PREDICTIVE VALUE OF C-ERBB-2, P53, CATHEPSIN-D AND HISTOLOGY OF THE PRIMARY TUMOR IN METASTATIC BREAST-CANCER

The value of various prognostic factors in breast cancer patients has been determined in a number of studies. Few reports have been publishe d on the dependence of treatment outcome on histological and immunohis tochemical characteristics in the primary tumour in patients with meta static disease. We studied the incidence and prognostic value of histo logical and molecular abnormalities in the primary tumour of patients who had developed metastatic breast cancer. Eligible patients received fluorouracil, epirubicin and cyclophosphamide (FEC) regimen either on ce a week or once every 4 weeks. Adequate specimens for various analys es were available from 127 patients. Median follow-up time of the pati ents ranged from 15 to 101 months. In this study, the histological gra de of the malignancy best predicted response to chemotherapy (P < 0.00 05). Most of the responses were observed in patients with grade 1 tumo urs; in this group, time to progression was delayed. C-erb B-2 gene am plification and oncoprotein expression had no predictive value. Neithe r p53 nor cathepsin-D predicted treatment outcome after chemotherapy. None of the factors had an effect on overall survival. Among breast ca ncer patients who received anthracycline-containing chemotherapy, resp onse to treatment correlated with histological grade. In patients with histological grade 1 breast cancer, the lime to progression was longe st. However, overall survival was not affected by histological grade n or the other parameters tested. In addition to histological grade, oth er prognostic factors that are not included in this study need to be i dentified to determine which patients with metastatic breast cancer wo uld benefit from cytotoxic treatment.