Same factors are also associated with the response to chemotherapy-- A. Agrawal, PhD
Friday, March 19, 2010 (Last Updated: 03/22/2010)
FRIDAY, March 19 (HealthDay News) -- Progressive disease after neoadjuvant chemotherapy for breast cancer is associated with factors ranging from race to advanced tumors, which are also linked to a response to chemotherapy, according to research published online March 15 in the Journal of Clinical Oncology.
Abigail S. Caudle, M.D., and colleagues from the University of Texas M.D. Anderson Cancer Center in Houston reviewed the medical records of 1,928 patients with stage I to III breast cancer who received neoadjuvant chemotherapy to identify factors that predict tumor progression.
The researchers found that 91 percent of patients had some response, 6 percent had stable disease, and 3 percent had progressive disease. African-Americans were more likely to have progressive disease. Other factors included advanced tumor stage, high nuclear grade, high proliferative score, and negativity for estrogen receptor and progesterone receptor. After adjusting for various factors, progressive disease was independently predicted by pretreatment advanced tumor stage (odds ratio. 6.31), African-American race (odds ratio, 2.07), and estrogen receptor negativity (estrogen receptor-positive status with odds ratio 0.24).
"Factors predictive of progressive disease include race, advanced tumor stage, high nuclear grade, high Ki-67 score, and estrogen receptor/progesterone receptor negativity," Caudle and colleagues conclude. "Because many of these variables are also associated with response to neoadjuvant chemotherapy, novel molecular predictors are needed to identify patients at risk for progression on standard neoadjuvant chemotherapy."
One author reported financial and consulting relationships with Bristol-Myers Squibb and Novartis.
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