31P S-Vegf (Vascular Endothelial Growth Factor) as Predictive Factor in Response to Anthracycline Based Chemotherapy in Patients with Locally Advanced Breast Cancer

ABSTRACT Purpose Breast cancer is the second most common cancer among women in India and many women present with locally advanced breast cancer (LABC). Neoadjuvant chemotherapy (NACT) has been used in patients of LABC to downstage tumours and enable surgery. Predictive factors are required to better guide the selection of chemotherapeutic regimens, in order to maximize the benefits (or response rates) and minimize unnecessary toxicity. Patients and methods Patients diagnosed with inoperable LABC at Gujarat Cancer and Research Institute from 1st August 2009 to 31st October 2010 were included in the study. Baseline samples were sent for S-VEGF levels for all patients using VEGF quantitative enzyme immunoassay technique. The first line NACT was FAC or FEC. Patients were evaluated clinically and radiologically at the end of 3 cycles for response assessment (mammography or ultrasonography of breast). S-VEGF levels were repeated at the end of 3 cycles of NACT or before surgery. All resectable patients underwent a Modified Radical Mastectomy. S-VEGF levels were also measured from “age and menopausal status matched” controls. The levels of S-VEGF from controls were compared to baseline S-VEGF levels from patients of LABC included in the study. Statistical analysis was done using SPSS software using independent samples T-Test, Paired T-Test, Chi-Square Test and Pearson’s test. Results Mean baseline S-VEGF in patients with LABC was significantly elevated as compared to controls. Mean baseline S-VEGF levels were lower in patients achieving a clinical or pathological response to anthracycline based NACT as compared to those who did not. However, these differences were not statistically significant. There was no statistically significant difference between mean S-VEGF at baseline and S-VEGF measured after NACT indicating that there was no impact of anthracycline based NACT on S-VEGF levels. Conclusions Mean baseline S-VEGF levels were lower in patients achieving a clinical or pathological response to anthracycline based NACT as compared to those who did not. These differences were not statistically significant. Acknowledgement Dr S. Trivedi, Dr T. Patel. Disclosure All authors have declared no conflicts of interest.