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Value of post-operative reassessment of estrogen receptor alpha expression following neoadjuvant chemotherapy with or without gefitinib for estrogen receptor negative breast cancer

Bernsdorf, Mogens; Balslev, Eva; Lykkesfeldt, Anne E.; Kroman, Niels; Harder, Eva; von der Maase, Hans; Jakobsen, Erik H.; Grabau, Dorthe LU and Ejlertsen, Bent (2011) In Breast Cancer Research and Treatment 128(1). p.165-170
Abstract
The NICE trial was designed to evaluate the possible benefits of adding epidermal growth factor receptor targeted therapy to neoadjuvant chemotherapy in patients with estrogen receptor alpha (ER) negative and operable breast cancer. Preclinical data have suggested that signalling through the ErbB receptors or downstream effectors may repress ER expression. Here the authors investigated whether gefitinib, given neoadjuvant in combination with epirubicin and cyclophosphamide (EC), could restore ER expression. Eligible patients in the NICE trial were women with unilateral, primary operable, ER negative invasive breast cancer a parts per thousand yen2 cm. Material from patients randomized and completing treatment (four cycles of neoadjuvant EC... (More)
The NICE trial was designed to evaluate the possible benefits of adding epidermal growth factor receptor targeted therapy to neoadjuvant chemotherapy in patients with estrogen receptor alpha (ER) negative and operable breast cancer. Preclinical data have suggested that signalling through the ErbB receptors or downstream effectors may repress ER expression. Here the authors investigated whether gefitinib, given neoadjuvant in combination with epirubicin and cyclophosphamide (EC), could restore ER expression. Eligible patients in the NICE trial were women with unilateral, primary operable, ER negative invasive breast cancer a parts per thousand yen2 cm. Material from patients randomized and completing treatment (four cycles of neoadjuvant EC plus 12 weeks of either gefitinib or placebo) in the NICE trial having available ER status both at baseline and after neoadjuvant treatment were eligible for this study. Tumors with indication of changed ER phenotype (based on collected pathology reports) were immunohistochemically reassessed centrally. 115 patients were eligible for this study; 59 patients in the gefitinib group and 56 patients in the placebo group. Five (4.3%) of 115 tumors changed ER phenotype from negative to positive. A change was seen in three patients in the gefitinib (5.1%) and in two patients in the placebo (3.6%) group with a difference of 1.51% (95% CI, -6.1-9.1). Results of the NICE trial have been reported previously. Post-operative reassessment of ER expression changed the assessment of ER status in a small but significant fraction of patients and should, whenever possible, be performed following neoadjuvant chemotherapy for ER negative breast cancer. Gefitinib did not affect the reversion rate of ER negative tumors. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breast cancer, Neoadjuvant, Estrogen receptor, Phenotype changes, Post-operative reassessment
in
Breast Cancer Research and Treatment
volume
128
issue
1
pages
165 - 170
publisher
Springer
external identifiers
  • wos:000291656200018
  • scopus:79959275487
ISSN
1573-7217
DOI
10.1007/s10549-011-1535-x
language
English
LU publication?
yes
id
69645240-ddc5-474d-b765-757c3f28ada0 (old id 2056779)
date added to LUP
2011-08-02 09:02:23
date last changed
2017-01-01 05:56:19
@article{69645240-ddc5-474d-b765-757c3f28ada0,
  abstract     = {The NICE trial was designed to evaluate the possible benefits of adding epidermal growth factor receptor targeted therapy to neoadjuvant chemotherapy in patients with estrogen receptor alpha (ER) negative and operable breast cancer. Preclinical data have suggested that signalling through the ErbB receptors or downstream effectors may repress ER expression. Here the authors investigated whether gefitinib, given neoadjuvant in combination with epirubicin and cyclophosphamide (EC), could restore ER expression. Eligible patients in the NICE trial were women with unilateral, primary operable, ER negative invasive breast cancer a parts per thousand yen2 cm. Material from patients randomized and completing treatment (four cycles of neoadjuvant EC plus 12 weeks of either gefitinib or placebo) in the NICE trial having available ER status both at baseline and after neoadjuvant treatment were eligible for this study. Tumors with indication of changed ER phenotype (based on collected pathology reports) were immunohistochemically reassessed centrally. 115 patients were eligible for this study; 59 patients in the gefitinib group and 56 patients in the placebo group. Five (4.3%) of 115 tumors changed ER phenotype from negative to positive. A change was seen in three patients in the gefitinib (5.1%) and in two patients in the placebo (3.6%) group with a difference of 1.51% (95% CI, -6.1-9.1). Results of the NICE trial have been reported previously. Post-operative reassessment of ER expression changed the assessment of ER status in a small but significant fraction of patients and should, whenever possible, be performed following neoadjuvant chemotherapy for ER negative breast cancer. Gefitinib did not affect the reversion rate of ER negative tumors.},
  author       = {Bernsdorf, Mogens and Balslev, Eva and Lykkesfeldt, Anne E. and Kroman, Niels and Harder, Eva and von der Maase, Hans and Jakobsen, Erik H. and Grabau, Dorthe and Ejlertsen, Bent},
  issn         = {1573-7217},
  keyword      = {Breast cancer,Neoadjuvant,Estrogen receptor,Phenotype changes,Post-operative reassessment},
  language     = {eng},
  number       = {1},
  pages        = {165--170},
  publisher    = {Springer},
  series       = {Breast Cancer Research and Treatment},
  title        = {Value of post-operative reassessment of estrogen receptor alpha expression following neoadjuvant chemotherapy with or without gefitinib for estrogen receptor negative breast cancer},
  url          = {http://dx.doi.org/10.1007/s10549-011-1535-x},
  volume       = {128},
  year         = {2011},
}