Biomarkers and outcome after tamoxifen treatment in node-positive breast cancers from elderly women
Autor: | E. Benini, Gabriele Martelli, Maria Grazia Daidone, Rosella Silvestrini, Gorana Tomasic, G. De Palo, Silvia Veneroni, A Luisi |
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Rok vydání: | 2000 |
Předmět: |
Oncology
Cancer Research medicine.medical_specialty Pathology Aging Antineoplastic Agents Hormonal p53 expression medicine.medical_treatment Mammary gland hormone responsiveness Breast Neoplasms Biology elderly patients Metastasis Predictive Value of Tests Internal medicine medicine Biomarkers Tumor Humans Prospective Studies Prospective cohort study Lymph node Aged Aged 80 and over Chemotherapy oestrogen receptors Hazard ratio Regular Article Antiestrogen medicine.disease Genes p53 Prognosis Genes bcl-2 Radiation therapy Gene Expression Regulation Neoplastic Tamoxifen medicine.anatomical_structure Treatment Outcome cell proliferation Receptors Estrogen bcl-2 expression Female Cell Division |
Zdroj: | British Journal of Cancer Scopus-Elsevier |
ISSN: | 0007-0920 |
Popis: | The predictive role of tumour proliferative rate and expression of p53, bcl-2 and bax proteins, alone and in association with tumour size, nodal involvement and oestrogen receptors (ER), was analysed on 145 elderly patients (≥70 years of age) with histologically assessed node-positive breast cancers treated with radical or conservative surgery plus radiotherapy followed by adjuvant tamoxifen for at least 1 year. The 7-year probability of relapse was significantly higher for patients with tumours rapidly proliferating (hazard ratio (HR) = 2.0, P = 0.01), overexpressing p53 (HR = 4.4, P = 0.0001), weakly or not exhibiting bcl-2 (HR = 1.9, P = 0.02), without ERs (HR = 3.4, P = 0.0001) or with ≥ 4 positive lymph nodes (HR = 2.3, P = 0.003) than for patients with tumours expressing the opposite patho-biological profile. Conversely, tumour size and bax expression failed to influence relapse-free survival. Adjustment for the duration of tamoxifen treatment did not change these findings. Oestrogen receptors, cell proliferation, p53 accumulation and bcl-2 expression were also predictive for overall survival. Within ER-positive tumours, cell proliferation, p53 accumulation, bcl-2 expression and lymph node involvement provided significant and independent information for relapse and, in association, identified subgroups of patients with relapse probabilities of 20% (low-risk group, exhibiting only one unfavourable factor) to 90% (high-risk group, exhibiting three unfavourable factors). Such data could represent the initial framework for a biologically tailored therapy even for elderly patients and highlight the importance of a patho-biological characterization of their breast cancers. © 2000 Cancer Research Campaign |
Databáze: | OpenAIRE |
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