P-glycoprotein expression as a predictor of response to neoadjuvant chemotherapy in breast cancer.
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Date
2013-07
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Abstract
BACKGROUND: Chemoresistance is an important factor determining the response of tumor to neoadjuvant chemotherapy
(NACT). P-glycoprotein (P-gp) expression-mediated drug efflux is one of the mechanisms responsible for multi-drug
resistance. Our study was aimed to determine the role of P-gp expression as a predictor of response to NACT in locally
advanced breast cancer (LABC) patients. MATERIALS AND METHODS: P-gp expression was performed by real-time
quantitative polymerase chain reaction [qRT-PCR] in 76 patients with LABC. Response to adriamycin-based regimen was
assessed both clinically and with contrast enhanced computed tomography (CECT) scan before and after NACT. The
significance of correlation between tumor and P-gp levels was determined with Chi-square test. RESULTS: Twenty-one
had high and 55 had low P-gp expression. On analyzing P-gp expression with response by World Health Organization
(WHO) criteria, statistical significance was obtained (P = 0.038). Similarly, assessment of P-gp expression with response
by Response Evaluation in Solid Tumors (RECIST) criteria in 48 patients showed statistical significance (P = 0.0005).
CONCLUSION: This study proves that P-gp expression is a determinant factor in predicting response to NACT. Finally,
detection of P-gp expression status before initiation of chemotherapy can be used as a predictive marker for NACT response
and will also aid in avoiding the toxic side effects of NACT in non-responders.
Description
Keywords
Breast cancer, neoadjuvant chemotherapy, P-glycoprotein
Citation
Vishnukumar S, Umamaheswaran G, Anichavezhi D, Indumathy S, Adithan C, Srinivasan K, Kadambari D. P-glycoprotein expression as a predictor of response to neoadjuvant chemotherapy in breast cancer. Indian Journal of Cancer. 2013 July-Sept; 50(3): 195-199.