[Impact of Her2 and BRCA1/2 status in high-dose chemotherapy and autologous stem cells transplantation in the treatment of breast cancer: The Institut Paoli Calmettes' experience]

Bull Cancer. 2017 Apr;104(4):332-343. doi: 10.1016/j.bulcan.2016.12.007. Epub 2017 Feb 16.
[Article in French]

Abstract

Introduction: Studies evaluating chemotherapy high dose chemotherapy with autologous haematopoietic stem cell transplantation (HDC-ACSH) in the treatment of metastatic (MBC), locally advanced (LABC) and inflammatory (IBC) breast cancer have in common lack of biomarker information, in particular the HER2 status.

Patients and methods: All consecutive female patients treated for breast cancer with HDC and AHSCT at Institut Paoli Calmettes between 2003 and 2012 were included. Patients were categorized in three subtypes based on hormonal receptor (HR) and HER2 status of the primary tumor: luminal, (HR+/HER2-), HER2 (HER2+, any HR) and triple negative (TN) (HER2- and HR-). The main objective was the analysis of overall survival (OS) according to the IHC subtypes.

Results: Three hundred and seventy-seven patients were included. For MBC, the TN subtype appeared to have the worst prognosis with a median OS of 19.68 months (95 % CI 11.76-44.4) compared to 44.64 months (95 % CI 40.32-67.56) for the luminal subtype and a median OS not reached for the HER2 subtype (P<0.01). For IBC, HER2 subgroup appeared to have the best prognosis with a 5-year OS of 89 % (95 % CI 64-97) compared to 57 % (95 % CI 33-76) for the TN subgroup (HR 5.38, 95 % CI 1.14-25.44; P=0.034). For CSLA, luminal subgroup appeared to have the best prognosis with a 5-year OS of 92 % (95 % CI 71-98) against 75 % (95 % CI 46-90) for HER 2 subtype and 70 % (95 %CI 97-88) for TN subtype (P=0.301).

Conclusion: The HDC-ACSH does not change the prognosis value of IHC subtype in breast cancer patients.

Keywords: Autogreffe de cellules-souches hématopoïétiques; Autologous haematopoietic stem cell transplantation; Breast cancer; Cancer du sein; Chimiothérapie à haute dose; Her2; High-dose chemotherapy.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Autografts
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / mortality*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery
  • Cancer Care Facilities
  • Carcinoma / drug therapy
  • Carcinoma / mortality
  • Carcinoma / secondary
  • Carcinoma / surgery
  • Combined Modality Therapy / methods
  • Cyclophosphamide / administration & dosage
  • Female
  • Genes, BRCA1*
  • Genes, BRCA2*
  • Genes, erbB-2*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Melphalan / administration & dosage
  • Middle Aged
  • Mitoxantrone / administration & dosage
  • Prognosis
  • Retrospective Studies
  • Thiotepa / administration & dosage

Substances

  • Antineoplastic Agents
  • Cyclophosphamide
  • Thiotepa
  • Mitoxantrone
  • Melphalan