title: Influence of neoadjuvant therapy with epirubicin and docetaxel on the expression of HER2/neu in patients with breast cancer.
abstract: BACKGROUND
  In primary breast cancer, the expression levels of biological markers relevant to the progression of the disease may be altered by administration of anticancer drugs. Since neoadjuvant chemotherapy with epirubicin and docetaxel is increasingly used in advanced breast cancer, our purpose was to assess the influence of this neoadjuvant chemotherapy on the expression of the growth factor receptor HER2/neu.
  
  
  METHODS
  We investigated changes of HER2/neu status by immunohistochemistry (IHC) and applied additional fluorescence in situ hybridization (FISH) in patients with potential modulation of HER2/neu status after administration of neoadjuvant chemotherapy with docetaxel and epirubicin in 97 breast cancer patients. The influence of neoadjuvant chemotherapy on HER2/neu expression was calculated by correlation of HER2/neu status before and after chemotherapy.
  
  
  RESULTS
  The accuracy of HER2/neu assessment before and after neoadjuvant chemotherapy by IHC combined with FISH analysis in selected cases was 100%. The evaluation of HER2/neu status in these patients by IHC alone yielded accuracy of 93%. Neoadjuvant chemotherapy with epirubicin and docetaxel caused no significant modulation of HER2/neu status (p = 0.66).
  
  
  CONCLUSIONS
  The administration of epirubicin and docetaxel in the neoadjuvant setting is not associated with significant changes of HER2/neu status in primary breast cancer. As a consequence, drug resistance or sensitivity is not induced by modulation of HER2/neu expression. Moreover, the time of assessment of the HER2/neu status is not a critical factor under neoadjuvant therapy with epirubicin and docetaxel.
authors.affiliation: Department of Surgery, Vienna University Medical School, Vienna, Austria. susanne.taucher@univie.ac.at
authors.forename: Susanne
authors.initials: S
authors.lastname: Taucher
authors.forename: Margaretha
authors.initials: M
authors.lastname: Rudas
authors.forename: Robert M
authors.initials: RM
authors.lastname: Mader
authors.forename: Michael
authors.initials: M
authors.lastname: Gnant
authors.forename: Emanuel
authors.initials: E
authors.lastname: Sporn
authors.forename: Peter
authors.initials: P
authors.lastname: Dubsky
authors.forename: Sebastian
authors.initials: S
authors.lastname: Roka
authors.forename: Thomas
authors.initials: T
authors.lastname: Bachleitner
authors.forename: Florian
authors.initials: F
authors.lastname: Fitzal
authors.forename: Daniela
authors.initials: D
authors.lastname: Kandioler
authors.forename: Catharina
authors.initials: C
authors.lastname: Wenzel
authors.forename: Günther G
authors.initials: GG
authors.lastname: Steger
authors.forename: Martina
authors.initials: M
authors.lastname: Mittlböck
authors.forename: Raimund
authors.initials: R
authors.lastname: Jakesz
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D000077143:Docetaxel; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D018734:Genes, erbB-2; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D014408:Biomarkers, Tumor; D043823:Taxoids; D000077143:Docetaxel; D015251:Epirubicin