Prognostic value of Bcl-2 in breast cancer patients treated with neoadjuvant anthracycline-based chemotherapy

LAURA M. VARGAS-ROIG; F. DARÍO CUELLO-CARRIÓN; NICOLÁS FERNÁNDEZ-ESCOBAR; PEDRO DAGUERRE; MARCELA LEUZZI; JORGE IBARRA; FRANCISCO E. GAGO; SILVINA B. NADIN; DANIEL R. CIOCCA

Chicago-Illinois-USA

Congreso; American Society of Clinical Oncology-Annual Meeting 08; 2008

American Society of Clinical Oncology

Bcl-2 has important roles in apoptosis, cell proliferation and cell differentiation in breast cancer. The value of BcI-2 protein as predictive/prognostic factor to adjuvant treatment in breast cancer has been investigated. However, there are few analyses in a homogeneous group of patients treated with neoadjuvant chemotherapy. We analyzed BcI-2 in pre- and post-chemotherapy biopsies and correlated its expression with clinical and pathological response, and with disease-free survival (DFS) and overall survival (OS) in patients treated with neoadjuvant chemotherapy. Methods: One hundred and ten patients were submitted to two different chemotherapeutic regimens: a) 5-fluorouracil, doxorubicin or epirubicin, and cyclophosphamide (FAC/FEC) during 2 to 6 cycles before surgery and 3 or 4 additional cycles of FAC/FEC after surgery (n=40) and b) doxorubicin (D) 75 mg/m2 or epirubicin (E) 120 mg/m2 during 4 cycles before surgery, and 6 cycles of cyclophosphamide, methotrexate, and 5-fluorouracil after surgey (n=70). Pre- and post-chemotherapy samples were immediately fixed and embedded in paraffin for studies (H&E,inmunohistochemistry, TUNEL). Kaplan-Neier method, Wilcoxon signed rank test, Spearman´s ran k correlation coefficient, Fisher´s exact test, logistic regression and Cox models were used. Results: BcI-2 expression did not change significantly after chemotherapy and was not related to clinical/pathologic response. The expression of BcI-2, Bax and p53 evaluated before chemotherapy did not correlate with the clinical and pathologic response. In FAC/FEC group, BcI-2 expression after chemotherapy correlated with better DFS and OS(P < 0.008 and P