Predictive Value of Biologic Parameters for Primary Chemotherapy in Operable Breast Cancer

Frassoldati, Antonio; Maur, M; Guarneri, Valentina; Nicolini, Massimiliano; Conte, Pierfranco

doi:10.3816/cbc.2005.n.034

Cited by 6 publications

(3 citation statements)

References 65 publications

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“…43,44 A series of studies on animal models and clinical cancer specimens have demonstrated that apoptosis plays an important role in the genesis and development of malignancies and appears to be a critical approach through which endocrine therapy, radiotherapy, chemotherapy and molecular targeting therapy with trastuzumab exert their biological effects. [12][13][14][15][16][17][18][19][43][44][45][46][47][48] It was reported that cyclophosphamide treatment of mice bearing the murine mammary adenocarcinoma MCa-4 increased the apoptotic index from 2.5% at baseline to more than 20% after treatment. 13 Similar results were also found after treatment with cisplatin, doxorubicin and ionizing radiation.…”

Section: Discussionmentioning

confidence: 99%

Correlation between hybrid 18F-FDG PET/CT and apoptosis induced by neoadjuvant chemotherapy in breast cancer

Yao²,

Liu³

et al. 2007

Cancer Biology & Therapy

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Quantitative or semi-quantitative analysis of fluorine-18 fluorodeoxyglucose positron emission tomography ( 18 F-FDG PET) has been reported to correlate with the clinical and pathological response of tumors to preoperative treatment. This study was conceived to evaluate the correlation between hybrid 18 F-FDG PET/CT and apoptosis in breast cancer after neoadjuvant chemotherapy. Three cycles of neoadjuvant chemotherapy were given to forty-five patients with primary breast cancer proven by core needle biopsy. Hybrid PET/CT was performed before and after treatment and tumor to non-tumor radioactivity ratio (T/N) was calculated. The apoptotic index (AI) in core-cut and surgically resected samples was determined using TUNEL techniques. The mean T/N pre-and postchemotherapy was 3.23 ± 0.63 and 2.31 ± 0.49, respectively (p = 0.006), with the mean reduction rate below baseline of 31.18 ± 13.18% (range, 6.4-50.8%). The mean AI pre-and post-chemotherapy was 2.81 ± 0.76% and 17.31 ± 6.85%, respectively (p < 0.0001). The mean AI change was 14.34 ± 5.36% (range, 1.9-41.3%). A positive correlation was detected between the T/N reduction rate and AI change (r s = 0.850, p < 0.0001). At a threshold of 20% decrease from baseline in T/N, the mean AI change in the tumors with a reduction of 20% or more in T/N was 20.86 ± 4.29%, while that in the tumors with a reduction of less than 20% in T/N was 8.59 ± 2.87% (p < 0.0001). The sensitivity, specificity, positive and negative predictive values, and the accuracy of PET/CT for the prediction of clinical response were 90.9%, 83.3%, 93.8%, 76.9% and 92%, respectively. These data suggested that neoadjuvant chemotherapy may effectively induce apoptosis in breast tumors and decrease their glucose uptake. Hybrid PET/CT imaging appeared to be positively related to apoptosis level and therefore to be of value in predicting the response of breast cancer to neoadjuvant chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Correlation between hybrid 18F-FDG PET/CT and apoptosis induced by neoadjuvant chemotherapy in breast cancer

Yao²,

Liu³

et al. 2007

Cancer Biology & Therapy

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“…As a consequence, a strong interest has grown for the research of new prognostic markers identifying subset of patients more likely to benefit from adjunctive systemic therapies and for the development of biological tests able to predict the tumor response to different treatments [1,2].…”

Section: Introductionmentioning

confidence: 99%

Bcl-2 expression correlates with lymphovascular invasion and long-term prognosis in breast cancer

Neri

Marrelli

Roviello

et al. 2006

Breast Cancer Res Treat

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Alterations in the mechanisms of apoptosis are responsible not only for the progression of breast cancer, but for different responses to treatment as well. Among the genes regulators of apoptosis, the tumor suppressor gene p53 and the bcl-2 gene have raised interest for their possible role as predictors of response to therapy and markers of prognosis. The purpose of our study was to prospectively analyze the prognostic value of the expression of p53 and bcl-2 genes in a series of 235 consecutive patients operated on for breast cancer at the Department of General Surgery and Surgical Oncology of the University of Siena, Italy.p53 and bcl-2 expression were evaluated by immunohistochemistry, their association with conventional clinicopathological factors was analyzed by univariate analysis and their prognostic impact was evaluated by multivariate analysis.p53 and bcl-2 were detected respectively in 15.7 and 75.7% of cases, and resulted significantly related to presence of estrogen receptors for p53 over-expression and presence of peritumor lymphovascular invasion (LVI) for bcl-2 expression. With a median follow-up of 79 months, an independent negative prognostic impact on disease free and overall survival was observed for presence of LVI, absence of bcl-2 expression and number of involved axillary lymphnodes. The expression of bcl-2 improved the prognosis of LVI positive tumors up to values similar to LVI negative cases, while its absence associated to presence of LVI resulted in a poor outcome with only 28% of patients alive at 8 years. These data may indicate that expression of bcl-2 is a marker of breast cancers with reduced capability of distant colonization, even in presence of LVI, and may be particularly useful in the clinical setting, allowing to identify a subset of patients with an high risk of relapse.

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“…(30) This was also proved in both the Estrogen receptor is dominant regulator and a key therapeutic target in cancer etiology and progression . (39) Higher estrogen receptors (ER) concentrations were positive and lower concentrations were negative prognostic factors for disease free survival. (40,41) In the present study, serum EGF level in patients having ER-ve showed a significant increase than that in patients having ER+ve (Table 4e).…”

Section: Methodsmentioning

confidence: 99%

Serum Epidermal Growth Factor in Cancer Breast

Fadaly

et al. 2007

Journal of High Institute of Public Health

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Several prognostic factors are evaluated in the breast carcinoma and there is a need for new markers for better discrimination of the biologic differences in the primary tumor. Epidermal growth factor (EGF) is presumed to play an important role in the local regulation of breast cell proliferation so, the aim of the current study, was to evaluate the serum level of EGF in breast cancer female patients in comparison with other prognostic parameters. It was carried out on fifty-seven females divided into two groups. A control group of twenty healthy women of comparable age and socioeconomic status with a group of thirty-seven breast cancer patients. All females were chosen non-pregnant, not on contraceptive therapy, not previously exposed to radiation, and have no previous history of cancer. To all patients, thorough clinical examination, plain X-ray for the chest and ultrasonography of the abdomen and pelvis were done. Preoperative fine needle aspiration cytology was also done for their breast lumps. In addition, blood samples were collected and analyzed for hemoglobin, fasting serum glucose, urea, and creatinine levels, aspartate and alanine aminotransferase activities, and also the epidermal growth factor level. The breast cancer tissues, removed by surgery, were subjected to histopathologic examination. The median of serum EGF in breast cancer patients group was relatively lower than that in control group but it did not reach the level of significance. No significant differences between the serum EGF levels were found in relation to the change in tumor size, type, grade, and stage. However, there was positive correlations between EGF level and tumor size (r=0.341, p=0.039) and AJCC stages (r=0.354, p=0.032). Also, in patients without lymph node metastasis, there were positive correlations between serum EGF level and both tumor size (r=0.596, p=0.024) and AJCC stages (r=0.596, p=0.024). In patients having lymph node metastasis, there was significant negative correlation between serum EGF level and the number of lymph node metastasis (r=-0.859, p<0.001).There was significant increase in EGF level in patients having lymph node metastasis (3 LN) when compared to patients having no LN metastasis (p=0.004) and its level in patients having (>3 LN) metastasis was significantly decreased than that in both patients having no LN metastasis (p=0.019) and patients having 3 LN metastasis (p<0.001). In addition, EGF level was significantly increased in patients with estrogen receptor (ER) negative than in patients with ER positive (p=0.049). Also, there was a negative correlation between EGF level and ER positivity (r=-0.454, p=0.005). Similar correlation was also found in patients having LN metastasis (r=-0.680, p<0.001). But there was no significant relationship between serum EGF level and the state of progesterone receptor. In conclusion, determination of serum EGF in combination with certain histological parameters could be useful in determining tumor prognosis and in deciding the selection of treatment modality, however...

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Predictive Value of Biologic Parameters for Primary Chemotherapy in Operable Breast Cancer

Cited by 6 publications

References 65 publications

Correlation between hybrid 18F-FDG PET/CT and apoptosis induced by neoadjuvant chemotherapy in breast cancer

Correlation between hybrid 18F-FDG PET/CT and apoptosis induced by neoadjuvant chemotherapy in breast cancer

Bcl-2 expression correlates with lymphovascular invasion and long-term prognosis in breast cancer

Serum Epidermal Growth Factor in Cancer Breast

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