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Review
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Korean J Med. 2006;71(1):177-177.
- Prognostic role of EGFR expression in breast cancer patients who received neoadjuvant docetaxel and doxorubicin chemotherapy
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Bhumsuk Keam, Seock-Ah Im, Hee-Jun Kim, Hye-Suk Han, Sang-Yoon Lee, Do-Youn Oh, Eui Kyu Chie, Jee Hyun Kim, Wonshik Han, Woo Kyung Moon, Tae-You Kim, In Ae Park, Dong-Young Noh, Sung Whan Ha and Yung-Jue Bang,
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- Prognostic role of EGFR expression in breast cancer patients who received neoadjuvant docetaxel and doxorubicin chemotherapy
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경북대학교 의과대학 내과학교실1, 계명대학교 의과대학 내과학교실2
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- Abstract
- Background : EGFR is reported to be associated with a poor clinical outcome in breast cancer, but its prognostic value remains still
controversial. The purpose of this study was to evaluate the predictive and prognostic value of EGFR expression in breast cancer patients
who received neoadjuvant chemotherapy. Methods : A total of 100 breast cancer patients who clinically staged II and III were evaluated.
The patients received neoadjuvant docetaxel and doxorubicin chemotherapy followed by surgery. To assess the role of EGFR, we
examined the conventional clinicopathologic factors including the seven different biological factors (ER, PR, p53, c-erbB2, bcl-2, Ki-67
and EGFR) by immunohistochemistry and evaluated their association with clinical outcomes. Results : Overall clinical response rate was
70.0% and pCR were achieved in 6 patients (6.0%). EGFR were positive in 8 (8.3%) of 96 cases and inversely correlated with ER
expression (p=0.066). Among the seven immunohistochemical markers, none of the markers showed significant association with clinical
response rate. There was no significant difference in the response rate according to EGFR status (71.6% vs 75.0%, p=0.837). Response
to neoadjuvant chemotherapy was not associated with disease free survival (DFS) or overall survival (OS). Positive ER, low level of
Ki-67 and negative EGFR status were associated with prolonged DFS in univariate analysis. Patients with EGFR expression had a
significantly shorter DFS (median 9.8 months in EGFR (+) vs. 34.9 months in EGFR (-), p<0.001) and OS (median 34.1 months in EGFR
(+) vs. not reached in EGFR (-), p=0.004). In multivariate analysis, only EGFR expression was an independent prognostic factor for DFS
and OS (HR= 20.919, p=0.001; HR= 45.393, p=0.016, respectively). Even though EGFR expression was correlated with negative ER status,
EGFR expression was more strongly associated with DFS and OS, independently from ER status. Conclusion : EGFR expression was
an independent prognostic factor for DFS and OS unrelated with ER status. However, EGFR expression was not a predictive factor for
response to neoadjuvant chemotherapy in stage II and III breast cancer.
Keywords :
