Predictive Factors Determining Neoadjuvant Chemotherapy Outcomes in Breast Cancer - a Single Center Experience

From January 1, 2008 to March 31, 2010, 101 patients with stage II-III breast cancer were enrolled in thisstudy and subjected to an anthracycline-based neoadjuvant chemotherapy regimen with or without docetaxel.Surgery was performed after 2-6 cycles of chemotherapy, and the clinical response was determined by pathologicaland histochemical assessments. The clinical response rate, as indicated by complete response (CR), partialresponse (PR), stable disease (SD), and progressive disease (PD), were 6.9, 52.5, 36.6, and 4.0%, respectively. Amultivariable correlation analysis indicated that the overall clinical response rate correlated with the number ofmetastatic lymph nodes, number of chemotherapy cycles, and vessel invasion status. Importantly, the CR ratewas only associated with the number of chemotherapy cycles. Nonparametric tests failed to detect a correlationbetween HER2 or Topo IIα status and clinical response to neoadjuvant chemotherapy in these patients. Whenthey were stratified by HER2 or HR status, for HER2-positive patients the CR rate was associated with vesselinvasion and Topo IIα status. Based on our findings, we propose that HR, HER-2 and Topo IIα are not putativepredictive biomarkers of chemotherapy outcome for breast cancer patients. Topo IIα expression level was onlyinversely correlated with CR rate among HR-positive patients. Importantly, the achievement of CR was largelyrelated to the number of chemotherapy cycles.