and included percentage of smear surface occupied by mucin, shape of cell groupings, size and outline of tumour nuclei as well as presence or absence of nucleolus. Results: Three of five pure mucinous carcinomas displayed at least two of the following features: abundant mucin, small nuclei and/or regular nuclear outlines. Sparse mucin, large nuclei, irregular nuclear outlines or the presence of nucleoli were found in 7 out of 17 mixed mucinous carcinomas but not in pure tumours. Conclusion: Cytopathological identification of patients with pure mucinous carcinomas may be performed in a limited number of cases.
Cytopathology 09/2012; · 1.59 Impact Factor
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ABSTRACT: Computer-aided detection (CAD) systems have been developed for interpretation to improve mammographic detection of breast cancer at screening by reducing the number of false-negative interpretation that can be caused by subtle findings, radiologist distraction and complex architecture. They use a digitized mammographic image that can be obtained from both screen-film mammography and full field digital mammography. Its performance in breast cancer detection is dependent on the performance of the CAD itself, the population to which it is applied and the radiologists who use it. There is a clear benefit to the use of CAD in less experienced radiologist and in detecting breast carcinomas presenting as microcalcifications. This review gives a detailed description CAD systems used in mammography and their performance in assistance of reading in screening mammography and as an alternative to double reading. Other CAD systems developed for MRI and ultrasound are also presented and discussed.
European journal of radiology 08/2012; · 2.65 Impact Factor
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M Arnedos,
V Scott,
B Job,
J De La Cruz,
F Commo,
M C Mathieu,
R Wolp-Diniz,
C Richon,
M Campone,
T Bachelot,
F Dalenc,
P Dessen,
L Lacroix,
V Lazar,
J C Soria, S Delaloge,
F Andre
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ABSTRACT: Breast cancer includes high number of molecular entities targetable by specific agents. In this study, array CGH and PIK3CA/AKT1 mutations were used to drive patients into targeted therapy. A prospective molecular analysis was offered to metastatic breast cancer patients for whom samples were collected prospectively or retrospectively either from frozen or paraffin-embedded tissue. Analyses were performed using array CGH (Agilent platform) and PIK3CA (exon 10 and 21) and AKT1 mutations were explored by standard Sanger sequencing. One hundred and eight patients were included. Good quality CGH was obtained in 79% cases and was better for frozen samples. Genomic alterations were identified in 50% of patients including 11 PIK3CA and 8 AKT1 mutations. Eighteen treatments (17 patients) were administered according to their molecular profile with evidence of activity in nine. Reasons for not providing a genomic-driven treatment included absence of progressive disease (38%), investigator's choice (9%), rapid PD (19%), and no drug access (21%). Array CGH correctly identified Her2 status in 97% cases; failures were related to low % of tumour cells. Our study showed that array CGH is feasible in the context of daily practice and, in combination with PIK3CA/AKT1 mutations, identifies a significant number of actionable molecular alterations that allow driving patients into specific targeted agents.
European journal of cancer (Oxford, England: 1990) 07/2012; 48(15):2293-9. · 4.12 Impact Factor
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ABSTRACT: Le concept de médecine personnalisée s’est fortement développé dans la prise en charge des cancers du sein ces dernières années.
Il repose sur des tests biologiques complexes, sur la tumeur évaluant le pronostic et la sensibilité de la maladie aux traitements
potentiels. La génétique constitutionnelle est aujourd’hui capable d’apporter des informations essentielles et complémentaires
aux données somatiques, en matière de pronostic local et général, mais surtout en termes de risque de nouveau cancer. Dans
les années qui viennent, elle sera essentielle pour l’évaluation de la sensibilité potentielle spécifique aux thérapeutiques,
en particulier avec l’arrivée de thérapeutiques ciblées spécialisées (les inhibiteurs de poly[ADP-ribose] polymérase [PARP]
étant les chefs de file en cas d’anomalies constitutionnelles de réparation de l’ADN par exemple). Dans certains cas très
rares, la sensibilité thérapeutique peut être excessive, comme en cas de présence d’une anomalie constitutionnelle de type
p53 qui peut contre-indiquer les radiations ionisantes. Cette revue fait le bilan de nos connaissances en matière d’impact
de la génétique constitutionnelle dans la prise en charge personnalisée des cancers du sein en 2010 et les modifications attendues
dans les années à venir.
The concept of personalized medicine has rapidly become a major part of breast cancer care. It relies on complex biological
evaluations and predictions of both the prognostic and the specific treatment sensitivity of a single tumor and a single individual.
Germline genetics can currently provide information that appears complementary to that provided by somatic analyses, regarding
local and general prognosis of the current cancer and also subsequent cancer risk. In the next few years, germline genetic
data should also have a major role to play in the evaluation of potential sensitivity to medical treatments (treatments targeting
DNA repair such as the recently emerging PARP inhibitors), and therefore guide major treatment choices. This paper summarizes
current existing data regarding the potential impact of germline genetics in the personalized care of breast cancer patients
in 2010 and the evolutions expected in the coming years.
Mots clésOncogénétique-BRCA1-BRCA2-Cancer du sein-Prise en charge-Mastectomie prophylactique-p53-Radiothérapie
KeywordsBreast cancer care-Genetics-BRCA1-BRCA2-Prophylactic mastectomy-p53
Oncologie 04/2012; 12(4):248-254. · 0.17 Impact Factor
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F Andre,
R Conforti,
C B Moeder,
A Mauguen,
M Arnedos,
N Berrada, S Delaloge,
G Tomasic,
M Spielmann,
F J Esteva,
D L Rimm,
S Michiels
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ABSTRACT: The purpose of this study was to evaluate the prognostic and predictive value of p27 expression in patients with early breast cancer.
Quantitative immunofluorescence assays for p27 were done on a tissue microarray that included 823 samples from patients randomized between anthracycline-based chemotherapy and no chemotherapy. Quantification of p27 was done using the AQUA® system (HistoRx, Inc., Branford, CT). Both p27 nuclear expression and the nuclear to cytoplasmic ratio were assessed.
Nuclear p27 expression was not predictive for the efficacy of anthracycline-based chemotherapy [adjusted P=0.18 for disease-free survival (DFS)] nor prognostic [95% confidence interval (CI) 0.99-1.01, P=0.49]. However, p27 nuclear/cytoplasmic ratio was predictive for the efficacy of adjuvant chemotherapy (adjusted P=0.016 DFS). The adjusted hazard ratio (HR) for relapse associated with adjuvant chemotherapy was 0.56 (95% CI 0.37-0.84, P=0.005) and 1.06 (95% CI 0.76-1.47, P=0.74) for patients with high and low nuclear/cytoplasmic ratio, respectively. p27 N/C ratio was prognostic in patients treated with chemotherapy (HR for relapse or death for a 1 unit increase in p27 N/C ratio was 0.30, 95% CI 0.12-0.77) but not in the untreated arm (HR for relapse or death was 1.27, 95% CI 0.58-2.8).
This study did not confirm the role of p27 nuclear expression as a prognostic parameter. However, the p27 nuclear/cytoplasmic ratio was predictive in patients treated with anthracycline-based chemotherapy.
Annals of Oncology 01/2012; 23(8):2059-64. · 6.43 Impact Factor
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M C Mathieu,
C Mazouni,
N C Kesty,
Y Zhang,
V Scott,
J Passeron,
M Arnedos,
C A Schnabel, S Delaloge,
M G Erlander,
F André
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ABSTRACT: The aim of neoadjuvant chemotherapy is to increase the likelihood of successful breast conservation surgery (BCS). Accurate identification of BCS candidates is a diagnostic challenge. Breast Cancer Index (BCI) predicts recurrence risk in estrogen receptor+lymph node-breast cancer. Performance of BCI to predict chemosensitivity based on pathological complete response (pCR) and BCS was assessed.
Real-time RT-PCR BCI assay was conducted using tumor samples from 150 breast cancer patients treated with neoadjuvant chemotherapy. Logistical regression and c-index were used to assess predictive strength and additive accuracy of BCI beyond clinicopathologic factors.
BCI classified 42% of patients as low, 35% as intermediate and 23% as high risk. Low BCI risk group had 98.4% negative predictive value (NPV) for pCR and 86% NPV for BCS. High versus low BCI group had a 34 and 5.8 greater likelihood of achieving pCR and BCS, respectively (P=0.0055; P=0.0022). BCI increased c-index for pCR (0.875-0.924; P=0.017) and BCS prediction (0.788-0.843; P=0.027) beyond clinicopathologic factors.
BCI significantly predicted pCR and BCS beyond clinicopathologic factors. High NPVs indicate that BCI could be a useful tool to identify breast cancer patients who are not eligible for neoadjuvant chemotherapy. These results suggest that BCI could be used to assess both chemosensitivity and eligibility for BCS.
Annals of Oncology 11/2011; 23(8):2046-52. · 6.43 Impact Factor
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J-Y Pierga,
D Hajage,
T Bachelot, S Delaloge,
E Brain,
M Campone,
V Diéras,
E Rolland,
L Mignot,
C Mathiot,
F-C Bidard
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ABSTRACT: Circulating tumor cells (CTCs) are a prognostic marker in metastatic breast cancer, but comparisons with serum tumor markers (CA 15-3, carcinoembryonic antigen and lactate dehydrogenase) variations are needed.
CTCs were counted with CellSearch® at baseline, before cycle 2 (C2) and cycle 3 or 4 (C3/4) in 267 metastatic breast cancer patients on first-line chemotherapy with/without targeted therapy.
Baseline CTC detection rate was 65% with ≥1 CTC/7.5 ml threshold and 44% with ≥5 CTC/7.5 ml and was independent of subtypes (luminal, triple negative, human epithelial growth factor receptor 2 (HER2)+). CTCs were associated with tumor markers, bone/liver involvement, tumor burden and performance status. CTC detection ≥1 CTC/7.5 ml was a strong prognostic factor for progression-free survival (PFS), P < 0.0001. Threshold of CTC ≥5 was statistically significant for PFS and overall survival (OS), P = 0.03 on multivariate analysis. Among patients with ≥5 CTC/7.5 ml at baseline, 50% had <5 CTC/7.5 ml at C2. Changes were correlated with both PFS and OS (P < 0.0001). All patients receiving anti-HER2 therapy had <5 CTC/7.5 ml after three cycles of treatment.
This is the largest prospective series validating the prognostic value of CTC independently from serum tumor marker. Elevated CTCs before C2 are an early predictive marker of poor PFS and OS, which could be used to monitor treatment benefit. CTC decrease under treatment seems stronger with targeted therapy.
Annals of Oncology 06/2011; 23(3):618-24. · 6.43 Impact Factor
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F Reyal,
F Valet,
P de Cremoux,
C Mathiot,
C Decraene,
B Asselain,
E Brain, S Delaloge,
S Giacchetti,
M Marty,
J Y Pierga,
F C Bidard
Annals of Oncology 06/2011; 22(6):1458-9. · 6.43 Impact Factor
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Cytopathology 04/2011; 22(2):137-9. · 1.59 Impact Factor
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R Rouzier,
G Werkoff,
C Uzan,
O Mir,
J Gligorov,
L Selleret,
F Goffinet,
F Goldwasser,
J M Treluyer,
S Uzan, S Delaloge
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ABSTRACT: The aim of this study was to determine the chemosensitivity of pregnancy-associated breast cancer (PABC) in the neoadjuvant setting by comparing the observed pathological complete response (pCR) rate with the rate predicted by a validated nomogram.
Data from 48 PABC patients who received neoadjuvant chemotherapy (NACT) were collected. To predict the response rate to chemotherapy, we used well-calibrated logistic regression-based nomograms to calculate individual probability of pCR.
Observed rates of pCR were concordant with predictions in the whole sample and in the analyzed subgroups. For the whole sample, the area under the receiver-operated curve (AUC) was 0.77 (95% CI 0.66-0.87). The calibration of predicted and observed probabilities was excellent. In the subgroup analyses (NACT initiated during pregnancy or postpartum, NACT with only anthracycline or both anthracycline and taxanes), discriminations assessed by AUC were significantly above 0.5, except for patients treated with anthracycline only. The interpretation was limited by a lack of power.
Through the use of nomograms, our study demonstrates that PABC is as chemosensitive as non-PABC and suggests that taxanes should be part of the NACT regimen for PABC. Further studies are warranted to increase the power of the presented data.
Annals of Oncology 01/2011; 22(7):1582-7. · 6.43 Impact Factor
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C Bourgier,
C Pichenot,
R Verstraet,
S Heymann,
B Biron,
C Balleyguier, S Delaloge,
M-C Mathieu,
C Uzan,
J-R Garbay,
J Bourhis,
A Taghian,
H Marsiglia
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ABSTRACT: Since 2009, accelerated partial breast irradiation (APBI) in North America has been allowed to be used for selected group of patients outside a clinical trial according to the ASTRO consensus statement. In France, accelerated partial breast irradiation is still considered investigational, several clinical trials have been conducted using either intraoperative (Montpellier) or Mammosite(®) (Lille) or brachytherapy modality (PAC GERICO/FNCLCC). Here, we report the original dosimetric results of this technique.
Since October 2007, Institut Gustave-Roussy has initiated a phase II trial using 3D-conformal accelerated partial breast irradiation (40 Gy in 10 fractions BID in 1 week). Twenty-five patients with pT1N0 breast cancer were enrolled and were treated by two minitangent photons beams (6MV) and an "en face" electron beam (6-22 MeV).
The mean clinical target volume and planning target volume were respectively 15.1cm(3) (range: 5.2-28.7 cm(3)) and 117 cm(3) (range: 52-185 cm(3)). The planning target volume coverage was adequate with at least a mean of 99% of the volume encompassed by the isodose 40 Gy. The mean dose to the planning target volume was 41.8 Gy (range: 41-42.4 Gy). Dose inhomogeneity did not exceed 5%. Mean doses to the ipsilateral lung and heart were 1.6 Gy (range: 1.0-2.3 Gy) and 1.2 Gy (range: 1.0-1.6 Gy), respectively.
The 3D conformal accelerated partial breast irradiation using two minitangent and "en face" electron beams using a total dose of 40 Gy in 10 fractions BID over 5 days achieves appropriate planning target volume coverage and offers significant normal-tissue sparing (heart, lung). Longer follow-up is needed to evaluate the tissue tolerance to this radiation dose.
Cancer/Radiothérapie 12/2010; 14(8):718-26. · 1.49 Impact Factor
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ABSTRACT: Triple-negative [estrogen receptor (ER)-/progesterone receptor (PR)-/HER2-] breast cancers account for ~15% of overall breast cancers. Triple-negative breast cancers demonstrate a panel of specific molecular alterations including a high rate of p53 mutations, frequent loss of function of BRCA1, phosphatase and tensin homolog (PTEN) loss and a specific panel of tyrosine kinase activation [fibroblast growth factor receptor 2 (FGFR2)]. This molecular entity is considered as sensitive to chemotherapy in the adjuvant setting. When metastatic, the disease is usually aggressive and drug resistant, leading to cancer death within 18 months for the majority of patients. There is no evidence from randomized trials that triple-negative breast cancers have a different sensitivity to specific chemotherapy compared with other molecular classes. Similar findings have been reported for bevacizumab. Several recent research efforts have focused on this entity in the last few years. DNA alkylating agents have shown promising activity in the neoadjuvant setting, but no evidence from a phase III trial currently supports its use. Several targeted therapies are also being successfully developed. Poly(ADP ribose) polymerase 1 (PARP1) inhibitors induce tumor response as a single agent in BRCA1-mutated breast cancer, and could sensitize cisplatin in the whole triple negative population. Several other targeted agents are being developed in this setting, including epidermal growth factor receptor (EGFR), FGFR2, mammalian target of rapamycin (mTOR) and NOTCH inhibitors.
Annals of Oncology 10/2010; 21 Suppl 7:vii30-5. · 6.43 Impact Factor
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ABSTRACT: There is a need to develop blood-based bioassays for breast cancer (BC) screening. In this study, differential gene expression between BC samples and benign tumours was used to identify candidate biomarkers for blood-based screening.
We identified two proteins (Fibronectin 1 and CXCL9) from a gene expression data set that included 120 BC samples and 45 benign lesions. These proteins fulfil the following criteria: differential gene expression between cancer and benign lesion, protein released in the extracellular medium and stable in the serum, commercially available ELISA kit, ELISA accuracy in a feasibility study. Protein concentrations were determined by ELISA. Blood samples were from normal volunteers (n=119) and early BC patients (n=133).
Seventy-three per cent of patients had cT1-T2 tumour. Patients had higher CXCL9 and Fibronectin 1 concentrations than volunteers. CXCL9 mean concentration was 851 and 635 pg ml(-1) for patients and volunteers respectively (P=0.013). CXCL9 concentration was significantly higher in patients with estrogen receptor (ER)-negative compared with volunteers (P=0.003), data consistent with gene expression profile. Fibronectin 1 mean concentration was 190 microg ml(-1) for patients and 125 microg ml(-1) for volunteers (P<0.001). Areas under the curve for BC diagnosis were 0.78 and 0.62 for Fibronectin 1 and CXCL9 respectively. A combined score including Fibronectin 1 and CXCL9 dosages presented 53% of sensitivity and 98% of specificity. Similar performances were observed for ER-negative tumours.
This study suggests that Fibronectin 1/CXCL9 dosage in serum could screen a significant rate of BC, including ER-negative, and that differential gene expression analysis is a good approach to select candidate biomarkers to set up blood assays cancer screening.
British Journal of Cancer 02/2010; 102(3):462-8. · 5.04 Impact Factor
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ABSTRACT: Circulation of cancer cells in the blood is a mandatory step for metastasis, but circulating tumor cells (CTC) have a low metastatic efficiency in preclinical animal models. In this prospective study, we reported the clinical outcome of nonmetastatic breast cancer patients according to CTC detection.
In 115 nonmetastatic patients diagnosed with large operable or locally advanced breast cancer, we prospectively detected CTC using the CellSearch system before and after neoadjuvant chemotherapy in a phase II trial (REMAGUS02).
At baseline, 23% of patients were CTC positive, but only 10% had >1 CTC/7.5 ml of blood. After a median follow-up of 36 months, CTC detection before chemotherapy was an independent prognostic factor for both distant metastasis-free survival [DMFS; P = 0.01, relative risk (RR) = 5.0, 95% confidence interval (CI) 1.4-17] and overall survival (OS; P = 0.007, RR = 9, 95% CI 1.8-45). CTC detection after chemotherapy was of less significance (P = 0.07 and 0.09, respectively). Moreover, CTC detection showed interesting characteristics as an individual predictive test for metastatic relapses (sensibility 55%, specificity 81%, and global accuracy 77%).
Detection of > or =1 CTC/7.5 ml before neoadjuvant chemotherapy can accurately predict OS. Our findings may change the clinical management of nonmetastatic breast cancer and indicate that the metastatic efficiency of CTC could be higher than previously reported.
Annals of Oncology 10/2009; 21(4):729-33. · 6.43 Impact Factor
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ABSTRACT: CA15-3, a peptide derived from MUC-1, an hormonally-regulated protein, is the most widely used serum marker of breast cancer. CA15-3 level increases at the metastatic phase in 50-80% breast cancer patients. Although rise of CA15-3 precede symptoms of metastasis by a mean time of 2-9 months, current international guidelines do not recommend its routine use for screening for metastases because of moderate sensitivity and absence of clinical impact. We conducted a retrospective study among all patients with metastatic breast cancer seen by three senior breast oncologists during a 4-month period. We evaluated correlation of CA15-3 level at the time of metastatic relapse with ER, PgR and Her2 expressions, tumor type, size and nodal status at initial diagnosis, and sites of metastases. CA15-3 was increased in 168/272 patients (62%) at diagnosis of metastases. ER/PgR positivity was strongly correlated with elevated CA15-3 at this time (P < 0.0001). CA 15-3 was elevated in 69% of the cases of HR+ Her2- primary tumors at time of metastatic relapse. It was elevated in 56% of HR+ Her2+++, 46% of HR- Her2+++ cases and only in 41% of triple-negative cases (P = 0.003). these data confirm that CA 15-3 is very variably elevated at time of metastatic relapse of breast cancer, and this is dependant on HR status.
Bulletin du cancer 08/2009; 96(10):923-8. · 0.67 Impact Factor
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Cytopathology 06/2009; 21(3):191-3. · 1.59 Impact Factor
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Cytopathology 10/2008; 20(6):403-5. · 1.59 Impact Factor
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ABSTRACT: We hypothesized that, among molecular subclasses of breast cancer, p53 status may have a differential predictive value for the efficacy of anthracyclines/alkylating agents-based regimen. We analysed the efficacy of a preoperative combination between 5-fluorouracil, anthracyclines and cyclophosphamide according to both p53 status and molecular classification.
Oestrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor 2 (HER2) expression and p53 status were determined by immunohistochemistry in 293 samples from two different centres. A logistic regression model was used for multivariate analysis of predictors for pathological complete response (pCR).
p53 immunostaining (54%) was associated with high grade (P = 0.002) and ER negativity (P = 0.04). p53 was detected in 59% of triple-negative tumours (ER-/PgR-/HER2-, n = 120 patients). In the overall population, pCR (9.6%) was independently predicted by high tumour grade (P = 0.002) and ER/PgR/HER2 triple negativity (P = 0.0004), but not by p53 status (P = 0.12). p53 immunostaining was associated with a trend for a higher rate of pCR in triple-negative tumours [relative risk (RR) = 2.5, 95% confidence interval (CI) = 0.8-7.5, P = 0.09], but not in non-triple-negative tumours (RR = 0.73, 95% CI = 0.16-3.3, P = 0.69).
p53 status may have a different predictive value for efficacy of anthracycline/alkylating agents-based regimen in each molecular subclass, a result which may explain the different results reported in literature.
Annals of Oncology 08/2008; 19(7):1261-5. · 6.43 Impact Factor
