Cancer Chemother Pharmacol (2011) 67:911–917 DOI 10.1007/s00280-010-1371-4 123 ORIGINAL ARTICLE Predictive factors for the eVectiveness of neoadjuvant chemotherapy and prognosis in triple-negative breast cancer patients Hiroko Masuda · Norikazu Masuda · Yoshinori Kodama · Masami Ogawa · Michiko Karita · Jun Yamamura · Kazunori Tsukuda · Hiroyoshi Doihara · Shinichiro Miyoshi · Masayuki Mano · Shoji Nakamori · Toshimasa Tsujinaka Received: 24 January 2010 / Accepted: 14 May 2010 / Published online: 1 July 2010  Springer-Verlag 2010 Abstract Purpose Triple-negative breast cancers (TNBCs) do not derive beneWt from molecular-targeted treatments such as endocrine therapy or anti-HER2 therapy because they lack those molecular targets. On the other hand, TNBCs have been shown to respond to neoadjuvant chemotherapy (NAC). In this study, we analyzed TNBC patients who were treated with NAC at Osaka National Hospital over a recent 5-year period to clarify the predictive factors for NAC and prognostic factors. Patients and methods Thirty-three TNBC patients under- went sequential NAC with anthracycline (FEC100: 5FU 500 mg/m 2 , epirubicin 100 mg/m 2 , and cyclophosphamide 500 mg/m 2 /q3w, 4 courses) and taxanes (paclitaxel 80 mg/ m 2 /qw, 12 courses or docetaxel 75 mg/m 2 /q3w, 4 courses) from May 2003 to July 2008. Pre-therapeutical and surgical specimens were studied for expressions of ER, PgR, HER-2, EGFR, cytokeratin 5/6, Ki-67, p53 and androgen receptor by immunohistochemistry (IHC). We analyzed clinicopathological factors and molecular markers in regard to the response to NAC and prognosis. Results Pathological complete response (pCR) was achieved in 12 TNBC patients (36%). The pCR rate in the basal-like phenotype was signiWcantly lower than in the non-basal-like phenotype (23 vs. 64%, respectively: P = 0.02). High pre-operative expressions of Ki-67 (¸50%) and HER-2 (2+) were considered as predictive factors for a better response from NAC. Pre-operative Ki-67 expression showed a signiWcant correlation with disease-free survival (DFS) and a lower expression of Ki-67 (<50%) after NAC was favorable for DFS among non-pCR patients. Conclusions A non-basal-like phenotype and higher expressions of Ki-67 and HER-2 (2+) were favorable fac- tors for NAC. However, a higher expression of Ki-67 on the surgical specimen after NAC was also a poor prognostic factor. Keywords Triple-negative breast cancer · Neoadjuvant chemotherapy · Pathological complete response · Ki-67 · Basal-like phenotype Abbreviations TNBC Triple negative breast cancer NAC Neoadjuvant chemotherapy pCR Pathological complete response ER Estrogen receptor PgR Progesterone receptor AR Androgen receptor EGFR Epidermal growth factor receptor CK Cytokeratin H. Masuda · N. Masuda · M. Ogawa · M. Karita · J. Yamamura · S. Nakamori · T. Tsujinaka Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan Y. Kodama · M. Mano Department of Pathology, National Hospital Organization Osaka National Hospital, Osaka, Japan H. Masuda (&) · K. Tsukuda · H. Doihara · S. Miyoshi Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho Kitaku, Okayama 700-8558, Japan e-mail: masuhiro123@hotmail.com