Study of serum EGFR, HER-2/neu,VEGF in metastatic breast cancer patients treated with taxanes

Abstract

757 Background: Novel drugs with activity against EGFR,Her-2/neu,VEGF are used in clinical practice. Previous studies have examined the possible prognostic and predictive role of soluble EGFR, Her-2/neu,VEGF, in metastatic breast cancer(MBC) with various results.We examine whether their combined measurement has any prognostic or predictive role. Methods: Retrospective analysis of frozen serum from women with MBC who received first line taxane based chemotherapy. Analysis was performed centrally with the use of commercially available ELISA. Specifically for EGFR and Her-2/neu a Microtiter ELISA (Bayer Diagnostics) and for VEGF a Microliter ELISA (R &D System). Normal values were calculated according to previous published literature. Results: Demographics: Total 41 women with a median age of 54, 54% premenopausal,51% postmenopausal,61% were ER positive 39% negative. Serum was drawn prior to chemotherapy. All patients received first line treatment: 22 Paclitaxel /Epirubicin,8 Paclitaxel /Carboplatin,8 Paclitaxel /Trastuzumab,3 Paclitaxel/Gemcitabine/Trastuzumab. Complete response had 10% partial response 49%.After a median follow-up of 46,7(3,2–62,8) months 38 patients have relapsed and 28 have died yielding a median TTP of 13,4 mo and a median OS of 34,8 mo. EGFR was abnormal in 51%,Her-2/neu in 61% and VEGF in 54%. 6/41 patients over-expressed all three markers and 7/41 none. OS was statistically worse for patients who had all abnormal (p=0.027 long rank) compared to those with all normal with median overall survival of 44,1 vs 10 months. Elevated Her-2/neu and elevated VEGF showed a trend for decreased OS ( p=0.0564,p=0.0519 respectively ). Patients with abnormal Her-2/neu who received trastuzumab based therapy had a better TTP (p=0.043). Conclusions: In this small retrospective analysis the group of MBC patients with elevated serum EGFR, Her -2/neu and VEGF seem to have a worse prognosis and trastuzumab based therapy seems to benefit patients with abnormal serum Her-2/neu level. Further study in larger groups of patients with MBC is warranted along with serial measurement during targeted therapy. No significant financial relationships to disclose.