Publication Year: 2000 Visited: 46

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C-erbB2 Overexpression and Treatment Outcome in a Randomized Trial Comparing Adjuvant CMF and AC in Equitoxic Regimen in Breast Cancer. Lubos B Petruzelka, Olga Pribylova, Jana Vedralova, Hana Honova, Libor Judas, Charles Univ, Prague, Czech Republic.

Overexpression of c-erbB-2 is associated with worse prognosis of pts.with N+ breast cancer. C-erbB-2 status may have a role in selecting pts. for CMF or anthracycline-based therapy. Methods: we completed a randomized trial comparing 4 cycles of CMF in equitoxic regimen versus 4 cycles of AC in the adjuvant treatment of 106 breast cancer pts., pT1c-3a, pN0-1 (Proc. ASCO, 1999: 376). We evaluated the expression of c-erbB-2 in 62 breast tumors from patients included in a multicenter trial in our institution. C-erbB-2 expression was measured by immunohistochemistry with the monoclonal antibody CB11 on paraffin embedded tumor samples in a single reference laboratory. Results: 31 pts were in CMF arm and 31 in AC arm. 24 (38,7%) c-erbB-2 positive tumors was observed, 11 (34 %) in CMF arm and 13(40 %) in AC arm. After median follow up of 46 months 16 relapses were observed (10 local relapses, 3 local and bone, 2 in lung and bone, 1 in the liver). 50% relapses were c-erbB-2 positive. 7 of 10 local relapses were c-erbB-2 positive. DFS and OS were calculated by the Kaplan Meier method. Long rank and Cox models were used to compare DFS and OS to c-erbB-2 positive pts. No statistically signifiant difference was observed between these two arms. Univariate and multivariate analysis (logistic regression) were used to asses the predictive power of each variable.A Cox regression model including menopausal status, T,N status, grade, location of reccurence, ER status, treatment schedule and c-erbB-2 does not show any correlation with c-erbB-2 status. Conlusions: We demonstrated that breast cancer patients benefited from adjuvant CMF and AC chemotherapy following radical mastectomy, irrespective of their c-erbB-2 status.