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Neoadjuvant palbociclib on ER+ breast cancer (N007): clinical response and EndoPredict’s value

The purpose of the study was to test the efficacy of neoadjuvant palbociclib therapy and to evaluate its impact on cell cycle arrest and changes in EndoPredict (EP) scores before and after treatment. Postmenopausal women with histologically proven ER+ve, HER2−ve invasive breast cancer, 2 cm or great...

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Autores principales: Chow, Louis W C, Morita, Satoshi, Chow, Christopher Y C, Ng, Wai-Kuen, Toi, Masakazu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bioscientifica Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763422/
https://www.ncbi.nlm.nih.gov/pubmed/29158285
http://dx.doi.org/10.1530/ERC-17-0396
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author Chow, Louis W C
Morita, Satoshi
Chow, Christopher Y C
Ng, Wai-Kuen
Toi, Masakazu
author_facet Chow, Louis W C
Morita, Satoshi
Chow, Christopher Y C
Ng, Wai-Kuen
Toi, Masakazu
author_sort Chow, Louis W C
collection PubMed
description The purpose of the study was to test the efficacy of neoadjuvant palbociclib therapy and to evaluate its impact on cell cycle arrest and changes in EndoPredict (EP) scores before and after treatment. Postmenopausal women with histologically proven ER+ve, HER2−ve invasive breast cancer, 2 cm or greater, were enrolled in an open-label, single-arm study. Twenty eligible patients were given letrozole 2.5 mg per day together with palbociclib 125 mg per day for 3 out of 4 weeks in repeated cycles for 16 weeks (4 cycles) before surgery. The primary end points were clinical response rates (cRR) and preoperative endocrine prognostic index (PEPI). The secondary end points were pathologic response and gene expression testing with EP test on collected tumor samples. The following results were obtained. 17 patients showed a clinical response of 50% or more, including 8 complete responses and 9 partial responses. There was significant reduction in area (P < 0.0001) and volume (P = 0.017) of the cancer. Pathologic complete response (pCR) was achieved in one patient; all cancers were downgraded after treatment. Ki67 (P = 0.044) and EP scores (P < 0.0001) were significantly reduced after treatment. Analysis of the relative gene expression levels showed that all proliferative genes, IL6ST and RBBP8 were decreased after palbociclib treatment. 6 patients with intermediate and three patients with high PEPI risk scores were found to have low EPclin scores. All patients with high PEPI relapse risk score had high EPclin score. In conclusion, effective clinical response was demonstrated by neoadjuvant letrozole in combination with palbociclib. Compared with PEPI, EPclin might be a better parameter to estimate prognosis after neoadjuvant therapy.
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spelling pubmed-57634222018-01-16 Neoadjuvant palbociclib on ER+ breast cancer (N007): clinical response and EndoPredict’s value Chow, Louis W C Morita, Satoshi Chow, Christopher Y C Ng, Wai-Kuen Toi, Masakazu Endocr Relat Cancer Research The purpose of the study was to test the efficacy of neoadjuvant palbociclib therapy and to evaluate its impact on cell cycle arrest and changes in EndoPredict (EP) scores before and after treatment. Postmenopausal women with histologically proven ER+ve, HER2−ve invasive breast cancer, 2 cm or greater, were enrolled in an open-label, single-arm study. Twenty eligible patients were given letrozole 2.5 mg per day together with palbociclib 125 mg per day for 3 out of 4 weeks in repeated cycles for 16 weeks (4 cycles) before surgery. The primary end points were clinical response rates (cRR) and preoperative endocrine prognostic index (PEPI). The secondary end points were pathologic response and gene expression testing with EP test on collected tumor samples. The following results were obtained. 17 patients showed a clinical response of 50% or more, including 8 complete responses and 9 partial responses. There was significant reduction in area (P < 0.0001) and volume (P = 0.017) of the cancer. Pathologic complete response (pCR) was achieved in one patient; all cancers were downgraded after treatment. Ki67 (P = 0.044) and EP scores (P < 0.0001) were significantly reduced after treatment. Analysis of the relative gene expression levels showed that all proliferative genes, IL6ST and RBBP8 were decreased after palbociclib treatment. 6 patients with intermediate and three patients with high PEPI risk scores were found to have low EPclin scores. All patients with high PEPI relapse risk score had high EPclin score. In conclusion, effective clinical response was demonstrated by neoadjuvant letrozole in combination with palbociclib. Compared with PEPI, EPclin might be a better parameter to estimate prognosis after neoadjuvant therapy. Bioscientifica Ltd 2017-11-20 /pmc/articles/PMC5763422/ /pubmed/29158285 http://dx.doi.org/10.1530/ERC-17-0396 Text en © 2018 The authors http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Chow, Louis W C
Morita, Satoshi
Chow, Christopher Y C
Ng, Wai-Kuen
Toi, Masakazu
Neoadjuvant palbociclib on ER+ breast cancer (N007): clinical response and EndoPredict’s value
title Neoadjuvant palbociclib on ER+ breast cancer (N007): clinical response and EndoPredict’s value
title_full Neoadjuvant palbociclib on ER+ breast cancer (N007): clinical response and EndoPredict’s value
title_fullStr Neoadjuvant palbociclib on ER+ breast cancer (N007): clinical response and EndoPredict’s value
title_full_unstemmed Neoadjuvant palbociclib on ER+ breast cancer (N007): clinical response and EndoPredict’s value
title_short Neoadjuvant palbociclib on ER+ breast cancer (N007): clinical response and EndoPredict’s value
title_sort neoadjuvant palbociclib on er+ breast cancer (n007): clinical response and endopredict’s value
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763422/
https://www.ncbi.nlm.nih.gov/pubmed/29158285
http://dx.doi.org/10.1530/ERC-17-0396
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