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

Research output: Contribution to journalArticle

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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
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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docetaxel
Estrogen Receptors
Breast Neoplasms
Progesterone Receptors
Disease-Free Survival
Doxorubicin
Cyclophosphamide
Tamoxifen
Adjuvant Chemotherapy
Fluorouracil
Population
Survival Rate
Immunohistochemistry
Clinical Trials

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Breast cancer subtypes and response to docetaxel in node-positive breast cancer : Use of an immunohistochemical definition in the BCIRG 001 trial. / Hugh, Judith; Hanson, John; Cheang, Maggie Chon U; Nielsen, Torsten O.; Perou, Charles M.; Dumontet, Charles; Reed, John; Krajewska, Maryla; Treilleux, Isahelle; Rupin, Matthieu; Magherini, Emmanuelle; Mackey, John; Martin, Miguel; Vogel, Charles.

In: Journal of Clinical Oncology, Vol. 27, No. 8, 10.03.2009, p. 1168-1176.

Research output: Contribution to journalArticle

Hugh, J, Hanson, J, Cheang, MCU, Nielsen, TO, Perou, CM, 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, vol. 27, no. 8, pp. 1168-1176. https://doi.org/10.1200/JCO.2008.18.1024
Hugh, Judith ; Hanson, John ; Cheang, Maggie Chon U ; Nielsen, Torsten O. ; Perou, Charles M. ; Dumontet, Charles ; Reed, John ; Krajewska, Maryla ; Treilleux, Isahelle ; Rupin, Matthieu ; Magherini, Emmanuelle ; Mackey, John ; Martin, Miguel ; Vogel, Charles. / Breast cancer subtypes and response to docetaxel in node-positive breast cancer : Use of an immunohistochemical definition in the BCIRG 001 trial. In: Journal of Clinical Oncology. 2009 ; Vol. 27, No. 8. pp. 1168-1176.
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title = "Breast cancer subtypes and response to docetaxel in node-positive breast cancer: Use of an immunohistochemical definition in the BCIRG 001 trial",
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.",
author = "Judith Hugh and John Hanson and Cheang, {Maggie Chon U} and Nielsen, {Torsten O.} and Perou, {Charles M.} and Charles Dumontet and John Reed and Maryla Krajewska and Isahelle Treilleux and Matthieu Rupin and Emmanuelle Magherini and John Mackey and Miguel Martin and Charles Vogel",
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T1 - Breast cancer subtypes and response to docetaxel in node-positive breast cancer

T2 - Use of an immunohistochemical definition in the BCIRG 001 trial

AU - Hugh, Judith

AU - Hanson, John

AU - Cheang, Maggie Chon U

AU - Nielsen, Torsten O.

AU - Perou, Charles M.

AU - Dumontet, Charles

AU - Reed, John

AU - Krajewska, Maryla

AU - Treilleux, Isahelle

AU - Rupin, Matthieu

AU - Magherini, Emmanuelle

AU - Mackey, John

AU - Martin, Miguel

AU - Vogel, Charles

PY - 2009/3/10

Y1 - 2009/3/10

N2 - 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.

AB - 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.

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