Clinical and Pathological Response to Primary Chemotherapy in Patients with Locally Advanced Breast Cancer Grouped According to Hormonal Receptors, Her2 Status, Grading and Ki-67 Proliferation Index

• Published in: Anticancer research Vol. 29; no. 5; pp. 1621 - 1625
• Main Authors: MIGLIETTA, Loredana, VANILLA, Paola, CANOBBIO, Luciano, PARODI, Maria Angela, GUGLIELMINI, Pamela, BOCCARDO, Francesco
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01.05.2009
• Subjects: Antineoplastic Agents - therapeutic use; Biological and medical sciences; Breast Neoplasms - drug therapy; Breast Neoplasms - metabolism; Breast Neoplasms - pathology; Cell Proliferation; Female; Gynecology. Andrology. Obstetrics; Humans; Ki-67 Antigen - metabolism; Mammary gland diseases; Medical sciences; Receptor, ErbB-2 - metabolism; Receptors, Estrogen - metabolism; Receptors, Progesterone - metabolism; Tumors; Histological grading; Cell proliferation; Breast disease; Adjuvant treatment; erbB2 Gene; Biological marker; Index; locally advanced breast cancer; Neo-adjuvant chemotherapy; Cancerology; Primary; Protooncogene; Human; Breast cancer; Malignant tumor; Human Epidermal growth factor Receptor 2; Mammary gland diseases; Chemotherapy; Treatment; C-Onc gene; Ki67 antigen; biological markers; Locally advanced stage; Cancer; Hormonal receptor
• ISSN: 0250-7005; 1791-7530

Objectives: Biological markers that reliably predict clinical and pathological response to primary systemic therapy may have considerable clinical potential; this study evaluated response compared to expression of ER, PgR and Her2, grading and Ki-67 proliferation index before and after neoadjuvant chemotherapy in patients with locally advanced breast cancer (LABC). Patients and Methods: Fifty-five patients received neoadjuvant chemotherapy for LABC. The incidence of clinical and pathological responses was assessed with respect to basal clinical stage, absent/low vs. high ER and PgR status, low vs. high proliferation index, grading and Her2 overexpression. Results: Overall, 30 patients (54%) underwent downstaging of their primary tumor; pathological complete remission was observed in only one patient with Her2 positive breast tumor. Patients with pre-treatment Ki-67 >20%, Her2 overexpression, T2b/T3 vs. T4 clinical stage achieved higher response rate. Conclusion: The future of neoadjuvant therapy lies in tailoring treatment to individual patients by identifying response predictors; although the number of patients reported is small, this study confirms that clinical stage at diagnosis, Ki-67 reduction and Her2 overexpression are predictive of tumor response to neoadjuvant regimens.