Investigation On Correlation Between Efficacies Of Paclitaxel To Advanced Breast Cancer And Molecular Phenotypes

Breast Cancer is one of the most common and important malignant tumors, which has the highest incidence and death rate. Breast cancer is a clinically heterogeneous disease. Histologically similar tumors may have different prognoses and may respond to therapy differently. It is believed that these differences in clinical behavior are due to molecular differences between histologically similar tumors. Paclitaxel is one of anti-cancer drugs which can get relatively good response for advanced patients。In this experiment 170 patients with advanced breast cancer were enrolled and treated with Paclitaxel (Taxol) or Docetaxel single or combined chemotherapy. Hormone receptors (ER and PR), Her-2, MDR-1 and apoptosis-related P53 and BCL-2 were measured with immunohistochemistric method. Relation between efficacy of chemotherapy and expression was analyzed. Major results were as followed:1. Response rate to chemotherapy: The rate to Paclitaxel was 40%,if combined with other chemotherapeutic agents such as cisplatine the rate was not significantly changed. The response rate to doxetaxel was 25%; it may be increased if was combined with other agents.2. Positive percent of expression of molecular markers: ER was 59.3%,PR was 50.9%, HER-2 was 25.7%, p53 was 33.9%, MDR-1 was 20.8%, BCL-2 was 21.5。3. Correlation between response rate to chemotherapy and expression of molecular markers: High response rate is correlated with negative ER and positive Her-2 expression, Breast cancers with both ER- and HER-2+ phenotype have a higher rate to the chemotherapy, up to 65.7%. PR,BCL-2,p53,MDR-1 were not predictve to resepose rate of breast cancer to the therapy with paclitaxel or doxetaxel.Conclusion: Paclitaxel or doxetaxeln based combination chemotherapy is an effective well-tolerated scheme in the treatment of breast cancer. ER negation was a positive predictive factor。HER-2 positivity is a very high intensive factor for the scheme. Immunohistocchemistry methods may be used to molecular classification of breast cancer.