Evaluation of the prognostic and predictive value of p53 and Bcl-2 in breast cancer patients participating in a randomized study with dose-dense sequential adjuvant chemotherapy
| Autor: | Sofia Markaki, Georgia Kafiri, Dimitrios Vlachodimitropoulos, Olympia Tzaida, Vassiliki Malamou-Mitsi, Chrisoula D. Scopa, E Karagianni, Stefanos Papadopoulos, Pavlos Papakostas, Kitty Pavlakis, C. Christodoulou, George Fountzilas, Maria Sotiropoulou, Helen Gogas, Vasiliki Kyriakou, Urania Dafni, A Bourli, T Fillipidis, Irini Papaspyrou, Dimitris Bafaloukos, T. Toliou |
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| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: |
Oncology
Pathology medicine.medical_treatment Breast Neoplasms/*diagnosis/drug therapy/metabolism/mortality/pathology Gene Expression Cyclophosphamide/administration & dosage Tumor Suppressor Protein p53/*metabolism Antineoplastic Combined Chemotherapy Protocols Methotrexate/administration & dosage Incidence (epidemiology) Carcinoma Ductal Breast Hematology Middle Aged Prognosis Chemotherapy regimen Fluorouracil/administration & dosage Molecular Diagnostic Techniques Proto-Oncogene Proteins c-bcl-2 Fluorouracil Chemotherapy Adjuvant dosage/*therapeutic use Female Tumor Markers Biological/metabolism medicine.drug Epirubicin Adult medicine.medical_specialty Paclitaxel Cyclophosphamide Breast Neoplasms Epirubicin/administration & dosage Proto-Oncogene Proteins c-bcl-2/*metabolism Breast cancer Predictive Value of Tests Internal medicine Paclitaxel/administration & dosage Biomarkers Tumor medicine Humans Carcinoma Ductal Breast/*diagnosis/drug therapy/metabolism/mortality/pathology Aged Chemotherapy Dose-Response Relationship Drug Molecular Diagnostic Techniques/methods business.industry medicine.disease Survival Analysis Antineoplastic Combined Chemotherapy Protocols/administration & Methotrexate Tumor Suppressor Protein p53 business |
| Popis: | PURPOSE: To assess the prognostic and predictive significance of p53 and Bcl-2 protein expression in high risk patients with breast cancer treated with dose-dense sequential chemotherapy. PATIENTS AND METHODS: From June 1997 until November 2000, 595 patients were randomized to three cycles of epirubicin (E) 110 mg/m2 followed by three cycles of paclitaxel (P) 250 mg/m2 followed by three cycles of 'intensified' CMF (cyclophosphamide 840 mg/m2, methotrexate 47 mg/m2 and fluorouracil 840 mg/m2) or to four cycles of E, followed by four cycles of CMF. p53 and Bcl-2 expression was investigated by immunohistochemistry in 392 and 397 patients respectively. RESULTS: Positive expression of p53 was detected in 104 (26.5%) patients and was significantly associated with negative hormonal status, worse histologic grade, higher incidence of disease relapse and higher rate of death. p53 positive expression was a significant negative predictor of overall survival (OS) (P = 0.002) and disease-free survival (DFS) (P = 0.001). Negative expression of Bcl-2 was detected in 203 (51%) patients and was significantly associated with negative hormonal status. Multivariate analysis revealed that, positive p53 expression, higher number of positive nodes and worse tumor grade were related to significantly poorer OS and DFS. CONCLUSIONS: For both treatments, p53 positive expression was a significant negative prognostic factor for OS and DFS while Bcl-2 was not. No predictive ability of p53 status or Bcl-2 status for paclitaxel treatment was evident. Ann Oncol |
| Databáze: | OpenAIRE |
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