Abstract
BackgroundTriple-negative breast cancer (TNBC) is considered to be higher grade, more aggressive and have a poorer prognosis than other types of breast cancer. Discover biomarkers in TNBC for risk stratification and treatments that improve prognosis are in dire need.MethodsClinical data of 195 patients with triple negative breast cancer confirmed by pathological examination and received neoadjuvant chemotherapy (NAC) were collected. The expression levels of EGFR and CK5/6 were measured before and after NAC, and the relationship between EGFR and CK5/6 expression and its effect on prognosis of chemotherapy was analyzed.ResultsThe overall response rate (ORR) was 86.2% and the pathological complete remission rate (pCR) was 29.2%. Univariate and multivariate logistic regression analysis showed that cT (clinical Tumor stages) stage was an independent factor affecting chemotherapy outcome. Multivariate Cox regression analysis showed pCR, chemotherapy effect, ypT, ypN, histological grades, and post- NAC expression of CK5/6 significantly affected prognosis. The prognosis of CK5/6-positive patients after NAC was worse than that of CK5/6-negative patients (p=0.036). Changes in CK5/6 and EGFR expression did not significantly affect the effect of chemotherapy, but changes from positive to negative expression of these two markers are associated with a tendency to improve prognosis.ConclusionFor late-stage triple negative breast cancer patients receiving NAC, patients who achieved pCR had a better prognosis than those with non- pCR. Patients with the change in expression of EGFR and CK5/6 from positive to negative after neoadjuvant chemotherapy predicted a better prognosis than the change from negative to positive group.
Highlights
Triple negative breast cancer (TNBC) which is defined by the lack of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (Her-2) accounts for 10–20% of all breast cancer
138 of 195 cases were feasible for IHC testing in which Basal-like breast cancer (BLBC) accounted for 92.7% (123/138) while non-basal-like breast cancer (NBLBC) accounted for only 7.3% (15/138)
The results showed that there was no significant difference in age, menopausal status, cT stage, Ki-67 and p53 expression between the two groups
Summary
Triple negative breast cancer (TNBC) which is defined by the lack of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (Her-2) accounts for 10–20% of all breast cancer. Over expression of EGFR in most basal-like breast cancer suggests that basal-like tumors may be caused by excessive activation of the growth factor receptor pathway in a manner similar to Her-2+ breast cancer. Since anti-Her-2 therapy has shown to be effective in treating Her-2+ breast cancer, a similar strategy using anti-Her-1 antibodies or blockers of Her-1 tyrosine kinase may be beneficial. This is especially important as it may offer new prospects for the treatment of triple negative BCBL [5, 6]. Discover biomarkers in TNBC for risk stratification and treatments that improve prognosis are in dire need
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