title: Prognostic value of Bcl-2 in breast cancer patients treated with neoadjuvant anthracycline based chemotherapy.
abstract: We have analyzed the predictive/prognostic value of Bcl-2 protein in breast cancer patients treated with neoadjuvant chemotherapy. One hundred and ten patients were submitted to two different chemotherapeutic regimens: a) 5-fluorouracil, adriamycin or epirubicin, and cyclophosphamide (FAC/FEC) during 2-6 cycles before surgery and 3 or 4 additional cycles of FAC/FEC after surgery (n=40) and b) doxorubicin (D) 75 mg/m(2) or epirubicin (E) 120 mg/m(2) during 4 cycles before surgery, and 6 cycles of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) after surgery (n=70). Bcl-2 expression, evaluated by immunohistochemistry, did not change significantly after chemotherapy and was not related to clinical/pathological response. In FAC/FEC group, Bcl-2 positive expression after chemotherapy correlated with better disease free survival (DFS) and overall survival (OS) (P=0.008 and P=0.001). In D/E group, Bcl-2 also correlated with better DFS and OS (P=0.03 and P=0.054) in the post-chemotherapy biopsies. An unusual nuclear localization of Bax was observed in some biopsies, but this localization did not correlate with the tumor response or outcome of the patients. We found that a high Bcl-2 expression had no predictive value but had prognostic value in breast cancer patients treated with neoadjuvant anthracycline based chemotherapy.
authors.affiliation: Institute of Medicine and Experimental Biology of Cuyo, Regional Center for Scientific and Technological Research, National Research Council of Argentine, Mendoza 5500, Argentina. vargasl@lab.cricyt.edu.ar
authors.forename: Laura M
authors.initials: LM
authors.lastname: Vargas-Roig
authors.forename: F Darío
authors.initials: FD
authors.lastname: Cuello-Carrión
authors.forename: Nicolás
authors.initials: N
authors.lastname: Fernández-Escobar
authors.forename: Pedro
authors.initials: P
authors.lastname: Daguerre
authors.forename: Marcela
authors.initials: M
authors.lastname: Leuzzi
authors.forename: Jorge
authors.initials: J
authors.lastname: Ibarra
authors.forename: Francisco E
authors.initials: FE
authors.lastname: Gago
authors.forename: Silvina B
authors.initials: SB
authors.lastname: Nadin
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Ciocca
mesh_terms: D018943:Anthracyclines / Q000627:therapeutic use; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality*; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis*; D016019:Survival Analysis; D016896:Treatment Outcome; D051028:bcl-2-Associated X Protein / Q000032:analysis
chemical_list: D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic; D019253:Proto-Oncogene Proteins c-bcl-2; D051028:bcl-2-Associated X Protein