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Gene alterations associated with response to anthracycline therapy for breast cancer
Date:4/28/2009

altered tumors when treated with anthracycline-based therapy is similar to the benefit the researchers detected in women with HER2-positive tumors.

The investigators conclude that TOP2A gene alteration is associated with increased benefit from an anthracycline-containing regimen compared with TOP2A-normal tumors. However, they add that the sample size was too small to determine whether this effect was independent of HER2.

Patients whose tumors are normal for TOP2A and HER2 do not appear to derive additional benefit from the anthracycline-based regimen and therefore could be treated with less toxic regimens, such as CMF, according to the authors. "Our data suggest that measurements of TOP2A alteration and HER2 amplification appear to have similar value in guiding the selection of anthracycline-containing regimens," they conclude.

In an accompanying editorial, Dennis J. Slamon, M.D., Ph.D., of the University of California School of Medicine at Los Angeles, and Michael F. Press, Ph.D., of the University of Southern California Keck School of Medicine in Los Angeles, agree that women whose tumors are TOP2A- and HER2-normal should not receive anthracycline-based therapy: "Currently, the overwhelming bulk of the published and/or reported data indicate that TOP2A alterations are the important predictive factors for determining the likelihood of incremental benefits from treating breast cancer patients with anthracyclines in the adjuvant setting," the editorialists write. "These data also show that TOP2A alterations most often occur in the context of HER2 amplification."


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Contact: Steve Graff
jncimedia@oxfordjournals.org
301-841-1285
Journal of the National Cancer Institute
Source:Eurekalert

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