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Impact of Pathologic Complete Response following Neoadjuvant Chemotherapy ± Trastuzumab in Locally Advanced Breast Cancer

PURPOSE: This study was designed to examine the relationship between breast cancer molecular subtypes and pathological response to neoadjuvant chemotherapy (NAC) ± trastuzumab, in locally advanced breast cancer (LABC). METHODS: Female patients with LABC (T2–T4, N0–N2, and M0) who received neoadjuvan...

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Autores principales: Al-Tweigeri, Taher, Elshenawy, Mahmoud, Badran, Ahmed, Omar, Ayman, Suleman, Kausar, Al Malik, Osama, Anwar, Ihab, Jastaniya, Noha, Tulbah, Asma, Al Shabanah, Mohammad, Ajarim, Dahish, Al Sayed, Adher
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7895557/
https://www.ncbi.nlm.nih.gov/pubmed/33628241
http://dx.doi.org/10.1155/2021/6639763
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author Al-Tweigeri, Taher
Elshenawy, Mahmoud
Badran, Ahmed
Omar, Ayman
Suleman, Kausar
Al Malik, Osama
Anwar, Ihab
Jastaniya, Noha
Tulbah, Asma
Al Shabanah, Mohammad
Ajarim, Dahish
Al Sayed, Adher
author_facet Al-Tweigeri, Taher
Elshenawy, Mahmoud
Badran, Ahmed
Omar, Ayman
Suleman, Kausar
Al Malik, Osama
Anwar, Ihab
Jastaniya, Noha
Tulbah, Asma
Al Shabanah, Mohammad
Ajarim, Dahish
Al Sayed, Adher
author_sort Al-Tweigeri, Taher
collection PubMed
description PURPOSE: This study was designed to examine the relationship between breast cancer molecular subtypes and pathological response to neoadjuvant chemotherapy (NAC) ± trastuzumab, in locally advanced breast cancer (LABC). METHODS: Female patients with LABC (T2–T4, N0–N2, and M0) who received neoadjuvant chemotherapy + trastuzumab if HER2+ subtype, followed by surgery and radiotherapy ± hormonal therapy, were identified. The primary endpoint was pathologic complete response (pCR) in the breast and axilla (ypT0/ypN0), with final analysis on disease-free survival (DFS) and overall survival (OS). RESULTS: Six hundred eighty-one patients with a median age of 44 years, premenopausal: 70%, median tumour size: 7.0 cm (range 4–11 cm), stage II B: 27% and III A/III B: 73%, ER+/HER2−: 40.8%, ER−/HER2−: 23%, ER+/HER2+: 17.7%, and ER−/HER2+: 18.5%. Overall pCR (ypT0/ypN0) was 23%. The pCR rates based on molecular subtypes were ER+/HER2−: 9%; ER+/HER2+: 29%; ER−/HER2−: 31%; and ER−/HER2+: 37%. At median follow-up of 61 months, ER+/HER2+ and ER+/HER2− subtypes had the best 5-year DFS and OS; meanwhile, ER−/HER2+ and ER−/HER2− subtypes had the worst. CONCLUSION: Women with ER+/HER2− disease are the least likely to achieve pCR, with the highest rates in HER2+ and triple-negative subgroups. Degree of response is associated with OS; despite the comparatively higher likelihood of achieving pCR in ER−/HER2+ and triple-negative, these subgroups experience a survival detriment. We are consistent with the published data that patients who attain the pathological complete response defined as ypT0/ypN0 have improved outcomes.
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spelling pubmed-78955572021-02-23 Impact of Pathologic Complete Response following Neoadjuvant Chemotherapy ± Trastuzumab in Locally Advanced Breast Cancer Al-Tweigeri, Taher Elshenawy, Mahmoud Badran, Ahmed Omar, Ayman Suleman, Kausar Al Malik, Osama Anwar, Ihab Jastaniya, Noha Tulbah, Asma Al Shabanah, Mohammad Ajarim, Dahish Al Sayed, Adher J Oncol Research Article PURPOSE: This study was designed to examine the relationship between breast cancer molecular subtypes and pathological response to neoadjuvant chemotherapy (NAC) ± trastuzumab, in locally advanced breast cancer (LABC). METHODS: Female patients with LABC (T2–T4, N0–N2, and M0) who received neoadjuvant chemotherapy + trastuzumab if HER2+ subtype, followed by surgery and radiotherapy ± hormonal therapy, were identified. The primary endpoint was pathologic complete response (pCR) in the breast and axilla (ypT0/ypN0), with final analysis on disease-free survival (DFS) and overall survival (OS). RESULTS: Six hundred eighty-one patients with a median age of 44 years, premenopausal: 70%, median tumour size: 7.0 cm (range 4–11 cm), stage II B: 27% and III A/III B: 73%, ER+/HER2−: 40.8%, ER−/HER2−: 23%, ER+/HER2+: 17.7%, and ER−/HER2+: 18.5%. Overall pCR (ypT0/ypN0) was 23%. The pCR rates based on molecular subtypes were ER+/HER2−: 9%; ER+/HER2+: 29%; ER−/HER2−: 31%; and ER−/HER2+: 37%. At median follow-up of 61 months, ER+/HER2+ and ER+/HER2− subtypes had the best 5-year DFS and OS; meanwhile, ER−/HER2+ and ER−/HER2− subtypes had the worst. CONCLUSION: Women with ER+/HER2− disease are the least likely to achieve pCR, with the highest rates in HER2+ and triple-negative subgroups. Degree of response is associated with OS; despite the comparatively higher likelihood of achieving pCR in ER−/HER2+ and triple-negative, these subgroups experience a survival detriment. We are consistent with the published data that patients who attain the pathological complete response defined as ypT0/ypN0 have improved outcomes. Hindawi 2021-02-12 /pmc/articles/PMC7895557/ /pubmed/33628241 http://dx.doi.org/10.1155/2021/6639763 Text en Copyright © 2021 Taher Al-Tweigeri et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Al-Tweigeri, Taher
Elshenawy, Mahmoud
Badran, Ahmed
Omar, Ayman
Suleman, Kausar
Al Malik, Osama
Anwar, Ihab
Jastaniya, Noha
Tulbah, Asma
Al Shabanah, Mohammad
Ajarim, Dahish
Al Sayed, Adher
Impact of Pathologic Complete Response following Neoadjuvant Chemotherapy ± Trastuzumab in Locally Advanced Breast Cancer
title Impact of Pathologic Complete Response following Neoadjuvant Chemotherapy ± Trastuzumab in Locally Advanced Breast Cancer
title_full Impact of Pathologic Complete Response following Neoadjuvant Chemotherapy ± Trastuzumab in Locally Advanced Breast Cancer
title_fullStr Impact of Pathologic Complete Response following Neoadjuvant Chemotherapy ± Trastuzumab in Locally Advanced Breast Cancer
title_full_unstemmed Impact of Pathologic Complete Response following Neoadjuvant Chemotherapy ± Trastuzumab in Locally Advanced Breast Cancer
title_short Impact of Pathologic Complete Response following Neoadjuvant Chemotherapy ± Trastuzumab in Locally Advanced Breast Cancer
title_sort impact of pathologic complete response following neoadjuvant chemotherapy ± trastuzumab in locally advanced breast cancer
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7895557/
https://www.ncbi.nlm.nih.gov/pubmed/33628241
http://dx.doi.org/10.1155/2021/6639763
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