title: Epirubicin and docetaxel as first-line treatment for hormonal receptor positive metastatic breast cancer: the predictive value of luminal subtype: a retrospective cohort analysis.
abstract: BACKGROUND
  We retrospectively evaluated the efficacy of first-line epirubicin and docetaxel in patients with metastatic, hormonal receptor (HR)-positive, and human epidermal growth factor receptor-2-negative breast cancer. A subgroup analysis evaluated the predictive value of immunohistochemistry-defined luminal subtype.
  
  
  METHODS
  We included patients with at least one visceral and measurable site of metastatic disease. Patients were grouped as luminal A (HR(+) and Ki67<13%) or luminal B (HR(+) and Ki67>13%).
  
  
  RESULTS
  Forty-four patients were entered and prognostic variables were similar between the subgroups. Luminal B patients achieved higher objective response rate than luminal A (69% versus 19%; P = 0.001), longer time to progression (12.2 months versus 8.6 months; P = 0.039), and longer overall survival (24.6 months versus 19.5 months; P = 0.041). The multivariate analysis confirmed the predictive value of luminal B subtype for longer time to progression.
  
  
  CONCLUSIONS
  Identification by Ki67 labelling index of human epidermal growth factor receptor-2-negative luminal A could predict a substantial benefit from systemic chemotherapy. Endocrine therapy would be the most appropriate therapy for luminal A tumours.
authors.affiliation: Department of Medical Oncology, Central Hospital of Belcolle, Viterbo, Italy. f.nelli@asl.vt.it
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Nelli
authors.forename: Guido
authors.initials: G
authors.lastname: Natoli
authors.forename: Luca
authors.initials: L
authors.lastname: Moscetti
authors.forename: Annalisa
authors.initials: A
authors.lastname: Massari
authors.forename: Giuliana
authors.initials: G
authors.lastname: D'Auria
authors.forename: Maria A
authors.initials: MA
authors.lastname: Fabbri
authors.forename: Patrizia
authors.initials: P
authors.lastname: Frittelli
authors.forename: Enzo M
authors.initials: EM
authors.lastname: Ruggeri
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000737:chemistry* / Q000145:classification / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D015331:Cohort Studies; D000077143:Docetaxel; D015251:Epirubicin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011237:Predictive Value of Tests; D011960:Receptors, Estrogen / Q000032:analysis*; D011980:Receptors, Progesterone / Q000032:analysis*; D012189:Retrospective Studies; D015996:Survival Rate; D043823:Taxoids / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D043823:Taxoids; D000077143:Docetaxel; D015251:Epirubicin