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Evaluation of ER, PgR, HER-2, Ki-67, cyclin D1, and nm23-H1 as predictors of pathological complete response to neoadjuvant chemotherapy for locally advanced breast cancer

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Abstract

The purpose of this study was to evaluate the importance of biological markers to predict pathologic complete response (pCR) to neoadjuvant docetaxel plus epirubicin combination chemotherapy in patients with locally advanced breast cancer (LABC). Two hundred and twenty consecutive patients with LABC who had received neoadjuvant chemotherapy (NCT) with docetaxel and epirubicin from March 2006 to March 2009 were included in this retrospective study. The pre- and post-neoadjuvant chemotherapy (NCT) treatment expression levels and changes of Ki-67 proliferation index, estrogen receptor (ER), progesterone receptor (PgR), epidermal growth factor receptor 2 (HER-2), cyclin D1, and nm23-H1 were detected by immunohistochemistry (IHC). The pCR rate was 9.1% (95% CI, 5.3–12.9%). In univariate analysis, poor tumor differentiation, OR after 2 cycles of NCT, both negative of ER/PgR, negative HER-2, positive cyclin D1, and positive nm23-H1 were found to be significantly predictive of a pCR. Histological grade and ER/PgR status were significant for pCR on multivariate analysis (P = 0.023 and 0.003, respectively). The expression levels of cyclin D1 (median, 8% vs. 9%; P = 0.016) after NCT treatment increased significantly, while the median Ki-67 proliferation index was dramatically decreased after NCT treatment from 35 to 15% (P = 0.036). However, after a Bonferroni adjustment, only the difference of Ki-67 proliferation index was still significant (P = 0.026). Histological grade and ER/PgR status are independent predictive factors of pCR to neoadjuvant docetaxel plus epirubicin combination chemotherapy in locally advanced breast cancer. Expression of HER-2, Ki-67, cyclin D1, and nm23-H1 were not predictive for pCR.

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Acknowledgments

This study is supported in part by Chinese Army Medical Research Fund (06MA245). The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.

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Authors and Affiliations

  1. Division of Breast Surgery, Department of General Surgery, General Hospital of Chinese People’s Liberation Army, No. 28, Fuxing Rd, Beijing, 100853, People’s Republic of China

    Xi-ru Li, Yan-jun Zhang, Jian-dong Wang, Yi-qiong Zheng, Jie Li & Bing Ma

  2. Department of Pathology, General Hospital of Chinese People’s Liberation Army, Beijing, People’s Republic of China

    Mei Liu & Xin Song

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  1. Xi-ru Li
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  2. Mei Liu
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Correspondence to Xi-ru Li.

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Xi-ru Li and Mei Liu contributed equally to this article.

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Li, Xr., Liu, M., Zhang, Yj. et al. Evaluation of ER, PgR, HER-2, Ki-67, cyclin D1, and nm23-H1 as predictors of pathological complete response to neoadjuvant chemotherapy for locally advanced breast cancer. Med Oncol 28 (Suppl 1), 31–38 (2011). https://doi.org/10.1007/s12032-010-9676-z

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  • DOI: https://doi.org/10.1007/s12032-010-9676-z

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