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High-grade breast cancers include both highly sensitive and highly resistant subsets to cytotoxic chemotherapy

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Abstract

Purpose

We reported that breast cancers achieving pathological complete response (pCR) or progressive disease (PD) to neoadjuvant chemotherapy (NAC), which are considered exact opposites on the chemosensitivity spectrum, have certain clinicopathological features in common. To determine the highly sensitive and highly resistant subsets to cytotoxic chemotherapy, we evaluated predictive factors for pCR and PD to NAC, and assessed the similarities in these factors.

Methods

Subjects comprised 300 women with 304 stage II or III breast cancers treated with chemotherapy that was anthracycline-based, taxane, or both, followed by surgery between 2007 and 2008. We retrospectively evaluated pre-NAC clinicopathological features including chemotherapy regimen, clinical T stage, nuclear grade (NG), hormone receptor (HR) status, and human epidermal growth factor receptor-2 (HER2) status in pCR and PD, using univariate χ2 testing and multivariate logistic regression analyses.

Results

Of 304 tumors, 30 (10%) achieved pCR and 22 (7%) showed PD to NAC. Multivariate analysis demonstrated that anthracycline plus taxane chemotherapy (P = 0.006), NG3 (P = 0.006), HR-negativity (P = 0.013), and HER2-positivity (P = 0.010) were significant predictors of pCR, and T3–4 (P = 0.002) and NG3 (P = 0.010) were significant predictors of PD.

Conclusions

High-grade breast cancers include both highly sensitive and highly resistant subsets to cytotoxic chemotherapy. Three factors can help discriminate between these subsets. HR-negative and HER2-positive can be predictive of high chemosensitivity. Advanced primary tumor stage can be predictive of high chemoresistance.

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Authors and Affiliations

  1. Divisions of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Tomo Osako, Rie Horii, Kaoru Domoto, Yoshimi Ide & Futoshi Akiyama

  2. Divisions of Cancer Genome Research, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan

    Masaaki Matsuura

  3. Divisions of Breast Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

    Yumi Miyagi & Takuji Iwase

  4. Divisions of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

    Shunji Takahashi & Yoshinori Ito

Authors
  1. Tomo Osako
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  2. Rie Horii
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  3. Masaaki Matsuura
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  4. Kaoru Domoto
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  5. Yoshimi Ide
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  6. Yumi Miyagi
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  7. Shunji Takahashi
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  8. Yoshinori Ito
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  9. Takuji Iwase
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  10. Futoshi Akiyama
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Correspondence to Tomo Osako.

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Osako, T., Horii, R., Matsuura, M. et al. High-grade breast cancers include both highly sensitive and highly resistant subsets to cytotoxic chemotherapy. J Cancer Res Clin Oncol 136, 1431–1438 (2010). https://doi.org/10.1007/s00432-010-0798-7

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  • DOI: https://doi.org/10.1007/s00432-010-0798-7

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