Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
Background: Since docetaxel /cyclophosphamide chemotherapy (TC) has proven to be superior to anthracycline/cyclophosphamide (AC) in U.S. Oncology Research Trial 9735, TC has been widely used for treating patients with breast cancer. However, taxane-specific adverse events like neuralgia and edema can’t be ignored. Thus, we performed neoadjuvant study with TC to clarify biological markers of this regimen. Methods: 79 patients with invasive breast cancer received TC (docetaxel 75 mg/m2, cyclophosphamide 600 mg/m2, q3w for 4 courses) at the neoadjuvant setting and underwent surgical treatment. Before treatment, the clinic-pathological and immunohistochemical markers (ER, PgR, HER-2, Ki-67, p53, topoisomerase IIα, ClassIII β tubulin, CK5/6, EGFR) were examined with core-needle biopsy specimens. The correlation between the pathological response and expressions of markers was investigated. Results: 33 patients (41.8%) achieved quasi-pathological complete response (QpCR). Univeriate analysis revealed that ER (p < 0.001), PgR (p = 0.007), Ki-67 (p = 0.022) and classIII β tubulin (p = 0.032) were associated with QpCR. Only ER (p = 0.050) and classIII β tubulin (p = 0.028) remained with a statistical significance at multivariate analysis. Subgroup analysis revealed that the negativity of CK5/6 and/or EGFR was correlated with QpCR in the triple negative subtype. Conclusions: ClassIII β tubulin had a specific predictive value for pathological response of TC in addition of ER, PgR and Ki-67. Sub-grouping is important for treating triple-negative breast cancer.
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