Measurement of molecular biomarkers that predict the tumor response in estrogen receptor-positive breast cancers after dose-dense (biweekly) paclitaxel/carboplatin neoadjuvant chemotherapy
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Teng Zhu1,*, Fangping Xu2,*, Liulu Zhang1, Yifang Zhang1, Ciqiu Yang1, Minyi Cheng1, Fulong Chen1 and Kun Wang1
1Department of Breast Cancer, Cancer Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou 510080, China
2Department of Pathology, Cancer Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou 510080, China
*These authors have contributed equally to this work
Kun Wang, email: email@example.com
Keywords: dose-dense; paclitaxel; carboplatin; ER-positive; biomarkers
Received: February 18, 2017 Accepted: June 05, 2017 Published: July 28, 2017
The aim of this study was to determine the predictive value of the clinical and histopathological characteristics of estrogen receptor (ER)-positive patients treated with dose-dense paclitaxel/carboplatin neoadjuvant chemotherapy (NCT). Pathological complete response (pCR) and the change in tumor size between pre- and post-NCT were used to evaluate the tumor response.85 ER-positive breast cancer patients who were treated with dose-dense (biweekly) paclitaxel/carboplatin NCT were analyzed with respect to the expression of progesterone receptor (PgR), Tau, Ki67, human epidermal growth factor receptor 2 (HER2), and Bcl-2 by immunohistochemistry (IHC). These data were used to determine whether these biomarkers could predict the tumor response. A univariate analysis showed that the patients who tested positive for HER2 expression (56.00% vs 11.67%, p<0.01), negative for Tau expression (41.94% vs 14.81%, p=0.005), negative for Bcl-2 expression (46.43% vs 14.04%, p<0.01) and had smaller (≤2 cm) tumors (45.00% vs 18.46%, p=0.02) were associated with higher pCR rates. A multivariate analysis showed that a HER2-positive status (OR: 6.244; 95%CI: 1.734-22.487; p=0.005), Bcl-2-negative status (OR: 0.236; 95%CI: 0.064-0.869; p=0.030) and smaller (≤2 cm) tumor sizes (OR: 0.188; 95%CI: 0.046-0.767; p=0.020) are independent predictors of pCRs. The tumor sizes were significantly reduced in patients with HER2-positive, Tau-negative, Bcl-2-negative and high Ki67 index breast cancer. In conclusion, Bcl-2 negative, HER2-positive and smaller (≤2 cm) tumor sizes are independent predictors of pCR in ER-positive patients treated with dose-dense (biweekly) paclitaxel/carboplatin NCT. This study is registered with ClinicalTrials.gov (NCT0205986).
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