title: Trastuzumab in Primary Inflammatory Breast Cancer  (IBC): High Pathological Response Rates and Improved  Outcome.
abstract: Inflammatory breast cancer (IBC) represents a rare but aggressive and lethal form of locally advanced breast cancer (LABC) and frequently with HER-2 neu overexpressed or amplified. We retrospectively identified 16 newly diagnosed HER-2 ⁄ neu-positive IBC patients who were treated with preoperative trastuzumab. We determined the pathological complete response rate (pCR) when trastuzumab was added to preoperative chemotherapy in patients with HER2⁄ neupositive IBC. Furthermore, we assessed the expression of CXCR4 in metastatic recurrence sites. Ten patients (62.5%)achieved a pCR. Six patients (37.5%) achieved a partial response. Median follow-up of all patients was 24.2 months. Four(25%) patients have experienced a progression, of which three were in the brain. Two-year progression-free survival was 59.4% (95% CI 35–100). High expression of CXCR4 was detected in the brain metastases. We conclude that in spite of high pCR rates among women with HER-2 ⁄ neu-positive IBC treated with neoadjuvant trastuzumab-based regimens the outcome remains dismal and brain recurrences are frequent. CXCR4 may represent a novel therapeutic target.
authors.affiliation: Department of Breast Medical Oncology, The University of Texas, M. D. Anderson Cancer Center, Houston, Texas; Deparment of Medical Oncology, Dubai Hospital, Dubai, UAE.
authors.forename: Shaheenah
authors.initials: S
authors.lastname: Dawood
authors.forename: Yun
authors.initials: Y
authors.lastname: Gong
authors.forename: Kristine
authors.initials: K
authors.lastname: Broglio
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Buchholz
authors.forename: Wendy
authors.initials: W
authors.lastname: Woodward
authors.forename: Anthony
authors.initials: A
authors.lastname: Lucci
authors.forename: Vicente
authors.initials: V
authors.lastname: Valero
authors.forename: Ana M
authors.initials: AM
authors.lastname: Gonzalez-Angulo
authors.forename: Gabriel N
authors.initials: GN
authors.lastname: Hortobagyi
authors.forename: Massimo
authors.initials: M
authors.lastname: Cristofanilli
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D058922:Inflammatory Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D019718:Receptors, CXCR4 / Q000378:metabolism; D000068878:Trastuzumab / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D019718:Receptors, CXCR4; D000068878:Trastuzumab; C527276:CXCR4 protein, human; C508053:ERBB2 protein, human