P-glycoprotein: The intermediate end point of drug response to induction chemotherapy in locally advanced breast cancer

被引:33
作者
Chung, HC [1 ]
Rha, SY [1 ]
Kim, JH [1 ]
Roh, JK [1 ]
Min, JS [1 ]
Lee, KS [1 ]
Kim, BS [1 ]
Lee, KB [1 ]
机构
[1] AJOU UNIV,SCH MED,DEPT PATHOL,SUWON 441749,SOUTH KOREA
关键词
breast cancer; drug response; induction chemotherapy; p-glycoprotein;
D O I
10.1023/A:1005739525196
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Expression and clinical relevance of p-glycoprotein (p-gp) were evaluated in 31 cases of locally advanced breast cancer and 9 cases involving inflammatory breast cancer after induction chemotherapy. The de novo p-gp expression rate was 26% and increased up to 58% (p = 0.03) with the FAC (5-fluorouracil, adriamycin, cyclophosphamide) regimen. Although more clinically complete responders were found in the secondary p-gp negative group (p = 0.02), this difference was not found in pathological tumor response. Moreover, as the grade of the secondary p-gp expression increased, the chemotherapeutic effect decreased, suggesting an inverse relationship between p-gp expression and drug effect (p = 0.04). When we subgrouped the patients into 4 groups using these two parameters, p-gp negative patients presenting with a high drug effect showed a low recurrence rate (p = 0.05) and marginal survival benefits (p = 0.09) as opposed to patients with a low drug effect. But in p-gp positive groups, the recurrence rate was the same between the two groups regardless of the drug effect. Thus, in the p-gp negative patient with a high drug effect, adjuvant chemotherapy with the same regimen as induction chemotherapy may induce more prognostically favorable results. Therefore, clinical application of the secondary p-gp detection can be used as an intermediate endpoint in evaluating drug response for an induction regimen.
引用
收藏
页码:65 / 72
页数:8
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