title: Cell proliferation as a predictor of response to chemotherapy in metastatic breast cancer: a prospective study.
abstract: Many biologic prognostic markers are available for patients with breast cancer, and considerable interest has been devoted to confirm preliminary evidence of their role as indicators of treatment response. It remains to be assessed whether such markers are predictors of response only to first-line or also to successive therapies. Proliferative activity, defined by the 3H-thymidine labeling index (TLI), was determined on the primary lesion from 76 patients at time of first diagnosis. At relapse, patients underwent chemotherapy as absolute (48 cases) or relative (28 cases) first-line treatment, and their clinical response was analyzed in relation to the TLI of the primary lesion. The objective clinical response was significantly higher for rapidly (47%; CL, 33-61%) than for slowly proliferating tumors (15%; CL, 1-29%). These findings held true also when adjusted for metastatic site, previous treatment, chemotherapy regimen administered, and hormone receptor status. However, the direct relation between cell proliferation and benefit from chemotherapy held true only when such a treatment was used as an absolute first-line approach. Cell proliferation of primary lesions represents a consistent indicator of response to chemotherapy over time. Previously administered regimens, at least hormone therapy, could alter the proliferation-related chemosensitivity profile of individual tumors.
authors.affiliation: Medical Oncology Department-Pierantoni Hospital, Forli, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Amadori
authors.forename: A
authors.initials: A
authors.lastname: Volpi
authors.forename: R
authors.initials: R
authors.lastname: Maltoni
authors.forename: O
authors.initials: O
authors.lastname: Nanni
authors.forename: L
authors.initials: L
authors.lastname: Amaducci
authors.forename: A
authors.initials: A
authors.lastname: Amadori
authors.forename: D C
authors.initials: DC
authors.lastname: Giunchi
authors.forename: A
authors.initials: A
authors.lastname: Vio
authors.forename: A
authors.initials: A
authors.lastname: Saragoni
authors.forename: R
authors.initials: R
authors.lastname: Silvestrini
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology*; D002455:Cell Division / Q000187:drug effects*; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D011446:Prospective Studies; D013936:Thymidine / Q000096:biosynthesis; D014407:Tumor Cells, Cultured / Q000187:drug effects
chemical_list: D015251:Epirubicin; D003520:Cyclophosphamide; D005472:Fluorouracil; D013936:Thymidine; D008727:Methotrexate