Different responses to preoperative chemotherapy for invasive lobular and invasive ductal breast carcinoma

Cocquyt, Véronique; Blondeel, Phillip; Depypere, Herman; Praet, Marleen; Schelfhout, Vera; Silva, O.E.; Hurley, Judith; Serreyn, Rudolphe; Daems, K; Belle, S.J.P. Van

doi:10.1053/ejso.2002.1404

Cited by 131 publications

(65 citation statements)

References 29 publications

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“…This is consistent with the finding that ILC shows a poor response rate to neoadjuvant chemotherapy (22)(23)(24). The tendency towards a high response rate in grade 3 and hormone receptor negative tumours has been confirmed by other trials (2,3,5,6,18,25,26), whereas a trend towards a higher response rate in hormone receptor positive tumours (not statistically significant) was seen by Burcombe et al (27).…”

Section: (33) -------------------------------------------------supporting

confidence: 88%

Neoadjuvant 5-fluorouracil, epirubicin and cyclophosphamide chemotherapy followed by docetaxel in refractory patients with locally advanced breast cancer

Heller

Mazhar²,

Ward³

et al. 2007

Oncol Rep

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Abstract. The objective of this study was to evaluate the clinical response of locally advanced breast cancer (LABC) to neoadjuvant (NA) chemotherapy with 5-fluorouracil, epirubicin and cyclophosphamide (FEC) and to study the role of docetaxel in patients who fail to respond to first-line chemotherapy. Patients were enrolled who had primary tumours without distant metastasis that were too extensive for conservative surgery. All underwent NA chemotherapy for breast cancer and thereafter surgery and/or radical radiotherapy. NA chemotherapy with FEC was administered to 88 patients between February 1998 and June 2005. A median of 6 cycles of FEC (range 1-8) was given, followed in 21 cases by a median of 4 cycles (range 2-6) of docetaxel. Where clinically established, with FEC the clinical complete response (cCR) was 22/81 (27%), clinical partial response (cPR) 41/81 (51%), clinical stable disease (cSD) 18/81 (22%). In patients where the response to FEC was regarded as insufficient, docetaxel was given. Response rates were cCR 3/21 (14%); cPR 10/21 (48%), cSD 8/21 (38%). There were 11 cases of pathological complete response (pCR), 9 in the FEC-only group and 2 in the docetaxel group. Following chemotherapy 49 (56%) patients underwent mastectomy, 32 (36%) breast conserving surgery and 5 (6%) radical radiotherapy, giving a breast conservation rate of 42%. Two patients died before receiving surgery or radical radiotherapy. The results show that neoadjuvant FEC is a reasonable NA therapy in breast cancer and that docetaxel is effective in FEC refractory cases. Only 8 of 81 (10%) assessable patients did not respond to any chemotherapy, giving an overall clinical response rate of 90%, which is comparable to studies in which taxanes were given irrespective of response to preceding therapy with antracycline including regimes. IntroductionNeoadjuvant chemotherapy is regarded as a useful procedure in the management of locally advanced (i.e. stage III) or large (≥3 cm) breast cancers. The aim of this approach is to induce tumour shrinkage in order to increase the possibility of breastconserving surgery in patients with potentially operable tumours and the response to neoadjuvant chemotherapy can be used to select subsequent adjuvant cytotoxic therapy.Studies comparing adjuvant with neoadjuvant chemotherapy, without adjustment on the basis of response, have found higher rates of breast conserving surgery but no significant differences in terms of disease-free or overall survival have been observed (1).Many studies have been published with various chemotherapy regimens, but we reasoned that the optimal choice of regimen would be to use as first-line the regimen we use as adjuvant therapy, i.e. the FEC regimen, and in those who fail to respond, switch to our second-line, non-cross-resistant therapy of choice, docetaxel. We felt that this approach would have two advantages: firstly, we could determine which patients were sensitive to one or other regimen, which would then be expected to inform about optimal adjuvant chemotherapy; ...

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Section: (33) -------------------------------------------------supporting

confidence: 88%

Neoadjuvant 5-fluorouracil, epirubicin and cyclophosphamide chemotherapy followed by docetaxel in refractory patients with locally advanced breast cancer

Heller

Mazhar²,

Ward³

et al. 2007

Oncol Rep

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“…Some long-term follow-up studies have shown a trend to later locoregional recurrence [11]. In addition, it has been reported that ILC is less responsive to chemotherapy [3,21], lacks potential benefit of HER2 targeted therapy [16,17], being typically HER2 negative, but is more often HR positive and responsive to adjuvant hormonal therapy (HT) [11,22,23]. Reported prognosis of ILC varies and has been reported to be worse [1,9,[24][25][26][27], no different [17,[28][29][30][31][32], or better [6] than that with IDC.…”

Section: Introductionmentioning

confidence: 99%

The biological and clinical characteristics of breast carcinoma with mixed ductal and lobular morphology

Rakha

Gill

El-Sayed

et al. 2008

Breast Cancer Res Treat

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“…However, they continue to pose a therapeutic challenge due to the lower than expected response rates to endocrine therapy (18) and neoadjuvant chemotherapy (19,20). Hence, there is a pressing need for more therapeutic options in this disease.…”

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confidence: 99%

FGFR1 Emerges as a Potential Therapeutic Target for Lobular Breast Carcinomas

Reis‐Filho

Simpson²,

Turner³

et al. 2006

Clinical Cancer Research

257

256

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Purpose: Classic lobular carcinomas (CLC) account for 10% to 15% of all breast cancers. At the genetic level, CLCs show recurrent physical loss of chromosome16q coupled with the lack of E-cadherin (CDH1 gene) expression. However, little is known about the putative therapeutic targets for these tumors. The aim of this study was to characterize CLCs at the molecular genetic level and identify putative therapeutic targets. Experimental Design: We subjected 13 cases of CLC to a comprehensive molecular analysis including immunohistochemistry for E-cadherin, estrogen and progesterone receptors, HER2/ neu and p53; high-resolution comparative genomic hybridization (HR-CGH); microarray-based CGH (aCGH); and fluorescent and chromogenic in situ hybridization for CCND1 and FGFR1. Results: All cases lacked the expression of E-cadherin, p53, and HER2, and all but one case was positive for estrogen receptors. HR-CGH revealed recurrent gains on 1q and losses on 16q (both, 85%). aCGH showed a good agreement with but higher resolution and sensitivity than HR-CGH. Recurrent, high level gains at 11q13 (CCND1) and 8p12-p11.2 were identified in seven and six cases, respectively, and were validated with in situ hybridization. Examination of aCGH and the gene expression profile data of the cell lines, MDA-MB-134 and ZR-75-1, which harbor distinct gains of 8p12-p11.2, identified FGFR1 as a putative amplicon driver of 8p12-p11.2 amplification in MDA-MB-134. Inhibition of FGFR1 expression using small interfering RNA or a small-molecule chemical inhibitor showed that FGFR1 signaling contributes to the survival of MDA-MB-134 cells. Conclusions: Our findings suggest that receptor FGFR1 inhibitors may be useful as therapeutics in a subset of CLCs.

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Different responses to preoperative chemotherapy for invasive lobular and invasive ductal breast carcinoma

Cited by 131 publications

References 29 publications

Neoadjuvant 5-fluorouracil, epirubicin and cyclophosphamide chemotherapy followed by docetaxel in refractory patients with locally advanced breast cancer

Neoadjuvant 5-fluorouracil, epirubicin and cyclophosphamide chemotherapy followed by docetaxel in refractory patients with locally advanced breast cancer

The biological and clinical characteristics of breast carcinoma with mixed ductal and lobular morphology

FGFR1 Emerges as a Potential Therapeutic Target for Lobular Breast Carcinomas

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