title: Molecular predictors of efficacy of adjuvant weekly paclitaxel in early breast cancer.
abstract: Treatment with fluororacil, epirubicin, and cyclophosphamide followed by weekly paclitaxel (FEC-P) yielded superior disease-free survival than FEC in the adjuvant breast cancer trial GEICAM 9906. We evaluate molecular subtypes predictive of prognosis and paclitaxel response in this trial. Two molecular subtype classifications based on conventional immunohistochemical and fluorescent in situ hybridization determinations were used: #1: Four groups segregated according to the combination of hormone receptor (HR) and HER2 status; #2: Intrinsic subtype classification (Triple Negative (TN), HER2, Luminal B and Luminal A).
  
  
  RESULTS
  Both subtype classifications yielded prognostic and predictive information. HR +/HER2- patients (and Luminal A patients) had a significantly better outcome than the other subgroups of patients. The superiority of FEC-P over FEC was clearly more marked in HR-/HER2- patients (TN patients), particularly in the subset with basal phenotype (TN and either EGFR+ or cytokeratins 5/6+). The Luminal A subtype also achieved a significant benefit with FEC-P. The molecular-defined subgroup of TN was clearly predictive of better response to treatment with FEC-P. Luminal A patients had the best prognosis and also have a better outcome with weekly paclitaxel.
authors.affiliation: Servicio de Oncología Médica, Departmento de Oncología, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain. mmartin@geicam.org
authors.forename: Miguel
authors.initials: M
authors.lastname: Martín
authors.forename: Alvaro
authors.initials: A
authors.lastname: Rodríguez-Lescure
authors.forename: Amparo
authors.initials: A
authors.lastname: Ruiz
authors.forename: Emilio
authors.initials: E
authors.lastname: Alba
authors.forename: Lourdes
authors.initials: L
authors.lastname: Calvo
authors.forename: Manuel
authors.initials: M
authors.lastname: Ruiz-Borrego
authors.forename: Ana
authors.initials: A
authors.lastname: Santaballa
authors.forename: César A
authors.initials: CA
authors.lastname: Rodríguez
authors.forename: Carmen
authors.initials: C
authors.lastname: Crespo
authors.forename: Mar
authors.initials: M
authors.lastname: Abad
authors.forename: Severina
authors.initials: S
authors.lastname: Domínguez
authors.forename: Jesús
authors.initials: J
authors.lastname: Florián
authors.forename: Cristina
authors.initials: C
authors.lastname: Llorca
authors.forename: Miguel
authors.initials: M
authors.lastname: Méndez
authors.forename: María
authors.initials: M
authors.lastname: Godes
authors.forename: Ricardo
authors.initials: R
authors.lastname: Cubedo
authors.forename: Adolfo
authors.initials: A
authors.lastname: Murias
authors.forename: Norberto
authors.initials: N
authors.lastname: Batista
authors.forename: María José
authors.initials: MJ
authors.lastname: García
authors.forename: Rosalía
authors.initials: R
authors.lastname: Caballero
authors.forename: Enrique
authors.initials: E
authors.lastname: de Alava
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000145:classification / Q000188:drug therapy* / Q000235:genetics*; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D053208:Kaplan-Meier Estimate; D017239:Paclitaxel / Q000627:therapeutic use*; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000096:biosynthesis / Q000235:genetics; D011960:Receptors, Estrogen / Q000096:biosynthesis / Q000235:genetics; D011980:Receptors, Progesterone / Q000096:biosynthesis / Q000235:genetics; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D003520:Cyclophosphamide; D015251:Epirubicin; D005472:Fluorouracil; D017239:Paclitaxel; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone