Objective: To study the changes of expression of Survivin mRNA, BCRP mRNA and HER-2 mRNA in breast cancer after TE regimen neoadjuvant chemotherapy, and to find biological markers to predict the efficiency of TE regimen neoadjuvant chemotherapy.
Methods: The gene expressions were detected by RT-PCR from 56 breast cancer patients before and after TE regimen neoadjuvant chemotherapy (docetaxel and epirubicin). The relationships between these gene expressions and chemotherapy responses were analyzed.
Results: The overall response rate to neoadjuvant chemotherapy was 71.4%, including 8.9% (5/56) with complete response and 62.5% (35/56) with partial response. Pathological complete response was found in 4 cases (7.1%). Stable disease and progression of disease were 23.2% (13/56) and 5.4% (3/56), respectively. The expression of Survivin mRNA after neoadjuvant chemotherapy was 35.7% (20/56), significantly lower than 60.7% (34/56) before neoadjuvant chemotherapy (P = 0.008). The expression of BCRP mRNA after neoadjuvant chemotherapy was 19.6%, significantly lower than 37.5% before neoadjuvant chemotherapy (P = 0.036). The positive rate of HER-2 mRNA expression was 41.1% before the chemotherapy, and reduced to 21.4% after the chemotherapy (P = 0.025). The effective rates of the single positive expression of Survivin mRNA or BCRP mRNA were both lower than that of negative expression (P < 0.05). The level of HER-2 mRNA expression alone was not significantly associated with the effective rate of chemotherapy (P = 0.144). When the expression of all Survivin mRNA, BCRP mRNA and HER-2 mRNA were negative, the effective rate of neoadjuvant chemotherapy was higher than that in patients with positive expression (P = 0.003). The level of Survivin mRNA expression was not significantly associated with BCRP mRNA and HER-2 mRNA (P > 0.05).
Conclusion: The expression of Survivin in combination with BCRP and HER-2 is associated with clinical response to TE neoadjuvant chemotherapy in breast cancer, and can be used as predictive biomarkers for chemosensitivity of TE regimen neoadjuvant chemotherapy for breast cancer.