High Plasma Fibrinogen Is Correlated With Poor Response To Trastuzumab Treatment In HER2 Positive Breast Cancer

Trastuzumab is an important therapy of breast cancer targeted treatment,which rescued millions of patients in the past decades.However,part of the HER-2-positive breast cancer patients failed to benefit from celecoxib trastuzumab therapy.Moreover,previous studies showed a significant correlation between plasma coagulation parameters and clinical characteristics in breast cancer patients.Thus,the purpose of our study was to determine the correlation between coagulation parameters and trastuzumab therapy response in breast cancer patients.This is a retrospectively study here.Coagulation parameters were collected from102 breast cancer patients who received trastuzumab treatment during 2006 to 2010.The relationship was analyzed between clinicalopathological features and routine coagulation factors,including prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fib)and D-dimer(DD).Kaplan-Meier analysis and Cox regression hazard model were used to assess their prognosis value in breast cancer.Totally 102 cases of trastuzumab treated breast cancer patients was collected from 401 PLA hospital and Southwest hospital,including clinical information and follow-up data for all patients.All of them were HER-2 positive advanced breast cancer patients,with an average age of 45 years old.Comparison analysis was obtained,which were summarized as follows:(1)No-effective group for trastuzumab therapy showed a prolonged PT,APTT and TT,as well as increased fibrinogen and DD levels.But only fibrinogen level showed a significant rise,indicating that fibrinogen is a key factor coagulation parameters for trastuzumab treatment failure.(2)High level of fibrinogen(Fib> 2.88 g / L)was associated with various clinical features,such as pathological grade.A significant negative correlation was also observed between fibrinogen level and PTEN expression,suggesting that PI3 K signaling pathways might be involved in fibrinogen regulated patient's response to trastuzumab therapy.(3)More importantly,high fibrinogen levels are an independent risk factor for breast cancer patients receiving trastuzumab therapy.Clinicians need to be promptedto pay attention to the fibrinogen level before trastuzumab therapy.(4)The patients with high fibrinogen levels exhibited a shorter disease-free survival expectation(DFS)and overall survival expectations(OS).The clinical value of fibrinogen levels is not only for coagulation status,but also has prognostic value.This retrospective study showed that there was a significant correlation between high fibrinogen level and poor response to trastuzumab treatment.Fibrinogen levels >2.88 g / L should alert the physician to consider preprocessing to reduce fibrinogen levels before trastuzumab treatment in HER-2 positive breast cancer,in order to increase the sensitivity to the monoclonal antibody therapy.Monitoring coagulation factors for the patients with monoclonal antibody therapy,especially those with high fibrinogen level will help monitor the status of the patient's physician to improve clinical outcomes.