Assessment Of Ihc4 - 1643 Words

Abstract Purpose: This study aimed to explore the value of IHC4 in predicting pathological response after neoadjuvant chemotherapy in patients with hormonal receptor (HR)-positive breast cancer (BC). Materials and Methods: In this retrospective exploratory study, data for 68 HR-positive BC patients who received neoadjuvant chemotherapy were recorded. IHC4 scores were calculated based on estrogen receptors/progesterone receptors, Ki-67 and HER2 status. Logistic and ordinal regression analyses in addition to likelihood ratio test were used to explore associations of IHC4 scores and other clinico-pathological parameters with pathological complete response (pCR) and pathological stage. Results: Taking the 25th percentile as the cut-off, a†¦show more content†¦This raised a critical need for predictors of response to neoadjuvant chemotherapy to optimize therapeutic outcome. The Oncotype DX recurrence score, based on a 21-gene signature, has been proven to estimate the risk of recurrence in early hormone receptors (HR)-positive BC patients treated with adjuvant hormonal therapy (Dowsett et al., 2010). It has also been shown to predict response to neoadjuvant chemotherapy.In Patients treated with neoadjuvant docetaxel, those with a high recurrence score were more likely to have pCR (Chang et al., 2008). In addition, pCR was linked with higher expression of proliferation-related genes and lower expression of estrogen receptor (ER)-related genes (Gianni et al., 2005). However, the cost and complexity of gene-based assays highlight the need for developing more simplified predictive tools. Immune-histochemistry (IHC)-4 score was developed based on the assessment of four key proteins in breast cancer including ER, progesterone receptors (PR), HER2 and Ki-67 (Cuzick et al., 2011). In the adjuvant setting of ER-positive patients, IHC4 score was found to provide prognostic information similar to that provided by Oncotype DX-recurrence score (Cuzick et al., 2011). This score was further validated in the cohort ofpatients involved in the tamoxifen exemestene adjuvant multinational (TEAM) study (Christiansen et al., 2012). However, the value of IHC4 score as a predictor of response to