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In Reply

Kathleen I. Pritchard, Maureen Trudeau

Sunnybrook Odette Cancer Centre and Department of Medicine, University of Toronto, Toronto, Ontario, Canada

Hans Messersmith

Cancer Care Ontario, Toronto, Ontario, Canada

Leela Elavathil

McMaster University and Henderson Hospital, Hamilton, Ontario, Canada

Frances O'Malley

Department of Pathology and Laboratory Medicine, Mount Sinai Hospital; and Department of Pathology and Laboratory Medicine, University of Toronto, Toronto, Ontario, Canada

Bindi Dhesy-Thind

McMaster University and Juravinski Cancer Centre, Hamilton, Ontario, Canada

It is difficult to comment on tumor grade as a predictive factor because it was not included in most of the multivariate analyses that are covered in this review, nor in many of the articles that were included in the various meta-analyses.^1-3 We did not specifically explore triple-negative (estrogen receptor–negative/progesterone receptor–negative/human epidermal growth factor receptor 2 [HER-2]–negative) patients in our own analyses, nor did any of the articles on which this review was based.

Certainly, in our own data^4-6 the inclusion of tumor grade and/or of estrogen receptor and progesterone receptor in multivariate analysis did not replace the association of HER-2 amplification or topoisomerase IIA alterations with improved benefit from cyclophosphamide/epirubicin/fluorouracil compared with cyclophosphamide/methotrexate/fluorouracil. It is likely true, however, that HER-2 and/or topoisomerase IIA are not the only predictive markers in this setting. That is why various investigators are exploring multifaceted gene signatures or combinations of markers to better predict response and to select more specific therapy for individual women.

AUTHORS’ DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

Although all authors completed the disclosure declaration, the following author(s) indicated a financial or other interest that is relevant to the subject matter under consideration in this article. Certain relationships marked with a "U" are those for which no compensation was received; those relationships marked with a "C" were compensated. For a detailed description of the disclosure categories, or for more information about ASCO's conflict of interest policy, please refer to the Author Disclosure Declaration and the Disclosures of Potential Conflicts of Interest section in Information for Contributors.

Employment or Leadership Position: None Consultant or Advisory Role: Kathleen I. Pritchard, Aventis (C), Roche (C), Pharmacia (C), Ortho-Biotech (C), Pfizer (C), YM Biosciences (C), Biomera (C) Stock Ownership: None Honoraria: Kathleen I. Pritchard, Aventis, AstraZeneca, Pharmacia, Pfizer Research Funding: None Expert Testimony: Kathleen I. Pritchard, Aventis (C), AstraZeneca (C) Other Remuneration: None

NOTES

published online ahead of print at www.jco.org on April 28, 2008

REFERENCES

1. Dhesy-Thind B, Pritchard KI, Messersmith H, et al: HER2/neu in systemic therapy for women with breast cancer: A systemic review. Br Cancer Res Treat [Epub ahead of print July 17, 2007]

2. Gennari A, Sormani M, Puntoni M: A pooled analysis on the interaction between Her-2 expression and responsiveness of breast cancer to adjuvant chemotherapy. Br Cancer Res Treat 100, 2006 (abstr)

3. De Laurentiis M, Arpino G, Massarelli E, et al: A meta-analysis on the interaction between HER-2 expression and response to endocrine treatment in advanced breast cancer. Clin Cancer Res 11:4741-4748, 2005[Abstract/Free Full Text]

4. Pritchard KI, Shepherd LE, O'Malley FP, et al: HER2 and responsiveness of breast cancer to adjuvant chemotherapy. N Engl J Med 354:2103-2111, 2006[Abstract/Free Full Text]

5. O'Malley FP, Chia S, Shepherd LE, et al: Topoisomerase II alpha protein overexpression has predictive utility in a randomized trial comparing CMF to CEF in premenopausal women with node positive breast cancer (NCIC CTG MA. 5). Presented at the 29th Annual San Antonio Breast Cancer Symposium, December 14-17, 2006, San Antonio, TX

6. O'Malley FP, Chia S, Tu D, et al: Prognostic and predictive value of topoisomerase II alpha in a randomized trial comparing CMF to CEF in premenopausal women with node positive breast cancer (NCIC CTG MA. 5). J Clin Oncol 24:11s, 2006 (suppl; abstr 533)

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This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Pritchard, K. I. Articles by Dhesy-Thind, B. Search for Related Content PubMed Articles by Pritchard, K. I. Articles by Dhesy-Thind, B. Social Bookmarking                            What's this?