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BMC Cancer. 2010; 10: 527.
Published online 2010 October 5. doi:  10.1186/1471-2407-10-527
PMCID: PMC2972282
Favorable response to doxorubicin combination chemotherapy does not yield good clinical outcome in patients with metastatic breast cancer with triple-negative phenotype
Seong Yoon Yi,1 Jin Seok Ahn,corresponding author1 Ji Eun Uhm,1 Do Hyoung Lim,1 Sang Hoon Ji,1 Hyun Jung Jun,1 Kyoung Ha Kim,1 Myung Hee Chang,1 Min Jae Park,1 Eun Yoon Cho,2 Yoon La Choi,2 Yeon Hee Park,1 and Young-Hyuck Im1
1Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul 135-710 Korea
2Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul 135-710 Korea
corresponding authorCorresponding author.
Seong Yoon Yi: seungyoon.yi/at/samsung.com; Jin Seok Ahn: ajis/at/skku.edu; Ji Eun Uhm: jieun.uhm/at/samsung.com; Do Hyoung Lim: dohyung.lim/at/samsung.com; Sang Hoon Ji: sanghoon.ji/at/samsung.com; Hyun Jung Jun: hyunjung.jun/at/samsung.com; Kyoung Ha Kim: kyoungha.kim/at/samsung.com; Myung Hee Chang: myunghee.chang/at/samsung.com; Min Jae Park: minjae.park/at/samsung.com; Eun Yoon Cho: eunyoon.cho/at/samsung.com; Yoon La Choi: yoonla.choi/at/samsung.com; Yeon Hee Park: yhparkhmo/at/skku.edu; Young-Hyuck Im: imyh00/at/skku.edu
Received October 1, 2009; Accepted October 5, 2010.
Abstract
Background
We analyzed the responses to first line treatment and clinical outcomes of metastatic breast cancer patients treated with palliative doxorubicin/cyclophosphamide (AC) according to molecular cancer subtype.
Methods
A retrospective analysis was performed for 110 metastatic breast cancer patients selected on the basis of palliative AC treatment and the availability of immunohistochemical data for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER-2/neu) status.
Results
Of the 110 patients analyzed, 71 (64.5%) were hormone receptor positive (HR+), 14 (12.7%) were HER2+, and 25 (22.7%) were triple negative (TN). There were no differences in age, stage at diagnosis, total number of cycles of palliative chemotherapy, incidence of visceral metastasis, and metastatic sites with the exception of liver among breast cancer subtypes. The overall response rates to AC were 55.9% for the HR+ subgroup, 42.9% for the HER2+ subgroup, and 56.5% for the TN subgroup. The progression-free survival (PFS) in patients with HER2+ and TN were significantly shorter than in the HR+ (median PFS, 9.1 vs 8.1 vs 11.5 months, respectively; p = 0.0002). The overall survival (OS) was 25.4 months in the TN subgroup and 27.3 months in HER2+ subgroup. The median OS for these two groups was significantly shorter than for patients in the HR+ subgroup (median, 38.5 months; 95% CI, 30.1-46.9 months; p < 0.0001).
Conclusions
The response to palliative AC chemotherapy did not differ among breast cancer subtypes. Despite chemosensitivity for palliative AC, the TN subtype has a shorter overall survival than non-TN subtypes. Innovative treatment strategies should be developed to slow the course of disease.
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