Breast Cancer Subtypes and Response to Docetaxel in Node-Positive Breast Cancer: Use of an Immunohistochemical Definition in the BCIRG 001 Trial Export

@article{citeulike:6088394, abstract = {Purpose: To investigate the prognostic and predictive significance of subtyping node-positive early breast cancer by immunohistochemistry in a clinical trial of a docetaxel-containing regimen.Methods: Pathologic data from a central laboratory were available for 1,350 patients (91\%) from the BCIRG 001 trial of docetaxel, doxorubicin, and cyclophosphamide (TAC) versus fluorouracil, doxorubicin, and cyclophosphamide (FAC) for operable node-positive breast cancer. Patients were classified by tumor characteristics as (1) triple negative (estrogen receptor [ER]-negative, progesterone receptor [PR]-negative, HER2/neu [HER2]-negative), (2) HER2 (HER2-positive, ER-negative, PR-negative), (3) luminal B (ER-positive and/or PR-positive and either HER2-positive and/or Ki67high), and (4) luminal A (ER-positive and/or PR-positive and not HER2-positive or Ki67high), and assessed for prognostic significance and response to adjuvant chemotherapy.Results: Patients were subdivided into triple negative (14.5\%), HER2 (8.5\%), luminal B (61.1\%), and luminal A (15.9\%). Three-year disease-free survival (DFS) rates (P values with luminal B as referent) were 67\% (P < .0001), 68\% (P = .0008), 82\% (referent luminal B), and 91\% (P = .0027), respectively, with hazard ratios of 2.22, 2.12, and 0.46. Improved 3-year DFS with TAC was found in the luminal B group (P = .025) and a combined ER-positive/HER2-negative group treated with tamoxifen (P = .041), with a marginal trend in the triple negatives (P = .051) and HER2 (P = .068) subtypes. No DFS advantage was seen in the luminal A population.Conclusion: A simple immunopanel can divide breast cancers into biologic subtypes with strong prognostic effects. TAC significantly complements endocrine therapy in patients with luminal B subtype and, in the absence of targeted therapy, is effective in the triple-negative population. 10.1200/JCO.2008.18.1024}, author = {Hugh, Judith and Hanson, John and Cheang, Maggie C. and Nielsen, Torsten O. and Perou, Charles M. and Dumontet, Charles and Reed, John and Krajewska, Maryla and Treilleux, Isabelle and Rupin, Matthieu and Magherini, Emmanuelle and Mackey, John and Martin, Miguel and Vogel, Charles}, citeulike-article-id = {6088394}, citeulike-linkout-0 = {http://dx.doi.org/10.1200/JCO.2008.18.1024}, citeulike-linkout-1 = {http://jco.ascopubs.org/content/JCO.2008.18.1024v1/.abstract}, citeulike-linkout-2 = {http://jco.ascopubs.org/content/JCO.2008.18.1024v1/.full.pdf}, citeulike-linkout-3 = {http://view.ncbi.nlm.nih.gov/pubmed/19204205}, citeulike-linkout-4 = {http://www.hubmed.org/display.cgi?uids=19204205}, day = {9}, doi = {10.1200/JCO.2008.18.1024}, journal = {J Clin Oncol}, keywords = {breast\_cancer, subtypes, therapy, trial}, month = {February}, pages = {JCO.2008.18.1024+}, posted-at = {2009-11-09 13:36:25}, priority = {3}, title = {Breast Cancer Subtypes and Response to Docetaxel in Node-Positive Breast Cancer: Use of an Immunohistochemical Definition in the BCIRG 001 Trial}, url = {http://dx.doi.org/10.1200/JCO.2008.18.1024}, year = {2009} }

TY - JOUR ID - citeulike:6088394 L3 - citeulike-article-id:6088394 N2 - Purpose: To investigate the prognostic and predictive significance of subtyping node-positive early breast cancer by immunohistochemistry in a clinical trial of a docetaxel-containing regimen.Methods: Pathologic data from a central laboratory were available for 1,350 patients (91%) from the BCIRG 001 trial of docetaxel, doxorubicin, and cyclophosphamide (TAC) versus fluorouracil, doxorubicin, and cyclophosphamide (FAC) for operable node-positive breast cancer. Patients were classified by tumor characteristics as (1) triple negative (estrogen receptor [ER]-negative, progesterone receptor [PR]-negative, HER2/neu [HER2]-negative), (2) HER2 (HER2-positive, ER-negative, PR-negative), (3) luminal B (ER-positive and/or PR-positive and either HER2-positive and/or Ki67high), and (4) luminal A (ER-positive and/or PR-positive and not HER2-positive or Ki67high), and assessed for prognostic significance and response to adjuvant chemotherapy.Results: Patients were subdivided into triple negative (14.5%), HER2 (8.5%), luminal B (61.1%), and luminal A (15.9%). Three-year disease-free survival (DFS) rates (P values with luminal B as referent) were 67% (P < .0001), 68% (P = .0008), 82% (referent luminal B), and 91% (P = .0027), respectively, with hazard ratios of 2.22, 2.12, and 0.46. Improved 3-year DFS with TAC was found in the luminal B group (P = .025) and a combined ER-positive/HER2-negative group treated with tamoxifen (P = .041), with a marginal trend in the triple negatives (P = .051) and HER2 (P = .068) subtypes. No DFS advantage was seen in the luminal A population.Conclusion: A simple immunopanel can divide breast cancers into biologic subtypes with strong prognostic effects. TAC significantly complements endocrine therapy in patients with luminal B subtype and, in the absence of targeted therapy, is effective in the triple-negative population. 10.1200/JCO.2008.18.1024 JF - J Clin Oncol TI - Breast Cancer Subtypes and Response to Docetaxel in Node-Positive Breast Cancer: Use of an Immunohistochemical Definition in the BCIRG 001 Trial SP - JCO.2008.18.1024 KW - breast_cancer KW - subtypes KW - therapy KW - trial AU - Hugh, Judith AU - Hanson, John AU - Cheang, Maggie AU - Nielsen, Torsten AU - Perou, Charles AU - Dumontet, Charles AU - Reed, John AU - Krajewska, Maryla AU - Treilleux, Isabelle AU - Rupin, Matthieu AU - Magherini, Emmanuelle AU - Mackey, John AU - Martin, Miguel AU - Vogel, Charles PY - 2009/02/09/ UR - http://dx.doi.org/10.1200/JCO.2008.18.1024 ER -