title: High plasma fibrinogen is correlated with poor response to trastuzumab treatment in HER2 positive breast cancer.
abstract: Some of HER-2 positive breast cancer patients failed to trastuzumab treatment. Recent reports have indicated the correlation between plasma coagulation parameters and clinical characteristics in breast cancer. The aim of this study was to analyze the role of coagulation parameters in trastuzumab treated patients. Coagulation parameters from trastuzumab treated breast cancer patients were retrospectively studied from 2006 to 2010. The correlation between routine coagulation levels and clinical characteristics were analyzed, including prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fib) and D-dimer (DD). The Kaplan-Meier analysis and Cox regression hazard model were applied to assess their effect on prognosis. Totally 102 hospitalized breast cancer patients who received trastuzumab were collected and followed-up. All patients were HER-2 positive advanced breast cancer, with a median age of 45 years old. Extended PT, APTT, and TT were found in trastuzumab treatment non-effective group, as well as increased Fib and DD. But significant increase was only found in Fib. High Fib status (Fib > 2.88 g/L) was correlated with clinical characteristics, such as pathological grade, and reversely correlated with PTEN expression. More importantly, poor disease-free survival (DFS) and overall survival (OS) to trastuzumab treatment were found in high Fib breast cancer patients. This retrospective study suggests high Fib status was correlated with poor treatment response to trastuzumab. Our findings indicated that Fib > 2.88 should alert physicians to consider a pretreatment for reducing Fib levels before trastuzumab treatment in HER-2 positive breast cancer patients.
authors: From the Department of Clinical Laboratory, 401st Hospital of People's Liberation Army, Qingdao 266071, China (Y-LL, J-WL, YX, JW, BL); Department of Pathogenic Biology, Qingdao University, Qingdao 266000, China (Y-LL, BL); Medical Affairs Department, 401st Hospital of People's Liberation Army, Qingdao 266071, China (QL, Y-RJ); Department of Pathology, the 401st hospital of People's Liberation Army, Qingdao 266071, China (WZ, F-FS, QW); Department of Breast Diseases, Southwest Cancer Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China (B-QH); Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China (QW).
authors: Yu-Lin
authors: YL
authors: Liu
authors: Qing
authors: Q
authors: Lu
authors: Ji-Wei
authors: JW
authors: Liang
authors: Yu
authors: Y
authors: Xia
authors: Wei
authors: W
authors: Zhang
authors: Bao-Quan
authors: BQ
authors: Hu
authors: Fang-Fang
authors: FF
authors: Shang
authors: You-Ran
authors: YR
authors: Ji
authors: Jun
authors: J
authors: Wang
authors: Qiang
authors: Q
authors: Wang
authors: Bing
authors: B
authors: Liang
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011379:Prognosis; D011517:Prothrombin Time; D018719:Erb-b2 Receptor Tyrosine Kinases; D012189:Retrospective Studies; D000068878:Trastuzumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D005338:Fibrin Fibrinogen Degradation Products; D005340:Fibrinogen; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C036309:fibrin fragment D
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