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Tumor histological subtyping determined by hormone receptors and HER2 status defines different pathological complete response and outcome to dose-dense neoadjuvant chemotherapy in breast cancer patients

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Abstract

Purpose

To assess the impact in pathological complete response (pCR) and outcome of two dose-dense neoadjuvant chemotherapy (DDNC) regimens among different histological subtypes determined by hormonal receptor (HR) and HER2 status in breast cancer patients.

Methods

A total of 127 breast cancer patients were treated with DDNC in two prospective studies. A: adriamycin 40 mg/m2 on day (d) 1 plus paclitaxel 150 mg/m2 and gemcitabine 2,000 mg/m2 on d2 for six cycles (n = 54). B: epirubicin 90 mg/m2, cyclophosphamide 600 mg/m2 on d1 for three cycles, followed by paclitaxel 150 mg/m2 and gemcitabine 2,500 mg/m2 on d1 ± trastuzumab according to HER2 status (n = 73). Histological subtypes of breast cancer were 49 % HR+/HER2−, 17.5 % HR+/HER2+, 13.5 % HR−/HER2+ and 20 % HR−/HER2−.

Results

pCR (absence of invasive cells in breast and lymph node) was achieved in 35 patients (28 %). The pCR rate was significantly different between histological subtypes: HR+/HER2− (9 %), HR+/HER2+ (23 %), HR−/HER2+ (50 %), HR−/HER2− (56 %) (p < 0.001). The median follow-up was 81 months (r: 15–150 months). HR−/HER2− tumor subtype had a significantly worse DFS compared to HR+/HER2− (p = 0.02), RH+/HER2+ (p = 0.04) and HR−/HER2+ tumor subtypes (p = 0.02). HR−/HER2− tumor subtype had a significantly shorter OS compared to HR+/HER2− (p = 0.007), RH+/HER2+ (p = 0.05), and HR−/HER2+ (p = 0.03) tumor subtypes. However, no significant difference was observed in DFS and OS among HR−/HER2− tumors that achieved a pCR.

Conclusions

HR−/HER2− and HR−/HER2+ subtypes had a high pCR rate to DDNC. HR−/HER2− tumors had a worse outcome compared to other tumor subtypes but no significant difference was observed among HR−/HER2− tumors that achieved a pCR.

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No potential conflicts of interest were disclosed.

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Authors and Affiliations

  1. Medical Oncology Service, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010, Málaga, Spain

    A. Sánchez-Muñoz, J. Pascual & E. Alba

  2. Medical Oncology Service, Complejo Hospitalario de Jaén, Av del Ejército Español, 10, 23007, Jaén, Spain

    Y. Plata-Fernández, M. Fernández, A. Jaén-Morago, M. Fernández-Navarro, C. de la Torre-Cabrera & P. Sánchez-Rovira

  3. Department of Pathology, Complejo Hospitalario de Jaén, Av del Ejército Español, 10, 23007, Jaén, Spain

    C. Ramirez-Tortosa

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  1. A. Sánchez-Muñoz
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  3. M. Fernández
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  4. A. Jaén-Morago
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  10. P. Sánchez-Rovira
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Correspondence to A. Sánchez-Muñoz.

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Sánchez-Muñoz, A., Plata-Fernández, Y., Fernández, M. et al. Tumor histological subtyping determined by hormone receptors and HER2 status defines different pathological complete response and outcome to dose-dense neoadjuvant chemotherapy in breast cancer patients. Clin Transl Oncol 16, 548–554 (2014). https://doi.org/10.1007/s12094-013-1116-z

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  • DOI: https://doi.org/10.1007/s12094-013-1116-z

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