title: Modulation of plasma complement by the initial dose of epirubicin/docetaxel therapy in breast cancer and its predictive value.
abstract: BACKGROUND
  Despite the widespread use of neoadjuvant chemotherapy in breast cancer patients, prediction of individual response to treatment remains an unsolved clinical problem. Particularly, administration of an inefficient chemotherapeutic regimen should be avoided. Therefore, a better understanding of the molecular mechanisms underlying response to neoadjuvant chemotherapy is of particular clinical interest. Aim of the present study was to test whether neoadjuvant chemotherapy with epirubicin/docetaxel induces early changes in the plasma proteome of breast cancer patients and whether such changes correlate with response to therapy.
  
  
  METHODS
  Plasma samples of 25 breast cancer patients obtained before and 24 h after initiation of epirubicin/docetaxel-based neoadjuvant chemotherapy were analysed using two-dimensional differential gel electrophoresis (2D-DIGE). Protein spots found to be differentially expressed were identified using mass spectrometry and then correlated with the pathological response after six cycles of therapy. Markers identified in a discovery set of patients (n=12) were confirmed in an independent validation set (n=13).
  
  
  RESULTS
  2D-DIGE revealed 33 protein spots to be differentially expressed in response to chemotherapy, including the complement factors C1, C3 and C4, inter-α-trypsin inhibitor, α-1-antichymotrypsin and α-2-Heremans-Schmid glycoprotein (AHSG). With respect to cytokines, only interleukin (IL)-6, IL-10 and soluble intracellular adgesion molecule 3 (sICAM3) were minimally modulated. Moreover, two protein spots within the complement component C3 significantly correlated with response to therapy.
  
  
  CONCLUSIONS
  We have identified acute phase proteins and the complement system as part of the early host response to epirubicin/docetaxel chemotherapy. As complement C3 cleavage correlates with the efficacy of docetaxel/epirubicin-based chemotherapy, it has the potential as an easily accessible predictive biomarker.
authors.affiliation: Department of Surgery, Medical University of Vienna, A-1090, Vienna, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Michlmayr
authors.forename: T
authors.initials: T
authors.lastname: Bachleitner-Hofmann
authors.forename: S
authors.initials: S
authors.lastname: Baumann
authors.forename: M
authors.initials: M
authors.lastname: Marchetti-Deschmann
authors.forename: I
authors.initials: I
authors.lastname: Rech-Weichselbraun
authors.forename: C
authors.initials: C
authors.lastname: Burghuber
authors.forename: U
authors.initials: U
authors.lastname: Pluschnig
authors.forename: R
authors.initials: R
authors.lastname: Bartsch
authors.forename: A
authors.initials: A
authors.lastname: Graf
authors.forename: R
authors.initials: R
authors.lastname: Greil
authors.forename: G
authors.initials: G
authors.lastname: Allmaier
authors.forename: G
authors.initials: G
authors.lastname: Steger
authors.forename: M
authors.initials: M
authors.lastname: Gnant
authors.forename: M
authors.initials: M
authors.lastname: Bergmann
authors.forename: R
authors.initials: R
authors.lastname: Oehler
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D054316:Biomarkers, Pharmacological / Q000032:analysis / Q000097:blood / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood / Q000378:metabolism; D001943:Breast Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000378:metabolism; D018270:Carcinoma, Ductal, Breast / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000378:metabolism; D003165:Complement System Proteins / Q000032:analysis* / Q000187:drug effects / Q000378:metabolism; D000077143:Docetaxel; D004305:Dose-Response Relationship, Drug; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010949:Plasma / Q000737:chemistry / Q000187:drug effects; D011237:Predictive Value of Tests; D043823:Taxoids / Q000008:administration & dosage; D054928:Validation Studies as Topic
chemical_list: D054316:Biomarkers, Pharmacological; D014408:Biomarkers, Tumor; D043823:Taxoids; D000077143:Docetaxel; D015251:Epirubicin; D003165:Complement System Proteins