ObjectiveTo explore the relationship of topoisomerase typeⅡA (TOP2A)to human epidermal growth factor receptor 2(HER2/neu), and the therapeutic prediction of TOP2A in clinical chemotherapy for breast cancer. MethodThe Cochrane, Medline, Embase, PubMed, CNKI, and WANFANG data were retrieved to get the related literatures about TOP2A and the effect of anthracycline-based drugs. ResultsThe TOP2A gene and HER2 gene were all located in 17q21, the TOP2A gene was a downstream gene of the HER2 gene. There was some relationship of the HER2 to TOP2A gene abnormality. There was some controversy about HER2 and TOP2A on anthracycline regimens reaction. It was generally accepted that the status of TOP2A gene for predicting the effect of patients with anthracycline regimens might be more precise. There was inconsistency between the gene amplification and overexpression of TOP2A, which was two different biological behaviors, and which might be the characteristics of different molecular subtypes. In terms of the present study, a plenty of clinical researches could illustrate that TOP2A was an important target of anthracycline. But anthracycline-based drugs could induce the apoptosis of the cell through various mechanisms, so the anthracyclinebased drugs killed tumor cells in breast cancer needed not inhibit TOP2A, might be more complex than previously predicted. ConclusionsTOP2A is an important target of anthracycline. But it seems to be limited only by observing the TOP2A for predicting curative effect of anthracycline-based drugs.
ObjectiveTo explore the role of toremifene in postmenopausal operable patients with luminal subtype of breast cancer in China. MethodsA total of 618 eligible patients diagnosed with luminal subtype of breast cancer from January 2000 to December 2009 in the Cancer Center of Sun Yat-sen University were analyzed. One hundred and fifteen patients were treated with toremifene(toremifene group) and 503 patients were treated with tamoxifen(tamoxifen group) as adjuvant endocrine therapy. Survival was compared by Kaplan-Meier with log-rank test in two groups. Cox analysis was used to compare different prognostic factors. ResultsThe general clinical data had no significant differences between the toremifene group and tamoxifen group (P > 0.05). After a median follow-up of 76 months, there was no statistical difference in the 5-year disease free survival rate and 5-year overall survival rate between the toremifene group and the tamoxifen group (5-year disease free survival rate:78.5% versus 85.5%, P=0.083;5-year overall survival rate:86.4% versus 92.0%, P=0.334). Univariated analysis showed that the histological grade, tumor size, lymph node status, TNM stage, HER-2 positive expression were associated with the disease free survival rate and overall survival rate(P < 0.05). Multivariated analysis showed that the tumor size and lymph node status were the independent risk factors of disease free survival rate and overall survival rate for postmenopausal operable patients with luminal subtype of breast cancer(P < 0.05). HER-2 positive expression was the independent risk factor in predicting disease free survival rate for patients with tamoxifen or toremifene. There was no grade 3 or 4 toxicity for all the patients according to CTC AE 4.0 grade. ConclusionsSimilar benefit is found in disease free survival rate and overall survival rate in Chinese postmenopausal patients with operable luminal subtype of breast cancer between patients receiving toremifene and tamoxifen with tolerable adverse effects. HER-2 status is associated with disease free survival rate.