Expérience de l’institut Paoli-Calmettes concernant la chimiothérapie à haute dose et autogreffe de cellules souches hématopoïétiques pour la prise en charge des cancers mammaires : impact du statut Her2 et BRCA1/2

Abstract

Studies evaluating chemotherapy high dose chemotherapy with autologous haematopoietic stem cell transplantation (HDC-ACSH) in the treatment of metastatic (MBC), locally advanced (LABC) and inflammatory (IBC) breast cancer have in common lack of biomarker information, in particular the HER2status. All consecutive female patients treated for breast cancer with HDC and AHSCT at Institut Paoli Calmettes between 2003and 2012were included. Patients were categorized in three subtypes based on hormonal receptor (HR) and HER2status of the primary tumor: luminal, (HR+/HER2-), HER2 (HER2+, any HR) and triple negative (TN) (HER2- and HR-). The main objective was the analysis of overall survival (OS) according to the IHC subtypes. Three hundred and seventy-seven patients were included. For MBC, the TN subtype appeared to have the worst prognosis with a median OS of 19.68months (95% CI 11.76-44.4) compared to 44.64months (95% CI 40.32-67.56) for the luminal subtype and a median OS not reached for the HER2subtype (P<0.01). For IBC, HER2subgroup appeared to have the best prognosis with a 5-year OS of 89% (95% CI 64-97) compared to 57% (95% CI 33-76) for the TN subgroup (HR 5.38, 95% CI 1.14-25.44; P=0.034). For CSLA, luminal subgroup appeared to have the best prognosis with a 5-year OS of 92% (95% CI 71-98) against 75% (95% CI 46-90) for HER 2subtype and 70% (95%CI 97-88) for TN subtype (P=0.301). The HDC-ACSH does not change the prognosis value of IHC subtype in breast cancer patients.