title: Survivin as a predictive biomarker of complete pathologic response to neoadjuvant chemotherapy in patients with stage II and stage III breast cancer.
abstract: BACKGROUND
  Predictive biomarkers of response to neoadjuvant chemotherapy in patients with breast cancer are needed to better characterize tumors and enable more tailored therapies.
  
  
  METHODS
  The expression levels of survivin, BCL-2, cyclin D1, ETS1, and PDEF in tumor samples obtained in the diagnostic biopsies of patients undergoing neoadjuvant chemotherapy for stage II and stage III disease were evaluated by immunohistochemistry (IHC). The mean expression score (range, 0-15) obtained by 3 different pathologists was used for analysis and correlated with complete pathologic response (pCR) and survival by standard univariate and multivariate methods.
  
  
  RESULTS
  Forty-five female patients were included in this study and received preoperative standard anthracycline/taxane-based chemotherapy. The median age at diagnosis was 49 years (range, 25-70 years). Three patients (7.1%) achieved pCR. The mean expression score of survivin in the diagnostic biopsies was significantly higher (P = .01) in patients with pCR (9.3) than in those without (3.4). There was no significant association with pCR for the other biologic markers analyzed nor was there correlation with prognosis. Survivin levels were not associated with age, tumor grade, clinical stage, or receptor status.
  
  
  CONCLUSIONS
  High expression levels of survivin in the primary tumor may be used as a potential predictive biomarker of pCR to neoadjuvant chemotherapy in patients with stage II and stage III breast cancer.
authors.affiliation: Department of Oncology and Pathology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre-RS, Brazil.
authors.forename: Cristiane Rios
authors.initials: CR
authors.lastname: Petrarca
authors.forename: Andre T
authors.initials: AT
authors.lastname: Brunetto
authors.forename: Vinicius
authors.initials: V
authors.lastname: Duval
authors.forename: Adriana
authors.initials: A
authors.lastname: Brondani
authors.forename: Gisele Pereira
authors.initials: GP
authors.lastname: Carvalho
authors.forename: Bernardo
authors.initials: B
authors.lastname: Garicochea
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D054316:Biomarkers, Pharmacological / Q000032:analysis / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism / Q000502:physiology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D002277:Carcinoma / Q000175:diagnosis* / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D051034:Inhibitor of Apoptosis Proteins / Q000378:metabolism / Q000502:physiology*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012074:Remission Induction; D000077022:Survivin; D055815:Young Adult
chemical_list: C107489:BIRC5 protein, human; D054316:Biomarkers, Pharmacological; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D000077022:Survivin