title: Immunohistochemical subtypes predict survival in metastatic breast cancer receiving high-dose chemotherapy with autologous haematopoietic stem cell transplantation.
abstract: The objective of this study was to evaluate the outcome of patients affected with different subtypes of metastatic breast cancer (MBC) following treatment with high-dose chemotherapy (HDC) and autologous haematopoietic progenitor cell transplantation (AHSCT).
  
  
  
  All consecutive female patients treated for MBC with HDC and AHSCT at the Institut Paoli-Calmettes between 2003 and 2012 were included. Patient, tumour and treatment characteristics were collected. Patients were categorised in three subtypes based on hormonal receptor (HR) and human epidermal growth factor receptor 2 (HER2) status of the primary tumour: luminal (L), (HR+/HER2-), HER2 (HER2+, any HR), and triple negative (TN) (HER2- and HR-). The main objective was the analysis of overall survival (OS) according to the immunohistochemical (IHC) subtypes.
  
  
  
  A total of 235 patients were included, median age was 46 (range 21-62). Median follow up was 53.28 months (95% confidence interval [CI] 45.12-57.6). The TN subtype appeared to have the worst prognosis with a median OS of 19.68 months (95% CI 11.76-44.4) compared to 44.64 months (95% CI 40.32-67.56) for the luminal subtype and a median OS not reached for the HER2 subtype (p < 0.01). In the multivariate analysis, the TN subtype retained an independent poor prognosis value compared to the luminal subtype, with a hazard ratio of 2.03 (95% CI 1.26-3.29, p = 0.037).
  
  
  
  HDC-AHSCT does not change the prognostic value of IHC subtypes in MBC patients. OS favourably compares with data available in the literature on similar groups of patients. These findings provide additional information and options for patients with MBC and who could potentially benefit of HDC-AHSCT.
authors.affiliation: Département d'Oncologie Médicale, Institut Paoli-Calmettes (IPC), Marseille, F-13273, France.
authors.forename: Laurys
authors.initials: L
authors.lastname: Boudin
authors.affiliation: Centre de Recherches en Cancérologie de Marseille (CRCM), UMR Inserm 1068/CNRS 7258/AMU 105/IPC, Marseille, F-13009, France; Centre de Thérapie Cellulaire, Département de Biologie du Cancer, Institut Paoli-Calmettes, Marseille, F-13273, France; Centre d'Investigations Cliniques en Biothérapies, Inserm CBT-1409, Marseille, F-13009, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Chabannon
authors.affiliation: Biostatistiques, Département de la Recherche Clinique et de l'Innovation (DRCI), Institut Paoli-Calmettes, Marseille, F-13273, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Sfumato
authors.affiliation: Département d'Oncologie Médicale, Institut Paoli-Calmettes (IPC), Marseille, F-13273, France; Centre de Recherches en Cancérologie de Marseille (CRCM), UMR Inserm 1068/CNRS 7258/AMU 105/IPC, Marseille, F-13009, France; Aix-Marseille Université, Marseille, F-13284, France.
authors.forename: Renaud
authors.initials: R
authors.lastname: Sabatier
authors.affiliation: Département d'Oncologie Médicale, Institut Paoli-Calmettes (IPC), Marseille, F-13273, France; Centre de Recherches en Cancérologie de Marseille (CRCM), UMR Inserm 1068/CNRS 7258/AMU 105/IPC, Marseille, F-13009, France; Aix-Marseille Université, Marseille, F-13284, France.
authors.forename: François
authors.initials: F
authors.lastname: Bertucci
authors.affiliation: Département d'Oncologie Médicale, Institut Paoli-Calmettes (IPC), Marseille, F-13273, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Tarpin
authors.affiliation: Département d'Oncologie Médicale, Institut Paoli-Calmettes (IPC), Marseille, F-13273, France.
authors.forename: Magali
authors.initials: M
authors.lastname: Provansal
authors.affiliation: Centre de Recherches en Cancérologie de Marseille (CRCM), UMR Inserm 1068/CNRS 7258/AMU 105/IPC, Marseille, F-13009, France; Aix-Marseille Université, Marseille, F-13284, France; Département de Chirurgie Oncologique, Institut Paoli-Calmettes, Marseille, F-13273, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Houvenaeghel
authors.affiliation: Centre de Recherches en Cancérologie de Marseille (CRCM), UMR Inserm 1068/CNRS 7258/AMU 105/IPC, Marseille, F-13009, France; Aix-Marseille Université, Marseille, F-13284, France; Département de Chirurgie Oncologique, Institut Paoli-Calmettes, Marseille, F-13273, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Lambaudie
authors.affiliation: Département de Radiothérapie, Institut Paoli-Calmettes, Marseille, F-13273, France.
authors.forename: Agnes
authors.initials: A
authors.lastname: Tallet
authors.affiliation: Département de Radiothérapie, Institut Paoli-Calmettes, Marseille, F-13273, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Resbeut
authors.affiliation: Centre de Recherches en Cancérologie de Marseille (CRCM), UMR Inserm 1068/CNRS 7258/AMU 105/IPC, Marseille, F-13009, France; Aix-Marseille Université, Marseille, F-13284, France; Biopathologie, Département de Biologie du Cancer Institut Paoli-Calmettes, Marseille, F-13273, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Charafe-Jauffret
authors.affiliation: Centre de Recherches en Cancérologie de Marseille (CRCM), UMR Inserm 1068/CNRS 7258/AMU 105/IPC, Marseille, F-13009, France; Centre de Thérapie Cellulaire, Département de Biologie du Cancer, Institut Paoli-Calmettes, Marseille, F-13273, France; Centre d'Investigations Cliniques en Biothérapies, Inserm CBT-1409, Marseille, F-13009, France.
authors.forename: Boris
authors.initials: B
authors.lastname: Calmels
authors.affiliation: Centre de Thérapie Cellulaire, Département de Biologie du Cancer, Institut Paoli-Calmettes, Marseille, F-13273, France; Centre d'Investigations Cliniques en Biothérapies, Inserm CBT-1409, Marseille, F-13009, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Lemarie
authors.affiliation: Biostatistiques, Département de la Recherche Clinique et de l'Innovation (DRCI), Institut Paoli-Calmettes, Marseille, F-13273, France.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Boher
authors.affiliation: Département d'Oncologie Médicale, Institut Paoli-Calmettes (IPC), Marseille, F-13273, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Extra
authors.affiliation: Département d'Oncologie Médicale, Institut Paoli-Calmettes (IPC), Marseille, F-13273, France; Centre de Recherches en Cancérologie de Marseille (CRCM), UMR Inserm 1068/CNRS 7258/AMU 105/IPC, Marseille, F-13009, France; Aix-Marseille Université, Marseille, F-13284, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Viens
authors.affiliation: Département d'Oncologie Médicale, Institut Paoli-Calmettes (IPC), Marseille, F-13273, France; Centre de Recherches en Cancérologie de Marseille (CRCM), UMR Inserm 1068/CNRS 7258/AMU 105/IPC, Marseille, F-13009, France; Aix-Marseille Université, Marseille, F-13284, France. Electronic address: goncalvesa@ipc.unicancer.fr.
authors.forename: Anthony
authors.initials: A
authors.lastname: Gonçalves
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000401:mortality / Q000628:therapy*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D016019:Survival Analysis; D064726:Triple Negative Breast Neoplasms / Q000401:mortality / Q000628:therapy; D055815:Young Adult
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: Autologous haematopoietic stem cell transplantation; Breast cancer; High-dose chemotherapy; Immunohistochemical subtypes