Patterns of Recurrence after Neoadjuvant Therapy in Early Breast Cancer, according to the Residual Cancer Burden Index and Reductions in Neoadjuvant Treatment Intensity.
RCB
early breast cancer
neoadjuvant systemic therapy
Journal
Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829
Informations de publication
Date de publication:
20 May 2021
20 May 2021
Historique:
received:
12
03
2021
revised:
10
05
2021
accepted:
18
05
2021
entrez:
2
6
2021
pubmed:
3
6
2021
medline:
3
6
2021
Statut:
epublish
Résumé
The prognostic performance of the residual cancer burden (RCB) score is a promising tool for breast cancer patients undergoing neoadjuvant therapy. We independently evaluated the prognostic value of RCB scores in an extended validation cohort. Additionally, we analyzed the association between chemotherapy dose reduction and RCB scores. In this extended validation study, 367 breast cancer patients with available RCB scores were followed up for recurrence-free survival (RFS), distant disease-free survival (DDFS), and overall survival (OS). We also computed standardized cumulative doses of anthracyclines and taxanes (A/Ts) to investigate a potential interaction between neoadjuvant chemotherapy dose reduction and RCB scores. Higher RCB scores were consistently associated with adverse clinical outcomes across different molecular subtypes (HR for RFS = 1.60, 95% CI 1.33-1.93, Our results confirm RCB score as a prognostic marker for RFS, DDFS, and OS independent of the molecular subtype. Importantly, we show that lower doses of cumulative neoadjuvant A/T were associated with higher RCB scores in patients who required a dose reduction.
Sections du résumé
BACKGROUND
BACKGROUND
The prognostic performance of the residual cancer burden (RCB) score is a promising tool for breast cancer patients undergoing neoadjuvant therapy. We independently evaluated the prognostic value of RCB scores in an extended validation cohort. Additionally, we analyzed the association between chemotherapy dose reduction and RCB scores.
METHODS
METHODS
In this extended validation study, 367 breast cancer patients with available RCB scores were followed up for recurrence-free survival (RFS), distant disease-free survival (DDFS), and overall survival (OS). We also computed standardized cumulative doses of anthracyclines and taxanes (A/Ts) to investigate a potential interaction between neoadjuvant chemotherapy dose reduction and RCB scores.
RESULTS
RESULTS
Higher RCB scores were consistently associated with adverse clinical outcomes across different molecular subtypes (HR for RFS = 1.60, 95% CI 1.33-1.93,
CONCLUSION
CONCLUSIONS
Our results confirm RCB score as a prognostic marker for RFS, DDFS, and OS independent of the molecular subtype. Importantly, we show that lower doses of cumulative neoadjuvant A/T were associated with higher RCB scores in patients who required a dose reduction.
Identifiants
pubmed: 34065332
pii: cancers13102492
doi: 10.3390/cancers13102492
pmc: PMC8161089
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
JAMA Oncol. 2016 Jun 1;2(6):751-60
pubmed: 26914222
JAMA. 1995 Feb 15;273(7):542-7
pubmed: 7837388
Lancet. 2012 Feb 4;379(9814):432-44
pubmed: 22152853
Ann Surg Oncol. 2019 Dec;26(13):4274-4283
pubmed: 31452052
Ann Oncol. 2015 Jul;26(7):1280-91
pubmed: 26019189
NCI Monogr. 1986;(1):87-94
pubmed: 3534595
Breast. 2015 Nov;24 Suppl 2:S26-35
pubmed: 26253814
Breast Cancer Res Treat. 2017 Aug;165(1):181-191
pubmed: 28577078
J Clin Oncol. 2007 May 20;25(15):2127-32
pubmed: 17513820
Lancet. 2019 Apr 6;393(10179):1440-1452
pubmed: 30739743
J Clin Oncol. 2009 Feb 10;27(5):720-5
pubmed: 19103732
PLoS One. 2020 Jun 24;15(6):e0234191
pubmed: 32579551
Cancer Res. 1988 Dec 15;48(24 Pt 1):7067-71
pubmed: 3191483
Semin Oncol. 2004 Dec;31(6 Suppl 15):3-9
pubmed: 15726532
Arch Pathol Lab Med. 2013 Aug;137(8):1074-82
pubmed: 23899063
BMC Cancer. 2018 Apr 20;18(1):453
pubmed: 29678165
J Clin Oncol. 2012 May 20;30(15):1796-804
pubmed: 22508812
Control Clin Trials. 1996 Aug;17(4):343-6
pubmed: 8889347
J Clin Oncol. 2020 Jan 20;38(3):203-213
pubmed: 31804894
J Clin Oncol. 2015 Jan 1;33(1):65-73
pubmed: 25422485
J Clin Oncol. 2014 Dec 1;32(34):3883-91
pubmed: 25349292
Breast Cancer Res Treat. 2016 Dec;160(3):475-489
pubmed: 27730423
Lancet. 2013 Mar 9;381(9869):805-16
pubmed: 23219286
J Clin Oncol. 2007 Oct 1;25(28):4414-22
pubmed: 17785706
J Clin Oncol. 2003 Dec 15;21(24):4524-31
pubmed: 14673039
N Engl J Med. 2019 Feb 14;380(7):617-628
pubmed: 30516102
Stat Med. 2002 Aug 15;21(15):2175-97
pubmed: 12210632
Lancet. 2014 Jul 12;384(9938):164-72
pubmed: 24529560
Cancer. 1971 Dec;28(6):1479-99
pubmed: 5127796
Breast Cancer Res Treat. 2009 Apr;114(3):479-84
pubmed: 18463977
J Clin Oncol. 2017 Apr 1;35(10):1049-1060
pubmed: 28135148
N Engl J Med. 2017 Jun 1;376(22):2147-2159
pubmed: 28564564