ADJUVANT CHEMOTHERAPY OF PRIMARY OPERABLE LUMINAL B BREAST CANCER WITHOUT OVEREXPRESSION OF HER2/NEU IN POSTMENOPAUSAL WOMEN: YES OR NO?
https://doi.org/10.17650/1994-4098-2017-13-4-29-33
Abstract
Background. Luminal tumors account for 65 % of all breast cancer (BC) cases; however, within this group, there are multiple subtypes with various clinical and morphological characteristics, disease course and prognosis. Choosing an optimal strategy for adjuvant chemotherapy (ACT) in postmenopausal women with primary operable luminal BC B subtype without overexpression of HER2/neu appears to be the most challenging.
Objective: to evaluate treatment outcomes in postmenopausal women with primary operable luminal BC without overexpression of HER2/neu depending on the ACT used.
Materials and methods. We analyzed treatment outcomes in 190 postmenopausal women with stages T1–2N0–1M0 primary operable luminal BC without overexpression of HER2/neu. Of them, 105 patients had luminal BC A subtype, whereas 50 patients were diagnosed with luminal BC B subtype. All patients underwent radical mastectomy or organ-preserving surgery + external beam radiotherapy + adjuvant hormonal therapy with tamoxifen or aromatase inhibitors; 35 patients with luminal BC B subtype additionally had 6 cycles of FAC ACT.
Results. We observed no significant differences in overall and relapse-free survival (assessed using the Kaplan–Meier method) across the groups during 37 months of follow-up (p >0.05).
Conclusions. Luminal BC B subtype without overexpression of HER2/neu is an extremely heterogeneous group in terms of planning ACT, especially in postmenopausal women. Our results encourage to pay particular attention to finding additional biological characteristics of the tumor, which will ensure more individual approach to treatment of these patients.About the Authors
Yu. S. Shatova
Rostov Research Institute of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
63 14th Line, Rostov-on-Don 344037
V. V. Tokmakov
Rostov Research Institute of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
63 14th Line, Rostov-on-Don 344037
L. Yu. Vladimirova
Rostov Research Institute of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
63 14th Line, Rostov-on-Don 344037
L. N. Vaschenko
Rostov Research Institute of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
63 14th Line, Rostov-on-Don 344037
References
1. Ignatiadis M., Sotiriou C. Luminal breast cancer: from biology to treatment. Nat Rev Clin Oncol 2013;10(9);494–506. DOI: 10.1038/nrclinonc.2013.124.
2. Parker C., Krontiras H., Urist M. Molecular targets in breast cancer. In: Current Surgical Therapy. 12th edn. Baltimore: Elsevier, 2017. Pp. 671–674.
3. Sabatier R., Goncalves A., Bertucci F. Personalized medicine: present and future of breast cancer management. Crit Rev Oncol Hematol 2014;91(3):223–33. DOI: 10.1016/j.critrevonc.2014.03.002.
4. Park S., Lee S.K., Paik H.J. et al. Adjuvant endocrine therapy alone in patients with node-positive, luminal A type breast cancer. Medicine (Baltimore) 2017;96(22):e6777. DOI: 10.1097/MD.0000000000006777.
5. Munzone E., Curigliano G., Colleoni M. Tailoring adjuvant treatments for the individual patient with luminal breast cancer. Hematol Oncol Clin North Am 2013;27(4):703–14. DOI: 10.1016/j.hoc.2013.05.012.
6. Siu A.L. Screening for breast cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med 2016;164(4);279–96. DOI: 10.7326/M15-2886.
7. Семенова А.И. Лекарственная терапия у больных пожилого и старческого возраста. Практическая онкология 2015;16(3):117. [Semenova A.I. Pharmacot therapy in elderly and senile patients. Prakticheskaya onkologiya = Practical Oncology 2015;16(3):117. (In Russ.)].
8. Colleoni M., Sun Z., Price K.N. et al. Annual hazard rates of recurrence for breast cancer during 24 years of follow-up: results from the international breast cancer study group trials I to V. J Clin Oncol 2016;34(9):927–35. DOI: 10.1200/JCO.2015.62.3504.
9. Wangchinda P., Ithimakin S. Factors that predict recurrence later than 5 years after initial treatment in operable breast cancer. World J Surg Oncol 2016;14(1):223. DOI: 10.1186/s12957-016-0988-0.
10. Tashima R., Nishimura R., Osako T. et al. Article received: 09.10.2017. Accepted for publication: 11.10.2017 the Ki-67 index as a prognostic factor in primary breast cancer: a retrospective study. PLoS One 2015;10(7):e0119565. DOI: 10.1371/journal.pone.0119565.
11. Andre F., Arnedos M., Goubar A. et al. Ki-67 – no evidence for its use in nodepositive breast cancer. Nat Rev Clin Oncol 2015;12(5);296–301. DOI: 10.1038/nrclinonc.2015.46.
12. Рябчиков Д.А., Воротников И.К., Титов К.С. и др. Иммунологическая и молекулярно-генетическая характеристика люминального В-фенотипа рака молочной железы. Обзор литературы. Опухоли женской репродуктивной системы 2016;12(4):32–6. [Ryabchikov D.A., Vorotnikov I.K., Titov K.S. et al. Immunological and molecular genetic characteristics of luminal B breast cancer: a literature review. Opukholi zhenskoy reproduktivnoy sistemy = Tumors of Female Reproductive System 2016;12(4):32–6. (In Russ.)].
13. Шатова Ю.С., Франциянц Е.М., Новикова И.А. и др. Антиандрогенная терапия: новое направление таргетной терапии рака молочной железы? Современные проблемы науки и образования 2017;3. Доступно по: https:// www.science-education.ru/ru/article/view?id=26392. [Shatova Yu.S., Fratsiyants E.M., Novikova I.A. et al. Antiandrogen therapy: a new approach of targeted therapy for breast cancer? Sovremennye problemy nauki i obrazovaniya = Modern Problems of Science and Education 2017;3. Available from: https://www.scienceeducation.ru/ru/article/view?id=26392. (In Russ.)].
14. Кит О.И., Шатова Ю.С., Новикова И.А. и др. Экспрессия p53 и BCL2 при различных подтипах рака молочной железы. Фундаментальные исследования 2014;10(1):85–8. [Kit O.I., Shatova Yu.S., Novikova I.A. et al. Expression of p53 and BCL2 in various subtypes of breast cancer. Fundamentalnye issledovaniya = Fundamental Research 2014;10(1):85–8. (In Russ.)].
15. Палтуев Р.М., Кудайбергенова А.Г., Семиглазов В.Ф., Комяхов А.В. Автоматизированный анализ клеточной плотности при раке молочной железы как дополнительный способ повысить объективность и достоверность прогноза рака молочной железы. Опухоли женской репродуктивной системы 2017;13(3):12–6. [Paltuev R.M., Kudaybergenova A.G., Semiglazov V.F., Komyakhov A.V. Automated analysis of cell density in breast cancer as an additional method of increasing objectivity and accuracy of breast cancer prognosis. Opukholi zhenskoy reproduktivnoy sistemy = Tumors of Female Reproductive System 2017;13(3):12–6. (In Russ.)].
Review
For citations:
Shatova Yu.S., Tokmakov V.V., Vladimirova L.Yu., Vaschenko L.N. ADJUVANT CHEMOTHERAPY OF PRIMARY OPERABLE LUMINAL B BREAST CANCER WITHOUT OVEREXPRESSION OF HER2/NEU IN POSTMENOPAUSAL WOMEN: YES OR NO? Tumors of female reproductive system. 2017;13(4):29-33. (In Russ.) https://doi.org/10.17650/1994-4098-2017-13-4-29-33
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