title: Her2/neu overexpression is associated with treatment failure in women with high-risk stage II and stage IIIA breast cancer (>10 involved lymph nodes) treated with high-dose chemotherapy and autologous hematopoietic progenitor cell support following standard-dose adjuvant chemotherapy.
abstract: Twenty-five patients with high-risk stage II and IIIA breast cancer (>10 or more involved lymph nodes) were treated with six cycles of standard-dose chemotherapy (5-fluorouracil, doxorubicin, and cyclophosphamide) followed by high-dose chemotherapy (2.5 g/m2 cyclophosphamide for 3 days and 225 mg/m2 thiotepa for 3 days) with autologous hematopoietic progenitor cell support. The actuarial relapse free survival at 3 years is 80%; the actuarial survival at 3 years is 96%. Four patients relapsed systemically between 6 and 18 months; all four patients who relapsed had breast cancers that overexpressed Her2/neu. In contrast, none of the 21 patients who had no or borderline overexpression of Her2/neu relapsed (P = 0.00004, Fisher's exact test). Patients with high-risk stage II and IIIA breast cancer who have overexpression of Her2/neu appear to be at a high risk for relapse, even when treated with high-dose chemotherapy and autologous hematopoietic progenitor cell support.
authors.affiliation: Department of Medicine and Divisions of Hematology/Oncology and Pathology, Lutheran General Hospital, Park Ridge, Illinois 60068, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Bitran
authors.forename: B
authors.initials: B
authors.lastname: Samuels
authors.forename: Y
authors.initials: Y
authors.lastname: Trujillo
authors.forename: L
authors.initials: L
authors.lastname: Klein
authors.forename: L
authors.initials: L
authors.lastname: Schroeder
authors.forename: J
authors.initials: J
authors.lastname: Martinec
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D017322:Clinical Trials, Phase II as Topic; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D015870:Gene Expression / Q000187:drug effects; D018734:Genes, erbB-2 / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000096:biosynthesis* / Q000187:drug effects; D012074:Remission Induction; D017211:Treatment Failure
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases