Pengembangan Eksplorasi Determinan Respons Neoajuvan Kemoterapi Pasien Kanker Payudara Stadium Lanjut Lokal Berbasis Kuantifikasi Penanda Penekan Tumor

Abstract

The management of locally advanced breast cancer is stillan issue and challenge for every oncologist, including lowpatient survival rates, high recurrences and unpredictablechemotherapy responses. Aggressive behavior of cancercells is a determinant of poor therapeutic outcomes,predominantly due to inhibition of tumor suppressorp53 activity. This study aims to examine the responseof neoadjuvant chemotherapy based on p53 expressionin cancer tissue prior to administration of neoadjuvantchemotherapy. At least 80 patients with locally advancedbreast cancer who will receive neoadjuvant chemotherapyregimens of taxane or anthracycline types were includedin this retrospective cohort study. The results of cancertissue biopsies before chemotherapy were isolated for theprocess of p53 staining using the immunohistochemicalmethod, followed by monitoring the response after givingneoadjuvant chemotherapy for 3 cycles with an interval of4 weeks each administration. Chemotherapy response wasbased on RECIST 1.1 criteria by validating changes in tumorvolume before and after administration of neoadjuvantchemotherapy. The results of this study indicated that p53expression in locally advanced breast cancer tissue did notaffect differences in response to neoadjuvant chemotherapy(p=0,6,21), p53 expression significantly increasedthe positive response after administration of taxanebased chemotherapy better than anthracycline-basedchemotherapy ( OR 4.64;p=0.036). Based on these findings, it can be concluded that the presence of p53 contributes tothe efficacy of neoadjuvant chemotherapy regimens butcannot be used as a clinical predictor of response. It is stillnecessary to study the mechanism of the role of p53 in thedrug efflux mechanism pathway which increases the risk ofa negative chemotherapy response.