Prognostic analysis of triple-negative breast cancer patients treated with adjuvant chemotherapy of fluorouracil, epirubicin and cyclophosphamide

Abstract

Abstract. The aim of the present study was to investigate the association between the clinicopathological and demographic factors, and the survival time of patients with triple-negative breast cancer (TNBC) in China. The patients had received adjuvant chemotherapy consisting of 5-fluorouracil, epirubicin and cyclophosphamide (FEC; 500 mg/m 2 cyclophosphamide, day 1; 75 mg/m 2 epirubicin, day 1; 500 mg/m 2 5-fluorouracil, days 1 and 8; every 3 weeks, for at least 4 cycles). The clinicopathological and demographic factors affecting the outcome of the patients with TNBC that received adjuvant FEC chemotherapy were evaluated. Within these variables, the overall survival (OS) and disease-free survival (DFS) times were analyzed using the log-rank test, which was constructed using the multivariate Cox proportional hazards regression model and Kaplan-Meier analysis. Additionally, Spearman's χ 2 test was used to analyze categorical variables. In the univariate statistical analysis, the significant risk factors for TNBC patient survival were the stage of disease and lymph node status, which were associated with the OS and DFS, and the total number of pregnancies, which was associated with the DFS. In the multivariate Cox proportional hazard model, lymph node status was an independent prognostic indicator of OS [P<0.001; hazard ratio (HR), 1.996; 95% confidence interval (CI), 1.465-2.720] and DFS (P<0.001; HR, 1.824; 95% CI, 1.315-2.531). By the Kaplan-Meier method, the stage of disease and lymph node status demonstrated a significant effect on OS and DFS. Patients with the lymph node status N3 and stage III disease possessed a poor prognosis and survival. An association between lymph node status and the tumor recurrence and mortality rate was identified. The area under the curves of the lymph node status for TNBC recurrence and mortality were 0.676 (P=0.002) and 0.685 (P=0.001), respectively. Additionally, the number of pregnancies was associated with tumor size, lymph node status and stages of disease. Lymph node status is an independent prognostic indicator of OS and DFS to TNBC patients with FEC adjuvant chemotherapy. IntroductionBreast cancer is one of the most common malignancies and leading causes of cancer-associated mortalities among females (1). Based on DNA microarray techniques, breast cancer is classified into five subtypes: Luminal A; luminal B; normal breast-like; human epidermal growth factor receptor 2 (HER2/neu) overexpressing; and basal-like (2). The subtype that is immunohistochemically characterized by the lack of expression of the estrogen receptor (ER), progesterone receptor (PR) and HER2 is defined as triple negative breast cancer (TNBC) (3).TNBC, which accounts for 10-15% of breast cancers, is considered to exhibit an aggressive clinical behavior and poor prognosis, due to the insensitivity of the cancer to endocrine and targeted therapy (4-12). Therefore, chemotherapy is a significant therapy for such cancers. The treatment options for TNBC include anthracyclines, taxanes, platinum and alkylating ...

Clinicopathological and Prognostic Characteristics of Malaysian Triple Negative Breast Cancer Patients Undergoing TAC Chemotherapy Regimen

“…In the present study, the cumulative 5 years of DFS and OS of TNBC patients were 63.5% and 76.5%, respectively. This is in agreement with several other studies that observed a higher DFS and OS in TNBC patients [21,24,26,27]. Thus, it indicates that early-stage TNBC patients who underwent surgery and completed with cycles of TAC regimens had a higher DFS and OS.…”

MicroRNA-941 regulates the proliferation of breast cancer cells by altering histone H3 Ser 10 phosphorylation

“…Fluorouracil (5-FU) is used as a single palliative treatment in combination with other antineoplastic agents for the therapy of breast cancers 69 . According to National Comprehensive Cancer Network guidelines, 5-fluorouracil, epirubicin and cyclophosphamide (FEC) adjuvant chemotherapy regimen is the recommended regimen for breast cancer 70 . Classical CMF (cyclophosphamide, methotrexate and 5-fluorouracil) has shown good clinical efficacy for the treatment of TNBC 71 .…”

Dancing from bottoms up – Roles of the POZ-ZF transcription factor Kaiso in Cancer

“…[76]. Although some therapeutic response is achieved through chemotherapy, patients with TNBC often relapse, thus associating this BC subtype with poor outcomes and shortened overall survival [77–80]. Notably, TNBC, is more frequently diagnosed in women of African ancestry, and Kaiso’s role in TNBC racial disparity in incidence and outcomes will be discussed in a later section.…”