OBJECTIVE: To identify the predictive markers associated with chemotherapy sensitivity, especially those producing pathological complete response (pCR) following neoadjuvant chemotherapy (NACT) in patients with locally advanced breast cancer. METHODS: Core needle biopsy of 50 locally advanced breast cancer patients was analysed for histopathology, grade, oestrogen receptor, progesterone receptor, HER2, Ki-67, p53, Bcl-2, and BAX before starting NACT. This was correlated with response to NACT using Response Evaluation Criteria in Solid Tumours criteria. RESULTS: The mean tumour reduction rate per chemotherapy cycle was significantly higher in BAXpositive (p = 0.01) and Bcl-2-negative (p = 0.04) tumours. BAX expression significantly (p = 0.043) correlated with a response of an at least 30% reduction in tumour size post-NACT on multivariate analysis. A significant relationship was seen between loss of Bcl-2 expression and pCR on univariate (p = 0.048) analysis. Overall, all of the above 12 parameters had 30.4% and 28.5% success in predicting clinical complete response and pCR, respectively, by the Cox and Snell formula. CONCLUSION: Of all parameters examined, only the apoptosis-related genes (Bcl-2 and BAX) seemed to exert some influence on the response to NACT, and neither by itself was sufficient to predict pCR; however, 50 patients is not sufficient to simultaneously analyse several predictive markers. © 2010 Asian Surgical Association.
M., T., S., P., U., S., T.B., S., & H.S., S. (2010). Assessment of predictive markers of response to neoadjuvant chemotherapy in breast cancer. Asian Journal of Surgery, 33(4), 157–167. https://doi.org/10.1016/S1015-9584(11)60001-8 LK - http://rug.on.worldcat.org/atoztitles/link/?sid=EMBASE&issn=10159584&id=doi:10.1016%2FS1015-9584%2811%2960001-8&atitle=Assessment+of+predictive+markers+of+response+to+neoadjuvant+chemotherapy+in+breast+cancer&stitle=Asian+J.+Surg.&title=Asian+Journal+of+Surgery&volume=33&issue=4&spage=157&epage=167&aulast=Tewari&aufirst=Mallika&auinit=M.&aufull=Tewari+M.&coden=AJSUE&isbn=&pages=157-167&date=2010&auinit1=M&auinitm=