title: HER2 as a predictive factor for successful neoadjuvant anthracycline chemotherapy of locally advanced and early breast cancer.
abstract: OBJECTIVE
  The aim of this study was to look for predictive and prognostic factors in anthracycline-based neoadjuvant chemotherapy.
  
  
  METHODS
  Three hundred and nine patients with early-stage or locally advanced breast cancer were enrolled in this study and preoperatively treated with neoadjuvant chemotherapies in intense dose-dense (cyclophosphamide + epirubicin) or conventional (paclitaxel + epirubicin) regimens. Outcome parameters included overall objective response rate, as well as factors for determining pathological features influencing the efficacy of chemotherapy, such as estrogen receptor, progesterone receptor, and HER2 status, Eastern Cooperative Oncology Group (ECOG) score, tumor size, tumor inflammation, and lymph node metastasis.
  
  
  RESULTS
  The overall pathological complete response (pCR) rate was 14.3%, and the main factor affecting the efficacy of chemotherapy was HER2 expression. The pCR rate was significantly higher for patients with HER2 overexpression, compared with patients with low HER2 expression (27.5% vs. 9.6%, p&lt;0.001). The recurrence risk for patients with pCR decreased 1.12-fold compared with patients without pCR (5-year disease-free survival [DFS]: 81.8% vs. 65.7%, p=0.038). Patients in the HER2 overexpression subgroup benefited more from pCR than those in the HER2 low expression group (5-year DFS: 86.4% vs. 62.1%, p=0.049).
  
  
  CONCLUSIONS
  HER2 overexpression in primary tumors might be a predictive marker for good efficacy of anthracycline-based neoadjuvant chemotherapy. The pCR is a suitable prognostic factor, even for patients with HER2 overexpression.
authors.affiliation: Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing - China.
authors.forename: Jiayu
authors.initials: J
authors.lastname: Wang
authors.forename: Binghe
authors.initials: B
authors.lastname: Xu
authors.forename: Peng
authors.initials: P
authors.lastname: Yuan
authors.forename: Qing
authors.initials: Q
authors.lastname: Li
authors.forename: Pin
authors.initials: P
authors.lastname: Zhang
authors.forename: Ruigang
authors.initials: R
authors.lastname: Cai
authors.forename: Fei
authors.initials: F
authors.lastname: Ma
authors.forename: Ying
authors.initials: Y
authors.lastname: Fan
authors.forename: Yang
authors.initials: Y
authors.lastname: Luo
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000096:biosynthesis*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000473:pathology / Q000601:surgery; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D058922:Inflammatory Breast Neoplasms / Q000188:drug therapy / Q000201:enzymology / Q000473:pathology / Q000601:surgery; D020360:Neoadjuvant Therapy; D017239:Paclitaxel / Q000008:administration & dosage; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000096:biosynthesis*
chemical_list: D014408:Biomarkers, Tumor; D003520:Cyclophosphamide; D015251:Epirubicin; D017239:Paclitaxel; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human