Relationship between oestrogen receptor status and proliferation in predicting response and long-term outcome to neoadjuvant chemotherapy for breast cancer
- 350 Downloads
Oestrogen receptor (ER) negative breast cancers are more likely to achieve a pathological complete response (pCR) to neoadjuvant chemotherapy compared to those with ER positive tumours. ER positive tumours exhibit low proliferation and ER negative cancers high proliferation. The aim of this study was to determine to what extent the better response of ER negative cancers correlates with proliferation rate. A retrospective analysis of a prospectively maintained database identified 175 neoadjuvant chemotherapy patients with tissue available for Ki67 analysis. On univariate analysis, pre-therapy Ki67 (P = 0.04), ER status (P = 0.002), HER2 status (P = 0.004) and grade (P = 0.0009) were associated with a pCR. In a multivariate model, HER2 was the only significant predictor of pCR. No significant relationship between pre-therapy Ki67 and relapse-free and overall survival was demonstrated. Ki67 is not an independent predictor of clinical CR or pCR. Aspects of ER status beyond its inverse relationship with proliferation may contribute to its predictive value for pCR.
KeywordsBreast cancer Neoadjuvant chemotherapy Proliferation ER Pathological complete response
This work was supported by the Cridlan Charity Fund.
- 14.Petit T, Wilt M, Velten M et al (2004) Comparative value of tumour grade, hormonal receptors, Ki-67, HER-2 and topoisomerase II alpha status as predictive markers in breast cancer patients treated with neoadjuvant anthracycline-based chemotherapy. Eur J Cancer 40:205–211. doi: 10.1016/S0959-8049(03)00675-0 CrossRefPubMedGoogle Scholar
- 18.Bottini A, Berruti A, Brizzi MP et al (2005) Cytotoxic and antiproliferative activity of the single agent epirubicin versus epirubicin plus tamoxifen as primary chemotherapy in human breast cancer: a single-institution phase III trial. Endocr Relat Cancer 12:383–392. doi: 10.1677/erc.1.00945 CrossRefPubMedGoogle Scholar
- 24.Lee J, Im YH, Lee SH et al (2008) Evaluation of ER and Ki-67 proliferation index as prognostic factors for survival following neoadjuvant chemotherapy with doxorubicin/docetaxel for locally advanced breast cancer. Cancer Chemother Pharmacol 61:569–577. doi: 10.1007/s00280-007-0506-8 CrossRefPubMedGoogle Scholar
- 25.Vincent-Salomon A, Rousseau A, Jouve M et al (2004) Proliferation markers predictive of the pathological response and disease outcome of patients with breast carcinomas treated by anthracycline-based preoperative chemotherapy. Eur J Cancer 40:1502–1508. doi: 10.1016/j.ejca.2004.03.014 CrossRefPubMedGoogle Scholar
- 27.Bonnefoi H, Diebold-Berger S, Therasse P et al (2003) Locally advanced/inflammatory breast cancers treated with intensive epirubicin-based neoadjuvant chemotherapy: are there molecular markers in the primary tumour that predict for 5-year clinical outcome? Ann Oncol 14:406–413. doi: 10.1093/annonc/mdg108 CrossRefPubMedGoogle Scholar