Clinical response to primary letrozole therapy in elderly patients with early breast cancer: possible role for p53 as a biomarker.
Autor: | Garimella V; Postgraduate Medical Institute of the University of Hull, Hull, UK; Breast Care Unit, Hull and East Yorkshire NHS Trust, Hull, UK., Hussain T; Postgraduate Medical Institute of the University of Hull, Hull, UK; Breast Care Unit, Hull and East Yorkshire NHS Trust, Hull, UK; Hull York Medical School, Hull, UK., Agarwal V; Postgraduate Medical Institute of the University of Hull, Hull, UK; Queens Centre for Oncology and Haematology, Hull and East Yorkshire NHS Trust, Hull, UK; Hull York Medical School, Hull, UK., Radhakrishna S; Postgraduate Medical Institute of the University of Hull, Hull, UK; Breast Care Unit, Hull and East Yorkshire NHS Trust, Hull, UK., Fox JN; Breast Care Unit, Hull and East Yorkshire NHS Trust, Hull, UK., Kneeshaw PJ; Breast Care Unit, Hull and East Yorkshire NHS Trust, Hull, UK., Long ED; Histopathology Department, Hull and East Yorkshire NHS Trust, Hull, UK., Mahapatra TK; Breast Care Unit, Hull and East Yorkshire NHS Trust, Hull, UK., McManus PL; Breast Care Unit, Hull and East Yorkshire NHS Trust, Hull, UK., Lind MJ; Postgraduate Medical Institute of the University of Hull, Hull, UK; Queens Centre for Oncology and Haematology, Hull and East Yorkshire NHS Trust, Hull, UK; Hull York Medical School, Hull, UK., Drew PJ; Postgraduate Medical Institute of the University of Hull, Hull, UK; Breast Care Unit, Hull and East Yorkshire NHS Trust, Hull, UK; Hull York Medical School, Hull, UK., Cawkwell L; Postgraduate Medical Institute of the University of Hull, Hull, UK; Hull York Medical School, Hull, UK. Electronic address: L.Cawkwell@hull.ac.uk. |
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Jazyk: | angličtina |
Zdroj: | International journal of surgery (London, England) [Int J Surg] 2014; Vol. 12 (8), pp. 821-6. Date of Electronic Publication: 2014 Jul 08. |
DOI: | 10.1016/j.ijsu.2014.06.009 |
Abstrakt: | Primary tamoxifen therapy has been widely used to treat elderly women with ER-positive breast cancer in the past. Aromatase inhibitors may be more beneficial than tamoxifen when used as primary endocrine therapy in elderly patients. We aimed to retrospectively evaluate a series of elderly women with ER-positive breast cancer treated with primary letrozole therapy as sole therapy with a minimum of 5 years follow up. To identify possible predictive biomarkers a pilot immunohistochemical analysis was performed to assess the expression of PR, HER2, EGFR, BCL2 and p53. A total of 45 women, aged more than 70 years with a diagnosis of ER-positive breast cancer that was treated with primary letrozole therapy were identified. A case note review was undertaken to obtain clinical information. Formalin fixed paraffin embedded tumour tissue from diagnostic core biopsies was available for all patients. Immunohistochemical analysis was performed to establish the protein expression status of p53, PR, HER2, EGFR and BCL2. The mean age of the 45 patients was 87 years (range 70-101). Clinical benefit was seen in 60% of the patients. Median progression free survival was 53 months (95% CI - 34-72) and the median time to progression was 43 months (95% CI - 22-64). BCL2 was expressed in 45/45 (100%); PR in 38/45 (84%); EGFR in 13/45 (28%); HER2 in 9/45 (20%) and p53 in 5/45 (11%) of tissue samples. Positive expression of p53 was associated with poor progression free survival (p = 0.03) in this pilot study. This study demonstrates that letrozole as sole treatment appears to be a suitable treatment option for elderly patients with ER-positive breast cancer who are not fit for, or decline, surgery. The analysis of p53 in a larger study is warranted in order to assess its role as a biomarker in this patient group. (Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.) |
Databáze: | MEDLINE |
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