ERCC1 expression in triple negative breast carcinoma: the paradox revisited
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- Sidoni, A., Cartaginese, F., Colozza, M. et al. Breast Cancer Res Treat (2008) 111: 569. doi:10.1007/s10549-007-9804-4
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To date it is not clear if the TN category corresponds completely to the basal-like group . However, patients with TN carcinomas are clinically relevant because the clinical behaviour is more aggressive  and since chemotherapy is the only treatment available due to lack of specific molecular targets .
This latter aspect has been called “the triple negative paradox”  based on an apparent better response to chemotherapeutics.
The study by Tan et al.  published in your Journal, conducted on a large series of TN breast carcinomas, gives a poor clinical outcome after anthracycline treatment.
The Authors claim that TN do not correspond precisely to the basal-like category however, triple negativity remains an adverse prognostic marker for which alternative first-line chemotherapeutic regimens are required.
A suitable option for patients with TN tumours may be a platinum-based therapy. A previous study conducted on non small cell lung cancers demonstrated that a common cause of cisplatin resistance may be related to ERCC1 (excision repair cross-complementation group 1) expression .
In view of a possible use of platinum-based therapy in TN breast cancer we decided to examine the ERCC1 expression in a group of 81 carcinomas with 0% expression of ER, PR and HER-2.
Our results demonstrate that about one third of the TN breast cancers harbour a relevant expression of ERCC1 that may be predictive of a poor response to platinum-based chemotherapies.
Therefore, we suggest that the immunohistochemical screening for ERCC1 in TN breast cancers could be a useful tool for a better identification of patients who may benefit from platinum-containing treatments.