Predictive factors of pathologic complete response and clinical tumor progression after preoperative chemotherapy in patients with stage II and III breast cancer

Invest New Drugs. 2012 Feb;30(1):408-16. doi: 10.1007/s10637-010-9555-7. Epub 2010 Oct 5.

Abstract

Background: This study aimed to define predictive factors of pathologic complete response (pCR) and disease progression in stage II and III breast cancer patients.

Patients and methods: Three hundred thirty-eight patients were included in the study. Patients had received preoperative chemotherapy as follows: 101 had doxorubicin plus cyclophosphamide (AC); 91 had doxorubicin plus docetaxel; 103 had docetaxel plus capecitabine; and 43 had paclitaxel plus gemcitabine. A pCR was defined as the absence of residual invasive carcinoma in the breast.

Results: The majority of patients (73%) were premenopausal with a median age of 44 (range, 21-76) years. Fifty-four patients (16%) achieved pCR and were distributed among the 4 breast cancer subtypes as follows: 10% of patients with -ER or PR+/HER2-, 13% with ER or PR+/HER2+, 33% with ER-/PR-/HER2+, and 19% with ER-/PR-/HER2-(p = 0.001). Taxane-containing regimen (p = 0.042) and Breast cancer subtype (p = 0.005) were significant predictive variables for pCR. On the other hand, significantly more patients who received non-taxane-containing regimen (AC) experienced no response (p = 0.001) or progression (p = 0.006).

Conclusions: Patients with ER-/PR-/HER2+ tumors and those who received taxane-containing regimen achieved a higher pCR rate, while significantly more patients developed tumor progression by preoperative non-taxane-containing regimen (AC) compared to those who received taxane-containing chemotherapy.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / genetics
  • Breast Neoplasms / chemistry
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / genetics
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery
  • Capecitabine
  • Carcinoma / chemistry
  • Carcinoma / drug therapy*
  • Carcinoma / genetics
  • Carcinoma / pathology
  • Carcinoma / surgery
  • Chemotherapy, Adjuvant
  • Chi-Square Distribution
  • Clinical Trials, Phase II as Topic
  • Clinical Trials, Phase III as Topic
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Docetaxel
  • Doxorubicin / administration & dosage
  • Female
  • Fluorouracil / administration & dosage
  • Fluorouracil / analogs & derivatives
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization, Fluorescence
  • Logistic Models
  • Mastectomy
  • Middle Aged
  • Multivariate Analysis
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Odds Ratio
  • Patient Selection
  • Randomized Controlled Trials as Topic
  • Receptor, ErbB-2 / analysis
  • Receptor, ErbB-2 / genetics
  • Receptors, Estrogen / analysis
  • Receptors, Progesterone / analysis
  • Republic of Korea
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Taxoids / administration & dosage
  • Treatment Outcome
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Taxoids
  • Deoxycytidine
  • Docetaxel
  • Capecitabine
  • Doxorubicin
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Fluorouracil