石蜡包埋的粗针活检组织的Oncotype DX®复发评分对预测乳腺癌女性新辅助化疗反应的影响。

The impact of Oncotype DX® recurrence score of paraffin-embedded core biopsy tissues in predicting response to neoadjuvant chemotherapy in women with breast cancer.

作者信息

Soran Atilla, Bhargava Rohit, Johnson Ronald, Ahrendt Gretchen, Bonaventura Marguerite, Diego Emilia, McAuliffe Priscilla F, Serrano Merida, Menekse Ebru, Sezgin Efe, McGuire Kandace P

机构信息

Department of Surgery, Division of Surgical Oncology, University of Pittsburgh, Pittsburgh, PA, USA.

Department of Pathology, Magee-Womens Hospital of UPMC, University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

Breast Dis. 2016 Jul 28;36(2-3):65-71. doi: 10.3233/BD-150199.

DOI:10.3233/BD-150199

PMID:27662272

Abstract

BACKGROUND

Oncotype DX® test is beneficial in predicting recurrence free survival in estrogen receptor positive (ER+) breast cancer. Ability of the assay to predict response to neoadjuvant chemotherapy (NCT) is less well-studied.

OBJECTIVE

We hypothesize a positive association between the Oncotype DX® recurrence score (RS) and the percentage tumor response (%TR) after NCT.

METHODS

Pre-therapy RS was measured on core biopsies from 60 patients with ER+, HER2- invasive breast cancer (IBC) who then received NCT. Pre-therapy tumor size was measured using imaging. %TR, partial response (PR; >50%), pathologic complete response (pCR) and breast conserving surgery (BCS) rates were measured.

RESULTS

Median RS was 20 (2-69). Median %TR was 42 (0-97)%. PR was observed in 43% of patients. There was no association between %TR and pre-NCT tumor size, age, Nottingham score or nodal status (p > 0.05). No statistically significant association with %TR was seen with RS as a categorical or continuous variable (p = 0.21 and 0.7, respectively). Response to NCT improved as ER (p = 0.02) by RT-PCR decreased. Lower ER expression by IHC correlated with response (p = 0.03).

CONCLUSIONS

In patients with ER+ IBC receiving NCT, RS did not predict response to NCT using %TR. The benefit of the assay prior to NCT requires further study.

摘要

背景

Oncotype DX®检测有助于预测雌激素受体阳性（ER+）乳腺癌的无复发生存率。该检测预测新辅助化疗（NCT）反应的能力研究较少。

目的

我们假设Oncotype DX®复发评分（RS）与NCT后的肿瘤反应百分比（%TR）之间存在正相关。

方法

对60例ER+、HER2-浸润性乳腺癌（IBC）患者的核心活检组织进行治疗前RS检测，这些患者随后接受NCT。使用影像学测量治疗前肿瘤大小。测量%TR、部分缓解（PR；>50%）、病理完全缓解（pCR）和保乳手术（BCS）率。

结果

RS中位数为20（2-69）。%TR中位数为42（0-97）%。43%的患者观察到PR。%TR与NCT前肿瘤大小、年龄、诺丁汉评分或淋巴结状态之间无关联（p>0.05）。RS作为分类变量或连续变量与%TR均无统计学显著关联（分别为p=0.21和0.7）。随着逆转录聚合酶链反应（RT-PCR）检测的雌激素受体（ER）降低，对NCT的反应改善。免疫组化检测显示较低的ER表达与反应相关（p=0.03）。