Skip to main content

Advertisement

SpringerLink
Log in

Effect of neoadjuvant anthracycline–taxane-based chemotherapy in different biological breast cancer phenotypes: overall results from the GeparTrio study

  • Clinical trial
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

In order to explore the effect of neoadjuvant chemotherapy (NACT) on clinical mid-course and pathological complete response (pCR) at surgery in different biological breast cancer subtypes. The GeparTrio study included 2,072 patients with operable or locally advanced breast cancer. After two cycles with docetaxel, doxorubicin and cyclophosphamide (TAC) patients were randomized according to their clinical response. Clinical and biological factors were assessed for predicting clinically mid-course response and pCR at surgery. The overall pCR rate, defined as no invasive residuals in breast and axilla, was 20.5%. The highest pCR rate of 57% was observed in patients below 40 years of age with triple negative or grade 3 tumors. Independent factors for mid-course response and pCR were: young age, non-T4 tumors, high grade, and hormone receptor status, the strongest single predictive factor. Within the biological subtypes, grading was an independent factor to predict pCR for luminal tumors, clinical tumor stage for the HER2 like tumors and age for the triple negative ones. Grading gave independent information for mid-course response within the triple negative group. No factor predicted mid-course response within the other groups. Grading and age can identify subgroups within the luminal and triple negative patients who have an increased benefit from NACT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Darb-Esfahani S, Loibl S, Müller BM et al (2009) Identification of biology-based breast cancer types with distinct predictive and prognostic features: role of steroid hormone and HER2 receptor expression in patients treated with neoadjuvant anthracycline/taxane-based chemotherapy. Breast Cancer Res 11:R69

    Article  PubMed  Google Scholar 

  2. von Minckwitz G, Sinn HP, Raab G et al (2008) Clinical response after two cycles compared to HER2, Ki-67, p53, and bcl-2 in independently predicting a pathological complete response after preoperative chemotherapy in patients with operable carcinoma of the breast. Breast Cancer Res 10(2):R30

    Article  Google Scholar 

  3. Rouzier R, Perou CM, Symmans WF et al (2005) Breast cancer molecular subtypes respond differently to preoperative chemotherapy. Clin Cancer Res 11:5678–5685

    Article  CAS  PubMed  Google Scholar 

  4. Colleoni M, Viale G, Zahrieh D et al (2008) Expression of ER, PgR, HER1, HER2 and response: a study of preoperative chemotherapy. Ann Oncol 19:465–472

    Article  CAS  PubMed  Google Scholar 

  5. Colleoni M, Bagnardi V, Rotmensz N et al (2009) Increasing steroid hormone receptors expression defines breast cancer subtypes non responsive to preoperative chemotherapy. Breast Cancer Res Treat 116:359–369

    Article  CAS  PubMed  Google Scholar 

  6. von Minckwitz G, Raab G, Caputo A et al (2005) Doxorubicin with cyclophosphamide followed by docetaxel every 21 days compared with doxorubicin and docetaxel every 14 days as preoperative treatment in operable breast cancer: the Geparduo study of the German Breast Group. J Clin Oncol 23:2676–2685

    Article  Google Scholar 

  7. von Minckwitz G, Kuemmel S, Vogel P et al (2008) Intensified neoadjuvant chemotherapy in early-responding breast cancer: phase III randomized GeparTrio study. J Natl Cancer Inst 100:552–562

    Article  Google Scholar 

  8. von Minckwitz G, Kümmel S, Vogel P et al (2008) Neoadjuvant vinorelbine–capecitabine versus docetaxel–doxorubicin–cyclophosphamide in early nonresponsive breast cancer: a phase III randomized GeparTrio trial. J Natl Cancer Inst 100:542–551

    Article  Google Scholar 

  9. Sinn HP, Schmid H, Junkermann H et al (1994) Histological regression of breast cancer after primary (neoadjuvant) chemotherapy. Geburtsh u Frauenheilk 54:552–558

    Article  CAS  Google Scholar 

  10. Loibl S, Müller B, Roller M et al. (2008) Local versus central HER2 immunohistochemistry correlates with kinetic RT-PCR but only central immunohistochemistry and RT-PCR predict pathological complete response: results from the neoadjuvant multicenter Gepar-Trio trial. Cancer Res 69(Suppl) (2): Abstract 1070

    Google Scholar 

  11. Guarneri V, Broglio K, Kau S-W et al (2006) Prognostic value of pathological complete response after primary chemotherapy in relation to hormone receptor status and other factors. J Clin Oncol 24:1037–1044

    Article  PubMed  Google Scholar 

  12. Sorlie T, Perou CM, Tibshirani R et al (2001) Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA 98:10869–10874

    Article  CAS  PubMed  Google Scholar 

  13. Liedtke C, Hatzis C, Symmans FW et al (2009) Genomic Grade Index is associated with response to chemotherapy in patients with breast cancer. J Clin Oncol 27:3185–3191

    Article  PubMed  Google Scholar 

  14. von Minckwitz G, Budczies J, Loibl S et al. (2009) Validated 3 gene signature predicts response to neo-adjuvant chemotherapy in luminal breast cancer—results from GeparTrio and GeparQuattro study. Cancer Res 69(Suppl) (24): Abstract 2132

    Google Scholar 

  15. Mazoumi C, Peintinger F, Wan-Kau S et al (2007) Residual carcinoma in situ in patients with complete eradication of invasive breast cancer after neoadjuvant chemotherapy does not adversely affect patient outcome. J Clin Oncol 25:2650–2655

    Article  Google Scholar 

  16. Goldstein NS, Decker D, Severson D et al (2007) Molecular classification system identifies invasive breast carcinoma patients who are most likely and those who are least likely to achieve a complete pathologic response after neoadjuvant chemotherapy. Cancer 110:1687–1696

    Article  CAS  PubMed  Google Scholar 

  17. Rakha EA, Ellis IO (2009) Triple-negative/basal-like breast cancer: review. Pathology 41:40–47

    Article  PubMed  Google Scholar 

  18. Liedtke C, Mazouni C, Hess KR et al (2008) Response to neoadjuvant chemotherapy and long term-survival in patients with triple negative breast cancer. J Clin Oncol 26:1275–1281

    Article  PubMed  Google Scholar 

  19. Cristofanilli M, Gonzalez-Angulo A, Sneige N et al (2005) Invasive lobular carcinoma classic type: response to primary chemotherapy and survival outcomes. J Clin Oncol 23:41–48

    Article  PubMed  Google Scholar 

  20. Katz A, Saad EA, Porter P et al (2007) Primary systemic chemotherapy of invasive lobular carcinoma of the breast. Lancet Oncol 8:55–62

    Article  CAS  PubMed  Google Scholar 

  21. Pestalozzi BC, Zahrieh D, Mallon E et al (2008) Distinct clinical and prognostic features of infiltrating lobular carcinoma of the breast: combined results of 15 International Breast Cancer Study Group clinical trials. J Clin Oncol 18:3006–3014

    Article  Google Scholar 

  22. Bonnefoi H, Potti A, Delorenzi M et al (2007) Validation of gene signatures that predict the response of breast cancer to neoadjuvant chemotherapy: a substudy of the EORTC 10994/BIG 00-01 clinical trial. Lancet Oncol 8:1071–1078

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Brustzentrum Kantonsspital St. Gallen, St. Gallen, Switzerland

    Jens Huober

  2. Department of Gynaecology, University Tübingen, Tübingen, Germany

    Jens Huober

  3. German Breast Group, Martin-Behaim Str. 12, 63263, Neu-Isenburg, Germany

    Gunter von Minckwitz, Keyur Mehta & Sibylle Loibl

  4. Charité, Institute of Pathology, Translational Tumorpathology Unit, Berlin, Germany

    Carsten Denkert & Silvia Darb-Esfahani

  5. Onkologische Gemeinschaftspraxis am Bethanien Krankenhaus, Frankfurt am Main, Germany

    Hans Tesch

  6. Hospital Sindelfingen-Böblingen, Böblingen, Germany

    Erich Weiss

  7. SRH Waldkliniken, Gera, Germany

    Dirk Michael Zahm

  8. Department of Gynaecology, University Greifswald, Greifswald, Germany

    Antje Belau

  9. St. Markus Hospital, Frankfurt am Main, Germany

    Fariba Khandan

  10. Hospital Rheinfelden, Rheinfelden, Germany

    Maik Hauschild

  11. Department of Gynaecology, Martin Luther University, Halle, Germany

    Christoph Thomssen

  12. Frauenklinik vom Roten Kreuz, München, Germany

    Bernhard Högel

Authors
  1. Jens Huober
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gunter von Minckwitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carsten Denkert
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hans Tesch
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Erich Weiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dirk Michael Zahm
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Antje Belau
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Fariba Khandan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Maik Hauschild
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Christoph Thomssen
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Bernhard Högel
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Silvia Darb-Esfahani
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Keyur Mehta
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Sibylle Loibl
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sibylle Loibl.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 22 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Huober, J., von Minckwitz, G., Denkert, C. et al. Effect of neoadjuvant anthracycline–taxane-based chemotherapy in different biological breast cancer phenotypes: overall results from the GeparTrio study. Breast Cancer Res Treat 124, 133–140 (2010). https://doi.org/10.1007/s10549-010-1103-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-010-1103-9

Keywords

Search

Navigation