Abstract
673 Background: Positive HR constitutes by their presence a favourable prognosis factor and predicts response to an adjuvant hormonal therapy. In breast cancer treated by NCT, HR expression has been shown to be modified in residual disease after induction chemotherapy (Miyoshi Y and al., Clin Cancer Res. 2004). Methods: A second centralized comparative lecture of oestrogenic and progestative receptors was realized by IHC. HR status was evaluated in a blinded fashion by two pathologists, on 414 out of 710 patients from several prospective phase II trials. Cut off value for positivity was 10% tumor cells (Amat et al, Breast Cancer Res Treat 2005). Median age of patients was 49.5 years. 555 (78%) patients had a ductal, 90 (13%) a lobular and 65 (9%) other type carcinoma, with a median size of 40 mm. Response was evaluated before, during and after a median number of 6 courses (1–9) of NCT. Study is curently ongoing. Results: Among these414 tumors, 157 (38%) were HR negative and 257 (62%) positive before NCT. HR status was changed in 105 patients (25%): 75 patients (48%) initially HR negative became HR positive. This HR positive switch was significantly correlated with a better overall survival (OS), compared with the unchanged HR negative tumors (p=0.032). However, HR positive switch had no effect on the disease free survival (p=0.085). More details concerning RH status and effect on hormonal adjuvant treatment will be presented.Conversely, Among the 257 HR positive tumors, 30 (12%) became negative after NCT, without effect on OS (p=0.28). Conclusions: We have previously shown that residual disease after NCT, rather than parameters evaluated on initial biopsy, must be considered for patients’ prognosis. NCT induced variations in HR status in 25% of patients; a positive switch was a strong prognostic indicator for patients outcome. No significant financial relationships to disclose.
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