Oncology Medical News about HER2 receptor expression;steroid hormone;neoadjuvant anthracycline/taxane-based chemotherapy

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Identification of biology-based breast cancer types with distinct predictive and prognostic features: role of steroid hormone and HER2 receptor expression in patients treated with neoadjuvant anthracycline/taxane-based chemotherapy
Breast Cancer Research, 09/18/09

Darb-Esfahani S et al. – A biology-based breast cancer classification using estrogen receptor (ER), progesterone receptor (PgR), and HER2 bears independent predictive and prognostic potential. The HR+/HER2+ co-expressing carcinomas emerged as a group of tumors with a good response rate to neoadjuvant chemotherapy and a favorable prognosis. HR+/HER2- tumors had a good prognosis irrespective of a pCR, whereas patients with HR-/HER- and HR-/HER+ tumors, especially if they had not achieved a pCR, had an unfavorable prognosis and are in need of additional treatment options.

Methods

Expression analysis was performed using immunohistochemistry and silver-enhanced in situ hybridization on tissue microarrays (TMAs) of pretherapeutic core biopsies

Results

pCR rates were significantly different between the biology-based tumor types with HR+/HER2+ and HR-/HER- tumors having higher pCR rates than HR+/HER2- tumors
Ki67 labeling index, confirmed as significant predictor of pCR in the whole cohort, identified HR-/HER- (triple negative) carcinomas with a higher chance for a pCR
Biology-based tumor type (P=0.046 for HR+/HER2+ vs. HR+/HER2-), Ki67 labeling index, and treatment arm were independent predictors of pCR in a multivariate model
DFS was different in the biology-based tumor types with HR+/HER2- and HR+/HER2+ tumors having the best prognosis and HR-/HER2+ tumors showing the worst outcome
Biology-based tumor type was an independent prognostic factor for DFS in multivariate analysis

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