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Value of post-operative reassessment of estrogen receptor alpha expression following neoadjuvant chemotherapy with or without gefitinib for estrogen receptor negative breast cancer

In English

Författare

  • Mogens Bernsdorf
  • Eva Balslev
  • Anne E. Lykkesfeldt
  • Niels Kroman
  • Eva Harder
  • Hans von der Maase
  • Erik H. Jakobsen
  • Dorthe Grabau
  • Bent Ejlertsen

Summary, in English

The NICE trial was designed to evaluate the possible benefits of adding epidermal growth factor receptor targeted therapy to neoadjuvant chemotherapy in patients with estrogen receptor alpha (ER) negative and operable breast cancer. Preclinical data have suggested that signalling through the ErbB receptors or downstream effectors may repress ER expression. Here the authors investigated whether gefitinib, given neoadjuvant in combination with epirubicin and cyclophosphamide (EC), could restore ER expression. Eligible patients in the NICE trial were women with unilateral, primary operable, ER negative invasive breast cancer a parts per thousand yen2 cm. Material from patients randomized and completing treatment (four cycles of neoadjuvant EC plus 12 weeks of either gefitinib or placebo) in the NICE trial having available ER status both at baseline and after neoadjuvant treatment were eligible for this study. Tumors with indication of changed ER phenotype (based on collected pathology reports) were immunohistochemically reassessed centrally. 115 patients were eligible for this study; 59 patients in the gefitinib group and 56 patients in the placebo group. Five (4.3%) of 115 tumors changed ER phenotype from negative to positive. A change was seen in three patients in the gefitinib (5.1%) and in two patients in the placebo (3.6%) group with a difference of 1.51% (95% CI, -6.1-9.1). Results of the NICE trial have been reported previously. Post-operative reassessment of ER expression changed the assessment of ER status in a small but significant fraction of patients and should, whenever possible, be performed following neoadjuvant chemotherapy for ER negative breast cancer. Gefitinib did not affect the reversion rate of ER negative tumors.

Avdelning/ar

Publiceringsår

2011

Språk

Engelska

Sidor

165-170

Publikation/Tidskrift/Serie

Breast Cancer Research and Treatment

Volym

128

Issue

1

Dokumenttyp

Artikel i tidskrift

Förlag

Springer

Ämne

  • Cancer and Oncology

Nyckelord

  • Breast cancer
  • Neoadjuvant
  • Estrogen receptor
  • Phenotype changes
  • Post-operative reassessment

Status

Published

ISBN/ISSN/Övrigt

  • ISSN: 1573-7217