title: Changes in tumour biological markers during primary systemic chemotherapy (PST).
abstract: BACKGROUND
  The influence of primary systemic therapy (PST) on the expression of relevant therapeutic markers is still under investigation.
  
  
  METHODS
  Corresponding "baseline" biopsies and post-chemotherapy surgical specimens from 87 patients treated with neoadjuvant anthracycline- or taxane-based chemotherapy were analysed for the expression of the oestrogen receptor (ER), the progesterone receptor (PR), the B-cell lymphoma protein 2 (Bcl-2), the v-erb-b2 erythroblastic leukemia viral oncogene homolog 2 (Her2/neu), the tumour protein p53 and the proliferation-related Ki-67 antigen.
  
  
  RESULTS
  The pathological response rate was 70%. Twenty-three tumours (26%) changed hormone receptor classification after chemotherapy (7, ER; 16 PR). A significant change was also observed for Her2/neu status. Eleven tumours which were positive prior to PST down-regulated Her2/neu after chemotherapy. The median Ki-67 index decreased from 30% before to 13% after treatment (p<0.01). Minor changes were observed in the expression of Bcl-2 and p53 (9%). Only the reduction of Ki-67 was associated with pathological response to PST.
  
  
  CONCLUSIONS
  Her2/neu status as well as ER and PR status should be re-evaluated on post-chemotherapy surgical specimens since changes can be observed.
authors.affiliation: Department of Gynaecology and Obstetrics, University of Tübingen, Tübingen, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Neubauer
authors.forename: Christian
authors.initials: C
authors.lastname: Gall
authors.forename: Ulrich
authors.initials: U
authors.lastname: Vogel
authors.forename: Rene
authors.initials: R
authors.lastname: Hornung
authors.forename: Diethelm
authors.initials: D
authors.lastname: Wallwiener
authors.forename: Erich
authors.initials: E
authors.lastname: Solomayer
authors.forename: Tanja
authors.initials: T
authors.lastname: Fehm
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000096:biosynthesis*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000096:biosynthesis; D009367:Neoplasm Staging; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000096:biosynthesis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000096:biosynthesis; D011960:Receptors, Estrogen / Q000096:biosynthesis; D011980:Receptors, Progesterone / Q000096:biosynthesis
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone