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Abstract
Approximately 50% of patients with estrogen receptor (ER)—positive breast cancer (BC)
and 70%–80% of patients with ER-positive and progesterone receptor (PgR)—positive
BC respond to hormonal therapy. Additional predictive markers are needed. A group
of 287 patients with ER- and/or PgR-positive tumors was selected from 804 patients
previously enrolled in a multicenter phase III trial. Bcl-2 expression was evaluated
and correlated with response to adjuvant tamoxifen and survival. Estrogen receptor
and PgR were determined by biochemical means and Bcl-2 by immunohistochemistry. With
a median follow-up of 76 months (95 relapses and 60 deaths), of the 287 patients with,
187 (65%) had Bcl-2—positive tumors and 78 of these patients received tamoxifen. Of
the 100 patients with Bcl-2—negative disease, 51 received tamoxifen and 49 regular
follow-up. Using patients treated with tamoxifen as a reference, a univariate analysis
of disease-free interval for patients who did not receive tamoxifen showed a hazard
ratio (HR) of 1.42 (95% CI, 0.82-2.44;P = 0.21) for patients with Bcl-2—positive disease and a HR of 1.05 (95% CI, 0.55-1.99;P = 0.89) for patients with Bcl-2—negative disease (P = 0.48). After adjusting for number of positive lymph nodes, degree of receptor and
PgR positivity, and type of surgery, the HRs were 1.54 (95% CI, 0.87–2.73;P = 0.14) for Bcl-2—positive disease and 1.05 (95% CI, 0.52–2.11; P = 0.88) for Bcl-2—negative disease. Despite its being a retrospective nonrandomized
study with a relatively low number of patients, our results suggest that Bcl-2 deserves
further evaluation as a predictive factor of sensitivity to tamoxifen.
Key words
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Article info
Publication history
Accepted:
February 18,
2004
Received in revised form:
February 18,
2004
Received:
June 24,
2003
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
