NEW YORK (Reuters Health) Mar 26 - Breast cancer patients with duplication of the CEP17 gene are more likely to respond to anthracycline chemotherapy, investigators reported yesterday at the seventh European Breast Cancer Conference in Barcelona, Spain.
Adding an anthracycline to a regimen of CMF (cyclophosphamide, methotrexate, and fluorouracil) benefits about 10% of patients, presenter Dr. John Bartlett of the University of Edinburgh, U.K. told Reuters Health. Trials looking at HER2 and TOP2A (both on chromosome 17) as potential biomarkers of response produced conflicting results.
Dr. Bartlett's group conducted a meta-analysis of four phase III breast cancer trials looking at chromosome 17 CEP (CEP17), which is the alpha satellite repeat in the pericentromeric region. The investigators theorize that CEP17 duplication may indicate chromosome instability and enhanced sensitivity to DNA damage.
Out of 2574 patients, 27.5% had duplication of CEP17. Median follow-up ranged from 6.9 to 11.5 years.
"Our analysis showed that in each of the four trials, the effect was consistently the same in showing benefit from anthracycline in the CEP17-positive group of patients," Dr. Bartlett said.
According to his presentation, the risk ratio for recurrence-free survival ranged from 0.57 to 0.67 across the four trials among patients positive for CEP17 duplication treated with anthracycline. After adjustment for treatment, nodes, grade, stage HER2, and TOP2A, the overall risk ratio was 0.63 (p = 0.001).
Similarly, the adjusted risk ratio for overall survival ranged from 0.49 to 0.64. The overall adjusted risk ratio was 0.63 (p = 0.0036).
By contrast, patients with CEP17 "normal" status did not benefit from the addition of anthracycline therapy (hazard ratios close to one).
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