Molecular subtyping of early-stage breast cancer identifies a group of patients who do not benefit from neoadjuvant chemotherapy
| Autor: | Justine K. Peeters, Femke De Snoo, Lisette Stork-Sloots, Stefan Glück, George Somlo |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Oncology
Adult Cancer Research medicine.medical_specialty Pathology Receptor ErbB-2 medicine.medical_treatment Breast Neoplasms Targeted therapy Breast cancer MammaPrint Internal medicine medicine Biomarkers Tumor Humans Stage (cooking) Neoadjuvant therapy In Situ Hybridization Fluorescence Aged Retrospective Studies medicine.diagnostic_test business.industry Retrospective cohort study Middle Aged medicine.disease Prognosis Immunohistochemistry Subtyping Neoadjuvant Therapy Clinical trial Treatment Outcome Receptors Estrogen Chemotherapy Adjuvant Female business Receptors Progesterone |
| Zdroj: | Breast cancer research and treatment. 139(3) |
| ISSN: | 1573-7217 |
| Popis: | The aim of this study was to analyze the correlation between the pathologic complete response (pCR) rate after neoadjuvant chemotherapy and long-term outcome (distant metastases-free survival [DMFS]) in patients with early-stage breast cancer using BluePrint and MammaPrint molecular subtyping versus clinical subtyping using immunohistochemistry/fluorescence in situ hybridization (IHC/FISH) for the determination of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2 (HER2). Data were analyzed from 437 patients in four neoadjuvant chemotherapy trials. BluePrint and MammaPrint outcomes were determined from 44K Agilent arrays, the I-SPY 1 data portal, or Affymetrix U133A arrays. The pCR rate differed substantially among BluePrint molecular subgroups: 6 % in Luminal A-type, 10 % in Luminal B-type, 47 % in HER2-type, and 37 % in Basal-type patients. In the Luminal A-type group (n = 90; including seven HER2-positive patients and eight triple-negative patients by IHC/FISH), the 5-year DMFS rate was 93 %. The pCR rate provided no prognostic information, suggesting these patients may not benefit from chemotherapy. Forty-three of 107 (40 %) HER2-positive patients were classified as Luminal-type by BluePrint and may have lower response rates to targeted therapy. Molecular subtyping identified 90 of 435 (21 %) patients as Luminal A-type (BluePrint Luminal-type/MammaPrint Low Risk) with excellent survival. The pCR rate provided no prognostic information. Molecular subtyping can improve the stratification of patients in the neoadjuvant setting: Luminal A-type (MammaPrint Low Risk) patients have a good prognosis with excellent survival and do not seem to benefit from chemotherapy. We observed marked benefit in response and DMFS to neoadjuvant treatment in patients subtyped as HER2-type and Basal-type. BluePrint with MammaPrint molecular subtyping helps to improve prognostic estimation and the choice of therapy versus IHC/FISH. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink