Breast Cancer Research and Treatment

, Volume 108, Issue 2, pp 183–190

HER2 expression and efficacy of preoperative paclitaxel/FAC chemotherapy in breast cancer

Authors

  • Fabrice Andre
    • Breast Cancer Unit and Translational Research Unit UPRES03535Institut Gustave Roussy
    • Department of Breast Medical Oncology, Unit 1354The University of Texas M. D. Anderson Cancer Center
  • Chafika Mazouni
    • Department of Breast Medical Oncology, Unit 1354The University of Texas M. D. Anderson Cancer Center
  • Cornelia Liedtke
    • Department of Breast Medical Oncology, Unit 1354The University of Texas M. D. Anderson Cancer Center
  • Shu-Wan Kau
    • Department of Breast Medical Oncology, Unit 1354The University of Texas M. D. Anderson Cancer Center
  • Debby Frye
    • Department of Breast Medical Oncology, Unit 1354The University of Texas M. D. Anderson Cancer Center
  • Marjorie Green
    • Department of Breast Medical Oncology, Unit 1354The University of Texas M. D. Anderson Cancer Center
  • Ana M. Gonzalez-Angulo
    • Department of Breast Medical Oncology, Unit 1354The University of Texas M. D. Anderson Cancer Center
  • W. Fraser Symmans
    • Department of PathologyThe University of Texas M. D. Anderson Cancer Center
  • Gabriel N. Hortobagyi
    • Department of Breast Medical Oncology, Unit 1354The University of Texas M. D. Anderson Cancer Center
    • Department of Breast Medical Oncology, Unit 1354The University of Texas M. D. Anderson Cancer Center
Preclinical Study

DOI: 10.1007/s10549-007-9594-8

Cite this article as:
Andre, F., Mazouni, C., Liedtke, C. et al. Breast Cancer Res Treat (2008) 108: 183. doi:10.1007/s10549-007-9594-8

Abstract

Purpose

We examined the correlation between HER2 expression and pathologic complete response (pCR) to paclitaxel/FAC (T/FAC) preoperative chemotherapy in breast cancer.

Patients and Methods

Retrospective analysis of data including 534 patients treated with preoperative T/FAC was performed. Gene expression results were available from two datasets of 132 and 286 patients, and were used to examine the co-expression of HER2 and topoisomerase II α (TOP2A) and microtubule associated protein tau (MAP-Tau).

Results

Of the 534 patients, 105 (20%) had HER2-overexpressing breast cancer. The pCR rates were 33% and 15% for patients with HER2+ and HER2- tumors (< 0.001). The 5-year relapse-free survival rates were 94% and 70% in HER2+ tumors with and without pCR (= 0.009). HER2 overexpression (odds ratio 2.3, 95%CI: 1.3–3.9, = 0.004), estrogen receptor (ER) status, grade and weekly schedule of paclitaxel were each significantly and independently associated with pCR in multivariate analysis. When patients were stratified by ER status, the pCR rates were 50% for HER2+/ER−, 30% for HER2−/ER−, 19% for HER2+/ER+, and 6% for HER2−/ER+ tumors. HER2 overexpression was associated with lower expression of MAP-tau (P = 0.001 and P < 0.001) and higher expression of TOP2A mRNAs (P = 0.048 and P = 0.001) in patients with ER+ disease. ER− cancers had low MAP-tau expression regardless of HER-status.

Conclusion

HER2 overexpression is associated with higher rate of pCR to preoperative T/FAC chemotherapy regardless of ER status. HER2 overexpression also correlates with increased TOP2A and decreased MAP-tau expression in ER-positive cancers.

Keywords

Breast neoplasmsChemotherapyPredictive biomarkerHER2Estrogen receptorTauTopoisomerase 2αPaclitaxelAnthracycline

Copyright information

© Springer Science+Business Media, LLC 2007