Clinical Implications of HER-2 and P53 in Taxane-Based and Anthracycline-Based Neoadjuvant Chemotherapy in Breast Cancer

Xiaolan WANG, Fan YAO, Nan LIU, Yunfei WU, Xinyu ZHENG, Jiguang LI, Caigang LIU, Xueshan QIU, Feng JIN


OBJECTIVE    To evaluate the predictive value of human epidermal growth factor receptor-2 (HER-2) and P53 in taxane-based and anthracycline-based neoadjuvant chemotherapy (NAC) in breast cancer.
METHODS    Sixty-two patients with breast cancer were included in this study. Twenty-two patients were treated with taxane-based (taxane group) and 40 with anthracycline-based (anthracycline group). ER, PR, c-erbB2 and P53 were detected by immunohistochemistry staining before NAC, and Fluorescence In Situ Hybridization(FISH) was used to detect the HER-2 gene ampli fi cation for the cases with the expression of c-erbB2 protein as (++) or (+++). The efficacy of the regimens was evaluated after NAC.
RESULTS    In the anthracycline group, objective response (OR) was observed in 30 out of 40 patients (75%), whereas no response (NR) was observed in 10 patients (25%). In the taxane group, OR was observed in 15 patients out of 22 patients (68.2%), whereas NR was observed in 7 patients (31.8%). HER-2-negative status was correlated with a high OR in both taxane-based and anthracycline-based NAC ( P =0.023 and  P  = 0.029), whereas P53-negative status was correlated with high OR rate in anthracycline-based NAC (P = 0.041). The significant difference of the CR rates was observed between the patients took < 4 cycles and ≥ 4 cycles NAC (4.65%  vs. 21.05%,  P  < 0.05).
CONCLUSION    The patients with HER-2 gene nonamplication may be sensitive to both taxane-based and anthracycline-based chemotherapy; the patients without P53 overexpression may suitable to select anthracycline-based chemotherapy; and proper increased NAC cycles may increase CR rates. 


breast neoplasms, neoadjuvant chemotherapy, HER-2, P53, taxane.

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