Breast cancer subtypes and response to docetaxel in node-positive breast cancer: Use of an immunohistochemical definition in the BCIRG 001 trial

Judith Hugh, John Hanson, Maggie Chon U. Cheang, Torsten O. Nielsen, Charles M. Perou, Charles Dumontet, John Reed, Maryla Krajewska, Isahelle Treilleux, Matthieu Rupin, Emmanuelle Magherini, John Mackey, Miguel Martin, Charles Vogel

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Abstract

To investigate the prognostic and predictive significance of subtyping node-positive early breast cancer by immunohistochemistry in a clinical trial of a docetaxel-containing regimen.Methods Pathologic data from a central laboratory were available for 1,350 patients (91 %) from the BCIRG 001 trial of docetaxel, doxorubicin, and cyclophosphamide (TAC) versus fluorouracil, doxorubicin, and cyclophosphamide (FAC) for operable node-positive breast cancer. Patients were classified by tumor characteristics as (1) triple negative (estrogen receptor [ER]-negative, progesterone receptor [PR]-negative, HER2/neu [HER2]-negative), (2) HER2 (HER2-positive, ER-negative, PR-negative), (3) luminal B (ER-positive and/or PR-positive and either HER2-positive and/or Ki67hlgh), and (4) luminal A (ER-positive and/or PR-positive and not HER2-positive or Ki67hlgh), and assessed for prognostic significance and response to adjuvant chemotherapy.Results Patients were subdivided into triple negative (14.5%), HER2 (8.5%), luminal B (61.1%), and luminal A (15.9%). Three-year disease-free survival (DFS) rates (P values with luminal B as referent) were 67% (P<.00011,68% (P=.0008), 82% (referent luminal B), and 91 % (P=.0027), respectively, with hazard ratios of 2.22, 2.12, and 0.46. Improved 3-year DFS with TAC was found in the luminal B group (P =.025) and a combined ER-positive/HER2-negative group treated with tamoxifen (P =.041), with a marginal trend in the triple negatives (P =.051) and HER2 (P =.068) subtypes. No DFS advantage was seen in the luminal A population. Conclusion A simple immunopanel can divide breast cancers into biologic subtypes with strong prognostic effects. TAC significantly complements endocrine therapy in patients with luminal B subtype and, in the absence of targeted therapy, is effective in the triple-negative population.

Original languageEnglish (US)
Pages (from-to)1168-1176
Number of pages9
JournalJournal of Clinical Oncology
Volume27
Issue number8
DOIs
StatePublished - Mar 10 2009
Externally publishedYes

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ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Hugh, J., Hanson, J., Cheang, M. C. U., Nielsen, T. O., Perou, C. M., Dumontet, C., Reed, J., Krajewska, M., Treilleux, I., Rupin, M., Magherini, E., Mackey, J., Martin, M., & Vogel, C. (2009). Breast cancer subtypes and response to docetaxel in node-positive breast cancer: Use of an immunohistochemical definition in the BCIRG 001 trial. Journal of Clinical Oncology, 27(8), 1168-1176. https://doi.org/10.1200/JCO.2008.18.1024