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Prognostic value of the Residual Cancer Burden index according to breast cancer subtype: Validation on a cohort of BC patients treated by neoadjuvant chemotherapy

INTRODUCTION: The Residual Cancer Burden (RCB) quantifies residual disease after neoadjuvant chemotherapy (NAC). Its predictive value has not been validated on large cohorts with long-term follow up. The objective of this work is to independently evaluate the prognostic value of the RCB index depend...

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Autores principales: Hamy, Anne-Sophie, Darrigues, Lauren, Laas, Enora, De Croze, Diane, Topciu, Lucian, Lam, Giang-Thanh, Evrevin, Clemence, Rozette, Sonia, Laot, Lucie, Lerebours, Florence, Pierga, Jean-Yves, Osdoit, Marie, Faron, Matthieu, Feron, Jean-Guillaume, Laé, Marick, Reyal, Fabien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313974/
https://www.ncbi.nlm.nih.gov/pubmed/32579551
http://dx.doi.org/10.1371/journal.pone.0234191
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author Hamy, Anne-Sophie
Darrigues, Lauren
Laas, Enora
De Croze, Diane
Topciu, Lucian
Lam, Giang-Thanh
Evrevin, Clemence
Rozette, Sonia
Laot, Lucie
Lerebours, Florence
Pierga, Jean-Yves
Osdoit, Marie
Faron, Matthieu
Feron, Jean-Guillaume
Laé, Marick
Reyal, Fabien
author_facet Hamy, Anne-Sophie
Darrigues, Lauren
Laas, Enora
De Croze, Diane
Topciu, Lucian
Lam, Giang-Thanh
Evrevin, Clemence
Rozette, Sonia
Laot, Lucie
Lerebours, Florence
Pierga, Jean-Yves
Osdoit, Marie
Faron, Matthieu
Feron, Jean-Guillaume
Laé, Marick
Reyal, Fabien
author_sort Hamy, Anne-Sophie
collection PubMed
description INTRODUCTION: The Residual Cancer Burden (RCB) quantifies residual disease after neoadjuvant chemotherapy (NAC). Its predictive value has not been validated on large cohorts with long-term follow up. The objective of this work is to independently evaluate the prognostic value of the RCB index depending on BC subtypes (Luminal, HER2-positive and triple negative (TNBCs)). METHODS: We retrospectively evaluated the RCB index on surgical specimens from a cohort of T1-T3NxM0 BC patients treated with NAC between 2002 and 2012. We analyzed the association between RCB index and relapse-free survival (RFS), overall survival (OS) among the global population, after stratification by BC subtypes. RESULTS: 717 patients were included (luminal BC (n = 222, 31%), TNBC (n = 319, 44.5%), HER2-positive (n = 176, 24.5%)). After a median follow-up of 99.9 months, RCB index was significantly associated with RFS. The RCB-0 patients displayed similar prognosis when compared to the RCB-I group, while patients from the RCB-II and RCB-III classes were at increased risk of relapse (RCB-II versus RCB-0: HR = 3.25 CI [2.1–5.1] p<0.001; RCB-III versus RCB-0: HR = 5.6 CI [3.5–8.9] p<0.001). The prognostic impact of RCB index was significant for TNBC and HER2-positive cancers; but not for luminal cancers (P(interaction) = 0.07). The prognosis of RCB-III patients was poor (8-years RFS: 52.7%, 95% CI [44.8–62.0]) particularly in the TNBC subgroup, where the median RFS was 12.7 months. CONCLUSION: RCB index is a reliable prognostic score. RCB accurately identifies patients at a high risk of recurrence (RCB-III) with TNBC or HER2-positive BC who must be offered second-line adjuvant therapies.
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spelling pubmed-73139742020-06-29 Prognostic value of the Residual Cancer Burden index according to breast cancer subtype: Validation on a cohort of BC patients treated by neoadjuvant chemotherapy Hamy, Anne-Sophie Darrigues, Lauren Laas, Enora De Croze, Diane Topciu, Lucian Lam, Giang-Thanh Evrevin, Clemence Rozette, Sonia Laot, Lucie Lerebours, Florence Pierga, Jean-Yves Osdoit, Marie Faron, Matthieu Feron, Jean-Guillaume Laé, Marick Reyal, Fabien PLoS One Research Article INTRODUCTION: The Residual Cancer Burden (RCB) quantifies residual disease after neoadjuvant chemotherapy (NAC). Its predictive value has not been validated on large cohorts with long-term follow up. The objective of this work is to independently evaluate the prognostic value of the RCB index depending on BC subtypes (Luminal, HER2-positive and triple negative (TNBCs)). METHODS: We retrospectively evaluated the RCB index on surgical specimens from a cohort of T1-T3NxM0 BC patients treated with NAC between 2002 and 2012. We analyzed the association between RCB index and relapse-free survival (RFS), overall survival (OS) among the global population, after stratification by BC subtypes. RESULTS: 717 patients were included (luminal BC (n = 222, 31%), TNBC (n = 319, 44.5%), HER2-positive (n = 176, 24.5%)). After a median follow-up of 99.9 months, RCB index was significantly associated with RFS. The RCB-0 patients displayed similar prognosis when compared to the RCB-I group, while patients from the RCB-II and RCB-III classes were at increased risk of relapse (RCB-II versus RCB-0: HR = 3.25 CI [2.1–5.1] p<0.001; RCB-III versus RCB-0: HR = 5.6 CI [3.5–8.9] p<0.001). The prognostic impact of RCB index was significant for TNBC and HER2-positive cancers; but not for luminal cancers (P(interaction) = 0.07). The prognosis of RCB-III patients was poor (8-years RFS: 52.7%, 95% CI [44.8–62.0]) particularly in the TNBC subgroup, where the median RFS was 12.7 months. CONCLUSION: RCB index is a reliable prognostic score. RCB accurately identifies patients at a high risk of recurrence (RCB-III) with TNBC or HER2-positive BC who must be offered second-line adjuvant therapies. Public Library of Science 2020-06-24 /pmc/articles/PMC7313974/ /pubmed/32579551 http://dx.doi.org/10.1371/journal.pone.0234191 Text en © 2020 Hamy et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Hamy, Anne-Sophie
Darrigues, Lauren
Laas, Enora
De Croze, Diane
Topciu, Lucian
Lam, Giang-Thanh
Evrevin, Clemence
Rozette, Sonia
Laot, Lucie
Lerebours, Florence
Pierga, Jean-Yves
Osdoit, Marie
Faron, Matthieu
Feron, Jean-Guillaume
Laé, Marick
Reyal, Fabien
Prognostic value of the Residual Cancer Burden index according to breast cancer subtype: Validation on a cohort of BC patients treated by neoadjuvant chemotherapy
title Prognostic value of the Residual Cancer Burden index according to breast cancer subtype: Validation on a cohort of BC patients treated by neoadjuvant chemotherapy
title_full Prognostic value of the Residual Cancer Burden index according to breast cancer subtype: Validation on a cohort of BC patients treated by neoadjuvant chemotherapy
title_fullStr Prognostic value of the Residual Cancer Burden index according to breast cancer subtype: Validation on a cohort of BC patients treated by neoadjuvant chemotherapy
title_full_unstemmed Prognostic value of the Residual Cancer Burden index according to breast cancer subtype: Validation on a cohort of BC patients treated by neoadjuvant chemotherapy
title_short Prognostic value of the Residual Cancer Burden index according to breast cancer subtype: Validation on a cohort of BC patients treated by neoadjuvant chemotherapy
title_sort prognostic value of the residual cancer burden index according to breast cancer subtype: validation on a cohort of bc patients treated by neoadjuvant chemotherapy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313974/
https://www.ncbi.nlm.nih.gov/pubmed/32579551
http://dx.doi.org/10.1371/journal.pone.0234191
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