Bcl2 is an independent prognostic marker of triple negative breast cancer (TNBC) and predicts response to anthracycline combination (ATC) chemotherapy (CT) in adjuvant and neoadjuvant settings

ABDEL-FATAH, T.M.A., PERRY, C., DICKINSON, P., BALL, G., MOSELEY, P., MADHUSUDAN, S., ELLIS, I.O. and CHAN, S.Y.T., 2013. Bcl2 is an independent prognostic marker of triple negative breast cancer (TNBC) and predicts response to anthracycline combination (ATC) chemotherapy (CT) in adjuvant and neoadjuvant settings. Annals of Oncology, 24 (11), pp. 2801-2807. ISSN 1569-8041

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Abstract

Background: TNBC represents a heterogeneous subgroup of BC with poor prognosis and frequently resistant to CT. Material and methods: The relationship between Bcl2 immunohistochemical protein expression and clinicopathological outcomes was assessed in 736 TNBC-patients: 635 patients had early primary-TNBC (EP-TNBC) and 101 had primary locally advanced (PLA)-TNBC treated with neo-adjuvant- ATC-CT. Results: Negative Bcl2 (Bcl2-) was observed in 70% of EP-TNBC and was significantly associated with high proliferation, high levels of P-Cadherin, E-Cadherin and HER3 (P’s<0.01), while Bcl2+ was significantly associated with high levels of p27, MDM4 and SPAG5 (P<0.01). After controlling for chemotherapy and other prognostic factors, Bcl2- was associated with 2-fold increased risk of death (P=0.006) and recurrence (P=0.0004). Furthermore, the prognosis of EP-TNBC/Bcl2- patients had improved both BC-specific survival (P=0.002) and disease-free survival (P = 0.003), if they received adjuvant-ATC-CT. Moreover, Bcl2- expression was an independent predictor of pathological complete response of primary locally advanced triple negative breast cancer (PLA-TNBC) treated with neoadjuvant-ATC-CT (P=0.008). Conclusion: Adding Bcl2 to the panel of markers used in current clinical practice could provide both prognostic and predictive information in TNBC. TNBC/Bcl2- patients appear to benefit from ATC-CT, whereas Bcl2+ TNBC seems to be resistant to ATC-CT and may benefit from a trial of different type of chemotherapy with/without novel-targeted agents. Key words: anthracyclin chemotherapy, Bcl2, predictive marker, prognostic marker, theraputic targets, triple negative breast cancer.

Item Type: Journal article
Publication Title: Annals of Oncology
Creators: Abdel-Fatah, T.M.A., Perry, C., Dickinson, P., Ball, G., Moseley, P., Madhusudan, S., Ellis, I.O. and Chan, S.Y.T.
Publisher: Oxford University Press
Date: 2013
Volume: 24
Number: 11
ISSN: 1569-8041
Identifiers:
NumberType
10.1093/annonc/mdt277DOI
Divisions: Schools > School of Science and Technology
Depositing User: EPrints Services
Date Added: 09 Oct 2015 09:53
Last Modified: 09 Jun 2017 13:13
URI: http://irep.ntu.ac.uk/id/eprint/4483

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