DOI: https://doi.org/10.22263/2312-4156.2018.4.64
Shliakhtunou Y.A., Semenov V.M.
Adjuvant cytostatic therapy of minimum residual disease in breast cancer
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2018;17(4):64-71.
Abstract.
Objectives. To assess the effectiveness of adjuvant cytostatic breast cancer therapeutic regimens for eradication of CTCs and parameters of adjusted tumor-specific annual recurrence-free and overall survival.
Material and methods. The study involved 162 female patients with verified breast cancer of the I-IIIC stage at the age of 58.16 ± 9.98 years. All patients received adjuvant drug treatment in accordance with the available recommendations, taking into account risk groups stratification.
In all patients their peripheral blood was studied for the presence of CTCs. For the identification of CTCs the BIRC5 and HER2-neu genes expression was studied using real-time PCR.
Results. The therapy regimens CAF (CEF), AC (EC) AC-T lead to a significant decrease in the frequency of identification of CTCs expressing the BIRC5 and HER2-neu genes with regard to the baseline (p<0,05). The most effective influence on the decrease in the frequency of CTCs detection is provided by the therapeutic scheme of combining anthracyclines with the subsequent administration of taxanes, which reduces the incidence of minimal residual disease from 84.6% up to 30.8% (p=0,006). The most frequently used regimen of CAF (CEF) therapy was effective in eradicating CTCs expressing BIRC5 and HER2-neu genes in 29.6% of cases, and that of AC (EC) therapy – in 26,6% (p>0,05). The use of trastuzumab did not result in a significant decrease in CTCs expressing the target HER2-neu gene. Hormonotherapy did not lead to a significant decrease of target CTCs. The presence of BIRC5 and HER2-neu mRNAs positive CTCs prior to the initiation of treatment is an independent prognostic factor of the disease progression (RR=4,904 (95% CI: 1.207-19.929)). The preservation of BIRC5 and HER2-neu mRNA positive CTCs after systemic therapy is also an independent factor of the progression of breast cancer (RR = 3.590 (95% CI: 1.521-8.472)).
Conclusions. The most effective regimen for the treatment of minimal residual disease in breast cancer is the therapeutic scheme of combining anthracyclines with the subsequent administration of taxanes (paclitaxel, docetaxel).
Key words: minimal residual disease, breast cancer.
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Information about authors:
Shliakhtunou Y.A. – Candidate of Medical Sciences, associate professor of the Chair of Oncology with the courses of Radiodiagnosis & Radiotherapy and the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University;
ORCID https://orcid.org/0000-0002-5906-5373
Semenov V.M. – Doctor of Medical Sciences, professor, head of the Chair of Infectious Diseases with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University.
Correspondence address: Republic of Belarus, 210009, Vitebsk, 27 Frunze ave, Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Oncology with the courses of Radiodiagnosis & Radiotherapy and the course of the Faculty for Advanced Training & Retraining. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Yauheni A. Shliakhtunou.
