Breast cancer-specific mRNA transcripts presence in peripheral blood after adjuvant chemotherapy predicts poor survival among high-risk breast cancer patients treated with high-dose chemotherapy with peripheral blood stem cell support.
Purpose: To study the prognostic significance of the presence of breast cancer-specific mRNA transcripts in peripheral blood (PB), defined by serial analysis of gene expression, in high-risk breast cancer (HRBC) patients undergoing high-dose chemotherapy after receiving adjuvant chemotherapy.Methods...
| Publicado en: | Journal of Clinical Oncology Vol. 24; no. 22; pp. 3611 - 3619 |
|---|---|
| Autores principales: | , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
American Society of Clinical Oncology
8/1/2006
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=89394233&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 89394233 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0732183X 20D jtl: Journal of Clinical Oncology issn: 0732183X maglogo: N pubinfo: dt: 8/1/2006 vid: 24 iid: 22 pid: 26892 pub: American Society of Clinical Oncology place: Alexandria, Virginia artinfo: ui: 89394233 89394233 NLM16877728 89394233 10.1200/JCO.2005.04.0576 NLM16877728 89394233 ppf: 3611 ppct: 8 formats: tig: atl: Breast cancer-specific mRNA transcripts presence in peripheral blood after adjuvant chemotherapy predicts poor survival among high-risk breast cancer patients treated with high-dose chemotherapy with peripheral blood stem cell support. aug: au: Quintela-Fandino, Miguel López, Joaquín Martínez Hitt, Ricardo Gamarra, Soledad Jimeno, Antonio Ayala, Rosa Hornedo, Javier Guzman, Cecilia Gilsanz, Florinda Cortés-Funes, Hernán affil: Medical Oncology Department, University Hospital 12 de Octubre, Madrid, Spain sug: subj: RNA Blood Antineoplastic Agents, Combined Therapeutic Use Hematopoietic Stem Cell Transplantation Breast Neoplasms Pathology Breast Neoplasms Chemotherapy, Adjuvant Odds Ratio Survival Analysis Treatment Outcomes Multivariate Analysis Adult Doxorubicin Administration and Dosage Receptors, Cell Surface RNA Female Breast Neoplasms Therapy Epirubicin Administration and Dosage Risk Assessment Paclitaxel Administration and Dosage Proteins Antineoplastic Agents, Combined Administration and Dosage Antigens, Surface Predictive Value of Tests Thiotepa Administration and Dosage Carboplatin Administration and Dosage Membrane Proteins Aged Prospective Studies Cyclophosphamide Administration and Dosage Fluorouracil Administration and Dosage Retrospective Design Calcium Binding Proteins Middle Age Prognosis Human Reverse Transcriptase Polymerase Chain Reaction Risk Factors Breast Neoplasms Blood Comparative Studies Multicenter Studies Evaluation Research Validation Studies Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Female ab: Purpose: To study the prognostic significance of the presence of breast cancer-specific mRNA transcripts in peripheral blood (PB), defined by serial analysis of gene expression, in high-risk breast cancer (HRBC) patients undergoing high-dose chemotherapy after receiving adjuvant chemotherapy.Methods: From 1994 to 2000, 84 HRBC patients (median age, 44 years; > 10 nodes; 74%) received adjuvant chemotherapy (fluorouracil, epirubicin, and cyclophosphamide for six cycles [83%] or doxorubicin and cyclophosphamide followed by paclitaxel) before undergoing one course of cyclophosphamide plus thiotepa plus carboplatin (STAMP V). Radiotherapy or hormone therapy was administered whenever indicated. Aliquots of apheresis-mononuclear blood cells were frozen from each patient. mRNA was isolated using an automatic nucleic acid extractor based on the magnetic beads technology; reverse transcription was performed using random hexamers. Cytokeratin 19, HER-2, P1B, PS2, and EGP2 transcripts were quantified to B-glucuronidase by real-time polymerase chain reaction (RT-PCR) using a linear DNA probe marked with a quencher and reporter fluorophores used in RT-PCR. Presence of PB micrometastases, estrogen receptor and progesterone receptor status, tumor size, age, tumor grade, number of nodes affected, and treatment with paclitaxel were included in the statistical analysis.Results: Median follow-up was 68.3 months (range, 6 months to 103 months). Forty-seven relapses (56%) and 35 deaths (41.7%) were registered. Both tumor size and presence of micrometastases reached statistical significance according to the Cox multivariate model. Relapse hazard ratio (HR) for those patients with PB micrometastases was 269% (P = .006); death HR, 300% (P = .011). Time relapse was 53 months longer for patients without micrometastases: 31.3 v 84.2 months (P = .021).Conclusion: PB micrometastases presence after adjuvant chemotherapy predicts both relapse and death more powerful than classical factors in HRBC patients undergoing high-dose chemotherapy. Micrometastases search using a gene panel appears to be a more accurate procedure than classical approaches involving only one or two genes. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|