Lanfang Yu1, Wei Ke1, Yanli Wang2, Wei Ding2, Bo Wang2, Sui Huang1, Jing Chen1, Xiaoting Wang1, Zhaoyi Wang3, Peng Shen4. 1. Department of Medical Oncology, The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou 310003, PR China. 2. Department of Pathology, The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou 310003, PR China. 3. Department of Medical Microbiology and Immunology, Creighton University, Omaha, NE 68178, USA. 4. Department of Medical Oncology, The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou 310003, PR China. Electronic address: pengshen001@hotmail.com.
Abstract
BACKGROUND: This study is to investigate the predictive and prognostic value of ER-α36 expression in breast cancer patients treated with chemotherapy. METHODS: ER-α36 expression in 120 breast cancer tumors was assessed by an immunohistochemistry assay. All patients were divided into two groups according to the chemotherapy procedure: group A, 50 patients who underwent neoadjuvant chemotherapy before surgery; group B, 70 patients who were performed adjuvant chemotherapy after surgery, and they all took at least two cycles of anthracycline-based and/or paclitaxel-based chemotherapy after surgery. The therapy effect on group A patients was evaluated two cycles later by Response Evaluation Criteria in Solid Tumors version 1.0 (RECIST 1.0). RESULTS: ER-α36 protein was positively expressed in 51 tumor specimens (42.5%) and no correlation was found between the expression of ER-α 36 and the expression of the full-length ER-α (ER-α66), progesterone receptor (PgR), human epidermal growth factor receptor 2 (HER-2), Ki-67, tumor sizes, and the numbers of lymph node metastasis. Patients with ER-α36 negative expression tumors treated with the neoadjuvant chemotherapy had a higher remission rate [partial response: stable: progressed (n) 25:3:1 vs.11:9:1; P=0.009], a better response (86% vs. 52%; P=0.009), and a more favorable outcomes in triple-negative breast cancer patients compared to ER-α36 positive patients and ER-α36 negative expression was correlated with DFS in patients treated with neoadjuvant chemotherapy. CONCLUSIONS: ER-α36 negative tumors benefit more from neoadjuvant chemotherapy and have better prognosis, which may warrant further studies with larger size of the sample.
BACKGROUND: This study is to investigate the predictive and prognostic value of ER-α36 expression in breast cancerpatients treated with chemotherapy. METHODS: ER-α36 expression in 120 breast cancer tumors was assessed by an immunohistochemistry assay. All patients were divided into two groups according to the chemotherapy procedure: group A, 50 patients who underwent neoadjuvant chemotherapy before surgery; group B, 70 patients who were performed adjuvant chemotherapy after surgery, and they all took at least two cycles of anthracycline-based and/or paclitaxel-based chemotherapy after surgery. The therapy effect on group A patients was evaluated two cycles later by Response Evaluation Criteria in Solid Tumors version 1.0 (RECIST 1.0). RESULTS: ER-α36 protein was positively expressed in 51 tumor specimens (42.5%) and no correlation was found between the expression of ER-α 36 and the expression of the full-length ER-α (ER-α66), progesterone receptor (PgR), human epidermal growth factor receptor 2 (HER-2), Ki-67, tumor sizes, and the numbers of lymph node metastasis. Patients with ER-α36 negative expression tumors treated with the neoadjuvant chemotherapy had a higher remission rate [partial response: stable: progressed (n) 25:3:1 vs.11:9:1; P=0.009], a better response (86% vs. 52%; P=0.009), and a more favorable outcomes in triple-negative breast cancerpatients compared to ER-α36 positive patients and ER-α36 negative expression was correlated with DFS in patients treated with neoadjuvant chemotherapy. CONCLUSIONS: ER-α36 negative tumors benefit more from neoadjuvant chemotherapy and have better prognosis, which may warrant further studies with larger size of the sample.