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Published on: February 12, 2017
Differential pathological response to preoperative chemotherapy across breast cancer intrinsic subtypes
Hiromitsu Jinno1, Sachiko Matsuda, Tetsu Hayashida
1Department of Surgery, Keio University School of Medicine, Tokyo, Japan. jinno@z7.keio.jp
Background:
Breast cancer is a heterogeneous disease with a diversity of clinical behaviors. The purpose of this study was to evaluate the utility of breast cancer intrinsic subtypes in the prediction of pathological complete response (pCR) in a cohort of breast cancer patients receiving preoperative chemotherapy.
Methods:
Patients with stage II/III breast cancer received 4 cycles of XT (capecitabine and docetaxel) followed by 4 cycles of FEC (fluorouracil, epirubicin, and cyclophosphamide) as preoperative chemotherapy. Tumors were classified as luminal A, luminal B, luminal/HER2, HER2, basal-like, or non-basal-like triple negative by immunohistochemical analysis in core needle biopsy samples at baseline.
Results:
The overall pCR rate was 11.9% (12/101). Multivariate analysis showed that intrinsic subtype was an independent factor to predict pCR. With luminal A patients as the reference group, luminal B (OR = 16.39; 95% CI 1.44-185.88; p = 0.024), HER2 (OR = 14.73; 95% CI 1.19-180.84; p = 0.035), and basal-like (OR = 13.27; 95% CI 1.27-138.79; p = 0.031) patients had a significantly higher likelihood of pCR.
Conclusion:
The present data indicate that intrinsic subtypes may be useful predictive biomarkers of pCR in breast cancer patients treated with preoperative chemotherapy.