Abstract
Improving the efficiency of treatment of locally distributed forms of breast cancer (BC) patients is relevant. The aim of the study: to determine the possibility of increasing the efficiency of treatment of patients with locally distributed BC by supplementing it with the determination of the expression of TOP2 alpha and beta-tubulin III genes in the primary tumor during various chemotherapy regimens. Method. 139 patients with locally distributed BC were examined. Patients received 2-4 courses of neoadjuvant chemotherapy (NAChT) according to the TC (docetaxel + cyclophosphamide) and TAC (docetaxel + doxorubicin + cyclophosphamide) regimens, subsequent surgical intervention and 2–4 courses of AchT according to the FAC regimen. Immunohistochemical (IHCh) study of the levels of estrogen receptors (ER), progesterone (PR), epidermal growth factor (HER2) in tumors was conducted. The expression of TOP2 alpha and beta-tubulin class III genes was determined using PCR. Statistical data processing was performed using the program Stastistica for Windows 6. 0, Excel. Results. In the third cycle of chemotherapy, patients were transferred from the TC scheme to the TAC scheme. The frequency of the FPR increased 4 times in the group of patients with a triple negative tumor subtype compared with patients with luminal B. A combination of low expression of the class III beta-tubulin gene with high expression of TOP2 alpha in tumor tissue was found in 64.5 % of patients treated according to the TAC + cross over regimen and in 56.3 % of cases according to the TC regimen. A change in the receptor status of MLN after NAChT was detected in some cases. Conclusions. The combination of high expression of TOP2 alpha with low expression of class III beta-tubulins can be considered as a predictive sign of full pathomorphological response when using taxane-containing locally distributed BC. These markers can be recommended for determination in MLN (along with definition of ER, PR, HER2) in order to increase the effectiveness of AchT.
Highlights
Breast cancer (BC) among the oncological pathologies in women by incidence in recent years has come first in the world
In connection with the foregoing, the aim of this study was to determine the possibility of increasing the effectiveness of treatment of patients with locally distributed BC by supplementing it with the determination of the expression of topoisomerase II alpha (TOP2 alpha) and beta-tubulin III genes in the primary tumor during various chemotherapy regimens
There were no significant differences between taxane-containing chemotherapy with the addition of anthracyclines and without them with a complete pathomorphological response (T0N0) due to the fact that in the third cycle of PCT, patients were transferred from the TC scheme to the TAC scheme, since the stabilization found in them was regarded as insufficient answer
Summary
Breast cancer (BC) among the oncological pathologies in women by incidence in recent years has come first in the world. More than 400 thousand women die from this disease [1]. In Ukraine, according to data of Cancer-Register of 2016–2017, [2], the incidence of breast cancer was 74.4, mortality 30.2 per 100 thousand of the population. The high incidence of breast cancer and mortality from this pathology, the high recurrence rate after standard treatment requires further study of ways to increase the efficiency of treatment for breast cancer and makes this issue relevant. Based on the immunohistochemical (IHCh) analysis of estrogen receptors (ER) and progesterone (PR), epidermal growth factor receptor 2 (HER2), some cytokeratins, the expression level of the Ki-67 proliferation marker, a breast cancer classification was created,
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