Study Of Sensitity Of Chemotherapy Drugs In Primary Breast Cancer

Objective: It has long been known that breast cancers are actually a heterogeneous group of diseases with different phenotypes, prognoses and responses to treatment. The aim of the study is to select optimal chemotherapy regimens for different molecular breast cancer so as to examine chemosensitivity of commonly used drugs by CD-DST.Methods: 1、From 2008 to 2014,a total of 536 fresh operable primary breast cancer samples were collected. The chemosensitivity of culture primary breast cancer cells to DOC, EPI, THP, NVB and CDDP was examined by CD-DST. To extract primary cells of fresh postoperative carcinoma tissue, and then culture primitive cells by Collagen gel embedding culture method, which is simulating the internal growth environment of cancer cells. If primitive cells are in good state, they can be cultured directly with five commonly used chemotherapy drugs(DOC, EPI, THP and NVB and CDDP).The drug sensitivity of five drugs is evaluated by electrophoresis power system. The drug susceptibility of five drugs in primitive cells is accessed with the ratio of the amount of cell cloning between drug exposure group(T) and non-drug exposure group(C).Among them, T represents the absorbence of primitive cells in drug exposure group, while C represents the absorbence of primitive cells in non-drug exposure group. If the ratio of one drug is equal or less than 50%, it means that the primitive cells are sensitive to the drug. If the ratio of one drug is more than 50%, it means that the primitive cells are resistant to the drug. The single drug efficiency is the ratio between drug sensitive cases and all cases. 2、We detect the expression of ER、PR 、HER-2、ki-67、p53、EGFR and CK5/6 in 536 cases of primary breast cancer by adopting the method of immunohistochemistry(IHC). Using fluorescence in situ hybridization(FISH) to detect the amplification state of C-er B-2/neu gene.According to the above indicators to judge the molecular classification of breast cancer. 3、The statistical analysis of experimental data is analyzed by SPSS17.0 statistical software. When P is equal or less than 0.05, it means that there are statistically significant differences between experimental data.Results: 1、The single drug efficiency of five chemotherapy drugs is respectively DOC(46.5%), EPI(42.9%), THP(42.7%), CDDP(42.5%) and NVB(34.0%).The comparison of single-agent efficiency between five chemotherapy drugs shows: the single drug efficiency between docetaxel、anthracyclines and cisplatin in primary breast cancers shows no statisticall significance(P>0.05), while the sensitivity of vinorelbine is lowest(P<0.05). 2、In the 536 cases of primary breast cancer, the positive rate of ER is 70.9%, the positive rate of PR is 57.6%, the positive rate of HER-2 is 19.8%, the positive rate of p53 was 32.3%, the positive rate of ki-67 was 75.9%.Among the 536 cases, 323 cases(60.3%) were luminal A, 63(11.8%) were luminal B, 81(15.1%) were basal-like subtype,and 69(12.9%) were HER-2(+) subtype. 3、The sensitivity of the five kinds of chemotherapy drugs is different in the clinical-pathological features and molecular types of primary breast cancer. Docetaxel is more sensitive in the primary breast cancer of age < 60, ER- negative and p53 positive and non-luminal subtype(P<0.05). Epirubicin is more sensitive in the primary breast cancer of tumor <5 cm, ER- negative, Her2 positive and non-luminal subtype(P< 0.05). Pirarubicin is more sensitive in the primary breast cancer of invasive ductal carcinoma, histopathological grade III and Her2-positive(P<0.05). Cisplatin is more sensitive in primary breast cancer of ER- positive and luminal subtype(P<0.05). Vinorelbine is more sensitive in the primary breast cancer of PR-positive, Luminal B subtype and non- Her2 subtype(P<0.05). The difference of single drug efficiency in different lymph node metastasis and different expression of Ki-67 shows no statistical significance(P > 0.05).Conclusion: In the primary breast cancer,the sensitivity of docetaxel is the highest,and the sensitivity of vinorelbine is the lowest.While the difference between anthracyclines and cisplatine shows no statistical significance. Examine the chemosensitivity of routine chemotherapy drugs by CD-DST,and find that the sensitivity of the five kinds of chemotherapy drugs is different in the clinical-pathological features and molecular types of primary breast cancer.As the first line of the primary breast cancer drugs, docetaxel and anthracyclines are more sensitive in triple-negative subtype and HER-2(+)subtype, and are not sensitive in the luminal subtype. Cisplatin is more sensitive in luminal subtype. Vinorelbine is more sensitive in luminal B subtype and nonHER-2(+) subtype.