Low Expression of Stathmin in Tumor Predicts High Response to Neoadjuvant Chemotherapy with Docetaxel-Containing Regimens in Locally Advanced Breast Cancer

Aims: We performed this retrospective study to evaluate the value of clinicopathological factors and a novel molecular marker stathmin in predicting treatment response to neoadjuvant chemotherapy (NCT) with docetaxel-containing regimens in patients with locally advanced breast cancer. Methods: Fifty-four consecutive locally advanced patients receiving docetaxel-containing NCT between January 2006 and July 2010 in Zhejiang Cancer Hospital were included. The expression levels of estrogen receptor (ER), progesterone receptor (PgR), epidermal growth factor receptor-2 (HER-2), and p53 were detected by immunohistochemistry, while expression of stathmin mRNA was measured by Quanti-Gene assay. Results: The overall clinical objective response (cOR) rate was 75.9% (41/54) in breast. A total of 34 patients (63.0%) experienced pathological OR (pOR), with pathological complete remission (pCR) rate of 20.4% (11/54) in breast and 16.7% (9/54) in both breast and axilla. In univariate analysis, there were associations of pOR in both breast and axilla with age (p = 0.054), ER status (p = 0.059), subtypes (p = 0.062), p53 (p = 0.030), and stathmin expression (three terciles) (p = 0.039). Mean expression of stathmin in pOR group was 0.410, compared with that in no response group of 0.556 (p = 0.051 by Student's t-test). Similarly, a lower expression of stathmin might represent a higher pCR rate (p = 0.061). Moreover, the LOWESS smoothing plot showed the same trend, that is, that tumor with a lower level of stathmin expression had a higher probability of response to docetaxel-containing NCT. After multivariate adjustment, both ER and stathmin remained significant with hazard ratio of 4.58 (95% CI: 1.11-18.94, p = 0.036) and 2.94 (95% CI: 1.26-6.86, p = 0.012), respectively. Conclusions: In conclusion, ER and stathmin were independent predictive factors for NCT with docetaxel-containing regimens.