Predictive factors for relapse in triple-negative breast cancer patients without pathological complete response after neoadjuvant chemotherapy.

multifocal disease neoadjuvant chemotherapy pathologic response residual cancer burden (RCB) triple-negative breast cancer

Journal

Frontiers in oncology
ISSN: 2234-943X
Titre abrégé: Front Oncol
Pays: Switzerland
ID NLM: 101568867

Informations de publication

Date de publication:
2022
Historique:
received: 10 08 2022
accepted: 09 11 2022
entrez: 19 12 2022
pubmed: 20 12 2022
medline: 20 12 2022
Statut: epublish

Résumé

Triple-negative breast cancer (TNBC) patients who do not obtain pathological complete response (pCR) after neoadjuvant chemotherapy (NACT) present higher rate of relapse and worse overall survival. Risk factors for relapse in this subset of patients are poorly characterized. This study aimed to identify the predictive factors for relapse in TNBC patients without pCR after NACT. Women with TNBC treated with NACT from January 2008 to May 2020 at the Modena Cancer Center were included in the analysis. In patients without pCR, univariate and multivariable Cox analyses were used to determine factors predictive of relapse. We identified 142 patients with a median follow-up of 55 months. After NACT, 62 patients obtained pCR (43.9%). Young age at diagnosis (<50 years) and high Ki-67 (20%) were signi!cantly associated with pCR. Lack of pCR after NACT resulted in worse 5-year event-free survival (EFS) and overall survival (OS). Factors independently predicting EFS in patients without pCR were the presence of multifocal disease [hazard ratio (HR), 3.77; 95% CI, 1.45-9.61; p=0.005] and residual cancer burden (RCB) III (HR, 3.04; 95% CI, 1.09-9.9; p=0.04). Neither germline BRCA status nor HER2-low expression were associated with relapse. These data can be used to stratify patients and potentially guide treatment decision-making, identifying appropriate candidates for treatment intensi!cation especially in neo-/adjuvant setting.

Identifiants

pubmed: 36531080
doi: 10.3389/fonc.2022.1016295
pmc: PMC9753128
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1016295

Informations de copyright

Copyright © 2022 Toss, Venturelli, Civallero, Piombino, Domati, Ficarra, Combi, Cabitza, Caggia, Barbieri, Barbolini, Moscetti, Omarini, Piacentini, Tazzioli, Dominici and Cortesi.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer EP declared a past co-editorship with one of the authors AT to the handling Editor.

Références

Eur J Surg Oncol. 2011 Feb;37(2):155-61
pubmed: 21111561
Ann Oncol. 2018 Jul 1;29(7):1497-1508
pubmed: 29873695
Cancer Manag Res. 2018 Jan 15;10:91-103
pubmed: 29391830
Breast Cancer Res. 2011 Mar 02;13(2):R22
pubmed: 21366896
PLoS One. 2019 Sep 19;14(9):e0222358
pubmed: 31536530
Cancers (Basel). 2020 May 15;12(5):
pubmed: 32429297
Lancet Oncol. 2018 Jan;19(1):3-5
pubmed: 29233560
J Natl Cancer Inst. 2013 Dec 18;105(24):1897-906
pubmed: 24203987
Lancet Oncol. 2018 Jan;19(1):40-50
pubmed: 29233559
Breast Cancer Res Treat. 2009 Jul;116(1):53-68
pubmed: 18592370
N Engl J Med. 2020 Feb 27;382(9):810-821
pubmed: 32101663
JAMA Oncol. 2020 Sep 1;6(9):1355-1362
pubmed: 32701140
Int J Radiat Oncol Biol Phys. 2020 Nov 1;108(3):676-685
pubmed: 32407932
Eur J Cancer. 2012 Dec;48(18):3342-54
pubmed: 22766518
Ann Oncol. 2014 Mar;25(3):611-618
pubmed: 24401929
Ann Surg Oncol. 2015 Apr;22(4):1118-27
pubmed: 25297900
Breast Cancer Res Treat. 2016 Jun;157(3):555-64
pubmed: 27225388
BMC Surg. 2015 Jan 14;15:1
pubmed: 25586679
J Clin Oncol. 2012 May 20;30(15):1796-804
pubmed: 22508812
Curr Oncol. 2018 Jun;25(Suppl 1):S142-S150
pubmed: 29910657
Lancet Oncol. 2018 Apr;19(4):497-509
pubmed: 29501363
Lancet Oncol. 2022 Jan;23(1):149-160
pubmed: 34902335
Breast Cancer Res Treat. 2017 Jan;161(2):279-287
pubmed: 27888421
JAMA. 2021 Jan 5;325(1):36-38
pubmed: 33300953
Radiol Oncol. 2011 Mar;45(1):46-52
pubmed: 22933934
Breast Cancer. 2011 Jul;18(3):146-51
pubmed: 20972742
Clin Cancer Res. 2007 Aug 1;13(15 Pt 1):4429-34
pubmed: 17671126
Eur J Cancer. 2019 Sep;118:41-48
pubmed: 31302586
Cancer Sci. 2009 Oct;100(10):1823-33
pubmed: 19604245
J Clin Oncol. 2007 Oct 1;25(28):4414-22
pubmed: 17785706
Clin Cancer Res. 2013 Aug 15;19(16):4521-31
pubmed: 23812670
NPJ Breast Cancer. 2021 Sep 10;7(1):119
pubmed: 34508075
Eur J Cancer. 2020 May;130:92-101
pubmed: 32179450
JAMA Oncol. 2021 Nov 01;7(11):1654-1663
pubmed: 34529000
J Clin Oncol. 2015 Mar 20;33(9):983-91
pubmed: 25534375
J Natl Compr Canc Netw. 2020 Mar;18(3):288-296
pubmed: 32135512
Clin Cancer Res. 2020 Jun 15;26(12):2838-2848
pubmed: 32046998
Lancet. 2014 Jul 12;384(9938):164-72
pubmed: 24529560
BJS Open. 2018 May 22;2(4):162-174
pubmed: 30079385
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
Oncotarget. 2016 Jul 12;7(28):44288-44298
pubmed: 27329588
N Engl J Med. 2021 Jun 24;384(25):2394-2405
pubmed: 34081848
J Clin Oncol. 2008 Mar 10;26(8):1275-81
pubmed: 18250347

Auteurs

Angela Toss (A)

Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.
Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Marta Venturelli (M)

Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.

Monica Civallero (M)

Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy.

Claudia Piombino (C)

Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.

Federica Domati (F)

Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Guido Ficarra (G)

Pathology Unit, University Hospital of Modena, Modena, Italy.

Francesca Combi (F)

Unit of Breast Surgical Oncology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.
Department of Biomedical, Metabolic and Neural Sciences, International Doctorate School in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy.

Eleonora Cabitza (E)

Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.

Federica Caggia (F)

Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.

Elena Barbieri (E)

Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.

Monica Barbolini (M)

Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.

Luca Moscetti (L)

Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.

Claudia Omarini (C)

Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.

Federico Piacentini (F)

Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.
Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Giovanni Tazzioli (G)

Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Unit of Breast Surgical Oncology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.

Massimo Dominici (M)

Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.
Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Laura Cortesi (L)

Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.

Classifications MeSH