Correlation between HER-2 expression and response to neoadjuvant chemotherapy with 5-fluorouracil, doxorubicin, and cyclophosphamide in patients with breast carcinoma.

Abstract

BACKGROUND:

The objective of this study was to determine whether HER-2 overexpression is associated with improved response to neoadjuvant chemotherapy with 5-fluorouracil, doxorubicin, cyclophosphamide (FAC) in patients with breast carcinoma.

METHODS:

Ninety-seven patients with Stage I-III breast carcinoma were included. HER-2 expression was determined by routine clinical laboratory assessment, and tumors with 3 + immunohistochemistry staining intensity or gene amplification by fluorescent in situ hybridization were considered HER-2 positive. Response was assessed by physical examination, imaging assessment, and pathologic assessment at the time of surgery.

RESULTS:

The median patient age was 45 years. At baseline, 68% of patients had lymph node positive disease, 87% had >/= T2 tumors, and 28% of patients had HER-2 positive tumors. Eighty-four percent of patients received four courses of FAC, 8% of patients received 3 courses of FAC, and the remaining 8% of patients received 5-6 courses of FAC. The clinical response rate (complete response [CR] and partial response [PR]) was 78%, the imaging response rate (CR and PR) was 64%, and 15% of patients had a good pathologic response, defined as a CR or minimal residual disease (tumor measuring < 1 cm in greatest dimension and negative lymph nodes). Concordance between the three methods of response assessment (clinical, pathologic, and imaging) was modest and was best between clinical assessment and imaging assessment (64% concordance). HER-2 status did not correlate with pathologic or clinical response (assessed by physical examination or imaging), although a nonsignificant trend was noted toward better response in patients with breast tumors that overexpressed HER-2.

CONCLUSIONS:

The authors found no significant correlation between HER-2 expression and clinical or pathologic response to neoadjuvant chemotherapy in patients with breast carcinoma.

• Authors: Fan Zhang, Ying Yang, Terry Smith, Shu-Wan Kau, Judy M McConathy, Francisco J Esteva, Henry M Kuerer, W Fraser Symmans, Aman U Buzdar, Gabriel N Hortobagyi, Lajos Pusztai
• Journal: Cancer (Cancer) Vol. 97 Issue 7 Pg. 1758-65 (Apr 01 2003) ISSN: 0008-543X [Print] United States
• PMID: 12655533 (Publication Type: Journal Article)
• Copyright: Copyright 2003 American Cancer Society.DOI 10.1002/cncr.11245

Chemical References

• Doxorubicin
• Cyclophosphamide
• Receptor, ErbB-2
• Fluorouracil

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Breast Neoplasms (drug therapy, metabolism)
• Carcinoma (drug therapy, metabolism)
• Cyclophosphamide (therapeutic use)
• Doxorubicin (therapeutic use)
• Female
• Fluorouracil (therapeutic use)
• Humans
• Middle Aged
• Neoadjuvant Therapy
• Receptor, ErbB-2 (metabolism)
• Retrospective Studies
• Survival Analysis
• Treatment Outcome