OBJECTIVETo detect the expression of IGF1R and estrogen receptor, and to explore the relationship between their expression and the pathological complete response (pCR) rate of neoadjuvant chemotherapy (docetaxel plus epirubicin) in breast cancer patients.

METHODSWe selected 139 women with breast cancer who underwent neoadjuvant chemotherapy (docetaxel plus epirubicin), and detected the expression of IGF1R and estrogen receptor in the samples taken before chemotherapy by Immunohistochemistry. The association between their expression and pCR rate of neoadjuvant chemotherapy was analyzed.

RESULTSAmong the 139 cases, IGF1R was highly expressed in 45.3% (63/139) cases, and ER was positively expressed in 62.6% (87/139) cases. IGF1R was highly expressed in 54.0% (47/87) of the ER+ cases, significantly higher than that of ER- cases (30.8%, P<0.01). The overall pCR rate of all the 139 patients who received docetaxel plus epirubicin as neoadjuvant chemotherapy was 10.1% (14/139). The pCR rate was 19.2% (10/52) of the ER- patients and 4.6% (4/87) of the ER+ patients (P<0.05). The pCR rate was 10.5% (8/76) in the patients with low IGF1R expression and 9.5% (6/63) in the patients with high IGF1R expression (P>0.05). The patients with negative expression of ER and high expression of IGF1R showed the highest pCR rate (31.2%, P<0.01).

CONCLUSIONSBreast cancer patients with negative expression of ER and high expression of IGF1R are more sensitive to neoadjuvant chemotherapy of docetaxel plus epirubicin, and their pCR rate is significantly higher than that of other patients.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Biomarkers, Tumor ; Breast Neoplasms ; drug therapy ; metabolism ; Epirubicin ; administration & dosage ; Female ; Humans ; Immunohistochemistry ; Neoadjuvant Therapy ; Receptors, Estrogen ; metabolism ; Receptors, Somatomedin ; metabolism ; Taxoids ; administration & dosage

OBJECTIVEThe aim of this study was to analyze the efficacy and safety of paclitaxel liposomal and docetaxel for neoadjuvant chemotherapy of breast cancer.

METHODSWe retrospectively analyzed the clinical data of 188 operable patients with breast cancer who received neoadjuvant chemotherapy. According to the treatment regimens, they were divided into the group of paclitaxel liposome (86 patients) and group of docetaxel (102 patients) treatment. All the patients received a combination therapy with epirubicin and cyclophosphamide, i.e. neoadjuvant chemotherapy with three drugs, 21 days as a cycle, and a total of 6 cycles. Surgery was carried out three weeks after the end of chemotherapy, and the chemotherapy efficacy and adverse reaction of both groups were evaluated.

RESULTSPathological complete response (pCR) rate in the paclitaxel liposome group and docetaxel group was 10.5% and 9.8%, respectively, the objective response rate (ORR) was 80.2% and 79.4%, respectively, and the disease control rate (DCR) was 95.3% and 93.1%, respectively, showing a non-significant difference in therapy efficacy between the two groups (P > 0.05). Safety analysis indicated that all the occurrence rates of skin and nail toxic reaction, body fluid retention, oral mucositis, allergic reaction (such as facial blushing, chest distress, palpitation, dyspnea. etc.), and grade III-IV leukopenia and neutropenia in the paclitaxel liposome group were significantly lower than that of the docetaxel group (all P < 0.05).

CONCLUSIONSCompared with docetaxel, paclitaxel liposome has the same anti-tumor efficacy, but causes fewer and milder adverse reactions with a higher safety in the neoadjuvant chemotherapy for breast cancer.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; Cyclophosphamide ; therapeutic use ; Epirubicin ; therapeutic use ; Female ; Humans ; Liposomes ; Neoadjuvant Therapy ; Neutropenia ; Paclitaxel ; therapeutic use ; Remission Induction ; Taxoids ; therapeutic use

OBJECTIVEThis study was conducted to analyze the Ki-67 expression before and after neoadjuvant chemotherapy and clinicopathological characteristics of different biological breast cancer phenotypes. The significance and prognostic predictive value of the changes of Ki-67 expression in different biological breast cancer phenotypes were analyzed.

METHODSA regression analysis was performed on 178 patients with invasive breast carcinoma who accepted neoadjuvant chemotherapy at Tianjin Medical University Cancer Institute and Hospital from August 2007 to August 2008. These patients were subtyped by hormone receptor status and HER-2 status. The Ki-67 index (percentage of Ki-67-positive cancer cell nuclei) was determined by immunohistochemistry. The prognostic value of Ki-67 index for disease-free survival (DFS) in different biological breast cancer phenotypes was analyzed using Kaplan-Meier survival and multivariable Cox regression.

RESULTSThe overall pathologic CR (pCR) rate, defined as no invasive residuals in the breast and axilla, was 15.2%. The highest pCR rate of 25.0% was observed in the TNBC patients, which was 14.3%, 10.3% and 18.2% in the luminal A, luminal B and HER2 overexpressing patients, respectively (P = 0.040). The changes of Ki-67 expression in pre-NAC and post-NAC patients showed a prognostic significance in luminal A and TNBC (P = 0.019 and P = 0.022, respectively) cases. Clinical stage, the efficacy of NAC, and changes of Ki-67 expression between pre- and post-NAC were independent prognostic factors in TNBC patients who did not achieve pCR.

CONCLUSIONSThe Ki-67 expression after neoadjuvant chemotherapy is an independent prognostic factor affecting the disease-free survival (DFS) in TNBC patients who have not achieved pCR.

Antineoplastic Combined Chemotherapy Protocols ; Breast Neoplasms ; metabolism ; therapy ; Disease-Free Survival ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Neoadjuvant Therapy ; Phenotype ; Prognosis ; Receptor, ErbB-2 ; Receptors, Estrogen ; Receptors, Progesterone