Prognostic Value of a Positive-to-negative Change in Hormone Receptor Status after Neoadjuvant Chemotherapy in Patients with Hormone Receptor–positive Breast Cancer

Chen, Sheng; Chen, Can Ming; Yu, Ke; Zhou, Ruoji; Shao, Zhi Ming

doi:10.1245/s10434-012-2318-2

Cited by 47 publications

(51 citation statements)

References 20 publications

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“…They found that the 5-year DFS and OS of patients whose tumors' HR status changed from positive to negative were significantly less than those of patients whose tumors remained HR-positive (P ¼ .003 and .001, respectively). 11 Our study, at a median follow-up of 40 months, found no significant differences in 5-year RFS or 5-year OS between patients whose tumors remained ER-positive and those whose tumors changed from ER-positive to ER-negative (P ¼ .89 and .28, respectively). We found a similar pattern among patients with and without changes in PR status.…”

Section: Discussioncontrasting

confidence: 52%

“…8 Few studies have investigated the association between biomarker status alterations and long-term outcomes, finding inconsistent results. [9][10][11] Furthermore, little is known about the relationship between alterations in receptor status after NCT and long-term survival outcomes. 12 The objectives of this study were to assess the frequency of ER, PR, and HER2 status changes and changes in breast cancer subtypes after NCT and to determine whether these changes were correlated with long-term survival outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Receptor Status Change From Primary to Residual Breast Cancer After Neoadjuvant Chemotherapy and Analysis of Survival Outcomes

Parinyanitikul

Lei

Chávez-MacGregor

et al. 2015

Clinical Breast Cancer

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Section: Discussioncontrasting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Receptor Status Change From Primary to Residual Breast Cancer After Neoadjuvant Chemotherapy and Analysis of Survival Outcomes

Parinyanitikul

Lei

Chávez-MacGregor

et al. 2015

Clinical Breast Cancer

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“…Hirata et al [29] recently reported that after adjuvant hormone therapy, the survival of patients whose HR status had changed (either positively or negatively) in the resection specimen after NACT did not differ from that of patients whose HR status remained positive after NACT. By contrast, Chen et al [30] reported that following adjuvant hormone therapy, the survival of patients whose HR status changed after NACT was poorer than that of patients whose HR status remained positive after NACT.…”

Section: Discussionmentioning

confidence: 99%

Expression of Immunohistochemical Markers before and after Neoadjuvant Chemotherapy in Breast Carcinoma, and Their Use as Predictors of Response

Lee

Seol³

et al. 2013

J Breast Cancer

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PurposeFor patients with breast carcinoma, immunohistochemical markers are important factors in determining the breast cancer subtype and for establishing a therapeutic plan, including the use of neoadjuvant chemotherapy (NACT). However, it is not clear whether the expression of certain markers changes after NACT.MethodsWe assessed estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), Ki-67, p53, and Bcl-2 expression in specimens from 345 breast cancer cases before and after NACT. We analyzed the association between response to NACT and the expression of the markers in pre-NACT specimens. We also compared the expression between pre- and post-NACT specimens.ResultsER and PR expression was negatively associated with pathological complete response (pCR). HER2 was associated with pCR in all cases, but the association was lost when the cases were subdivided according to hormone receptor status. The pre-NACT tumor size of cases with pCR after NACT was smaller than that of cases with residual disease. HER2-enriched and triple-negative breast cancers were more likely to achieve pCR than luminal A type cancers. PR expression and the Ki-67 index decreased after NACT. A decrease in the Ki-67 index was also demonstrated in hormone receptor positive and HER2-enriched subtypes, but no similar tendency was observed in the triple-negative subtype.ConclusionA patient with breast cancer scheduled for NACT should be assessed for the breast cancer subtype, as this will influence the treatment plans for the patient. The expression of PR and Ki-67 after NACT should be interpreted carefully because NACT tends to reduce the expression of these molecules.

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“…found that the positive-to-negative change in hormone-receptor status after neoadjuvant chemotherapy was an independent predictor of poor survival. 12 Other studies found that cases with discordant receptor status of metastatic disease and primary breast cancer have a worse prognosis than those with ER concordant-positive status. 13-15 …”

Section: Introductionmentioning

confidence: 98%

Heterogeneity in hormone-receptor status and survival outcomes among women with synchronous and metachronous bilateral breast cancers

2015

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To examine whether discordance in the hormone-receptor status predicts clinical outcomes in patients with bilateral synchronous (SBC) and metachronous breast cancer (MBC), we analyzed data from the Surveillance, Epidemiology, and End Results program (1998−2011) using Cox models. After excluding 10231 patients with missing data in hormone receptors in at least one tumor, 4403 SBC and 7159 MBC were included in the study. Among SBC cases, patients with estrogen receptor (ER)-discordant tumors had higher mortality risk (multivariable-adjusted hazard ratio [HR]=1.96, 95% confidence interval [CI] 1.60-2.40) than patients with ER concordant-positive tumors, whereas patients with ER concordant-negative tumors had the highest risk (HR=2.49, 95% CI 2.03-3.07). Among MBC cases, patients with a positive-to-negative change in ER status (HR=1.32, 95% CI: 1.08-1.62) or ER concordant-negative tumors (HR=1.48, 95% CI: 1.19-1.85) had worse survival than patients with ER concordant-positive tumors. In conclusion, discordance in the hormone-receptor status was an independent predictor of survival outcomes.

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Prognostic Value of a Positive-to-negative Change in Hormone Receptor Status after Neoadjuvant Chemotherapy in Patients with Hormone Receptor–positive Breast Cancer

Abstract: The switch of HR status after NCT is remarkable for HR-positive tumors. An HR-negative switch may identify patients who would benefit from alternative systemic therapies.

Cited by 47 publications

References 20 publications

Receptor Status Change From Primary to Residual Breast Cancer After Neoadjuvant Chemotherapy and Analysis of Survival Outcomes

Receptor Status Change From Primary to Residual Breast Cancer After Neoadjuvant Chemotherapy and Analysis of Survival Outcomes

Expression of Immunohistochemical Markers before and after Neoadjuvant Chemotherapy in Breast Carcinoma, and Their Use as Predictors of Response

Heterogeneity in hormone-receptor status and survival outcomes among women with synchronous and metachronous bilateral breast cancers

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