e12012 Background: Immune response in Triple Negative Breast Cancer (TNBC) plays a critical role in pathological complete response (pCR) after neoadjuvant chemotherapy (NAC). Therefore, neutrophil to lymphocyte ratio (NLR) could be an interesting biomarker to evaluate systemic inflammation in TNBC. Our aim was to evaluate the effect of NLR, also progression free survival (PFS) and overall survival (OS) as secondary objectives. Methods: We reviewed 338 medical records of II-III CS TNBC patients treated with NAC, in the 2000-2014 period, at Instituto Nacional de Enfermedades Neoplasicas. Patients were grouped in NLR < 3 and ≥3. Survival differences were assessed by log-rank test in the univariate analysis and prognostic factors were then investigated by Cox regression analysis. Results: Mean age was 47y [range:24-79], 54% were premenopausal, 90.9% had clinical T3-T4 tumor and 80.5% clinical nodal involvement. There were 44 and 294 pts with II and III CS, respectively. From 338 patients, 259 had NLR < 3 and 79, ≥3. No significant clinical differences were noted between these groups, except a higher mean BMI among patients with NLR < 3 (28 vs 26Kg/m2, p = 0.01). pCR rate was higher in NLR < 3 patients (22% vs 15.2%, p < 0.001) and partial response was reached on 70.7% and 62% of pts with NLR < 3 and ≥3, respectively. At 5 year median follow-up, 5-year DFS was higher among patients with NLR < 3 (47 vs 34%, HR = 0.69, 95%CI: 0.50-0.95, p = 0.02) and so was 5-year OS (55 vs 40%, HR: 0.61, CI95%: 0.43-0.85, p = 0.004). At multivariate analysis, premenopausal status, non-pCR and nodal involvement were associated with worse DFS. Otherwise, NLR < 3 (HR: 0.61, 95%CI: 0.43-0.86, p = 0.005) and pCR were predictors of better OS, nonetheless nodal involvement had negative impact on OS. Conclusions: NLR is a valuable predictive biomarker of pCR and OS in TNBC patients. We report less pCR rates due to higher stages among peruvian population.
e12100 Background: Obesity has been associated with development of TNBC, but its prognostic value on outcomes is still controversial. The aim of this study was to describe clinicopathological characteristics and compare Disease Free Survival (DFS) and Overall Survival (OS) according to obesity status. Methods: We performed a retrospective study on 1415 patients diagnosed with TNBC, admitted during the 2000-2014 period at the Instituto Nacional de Enfermedades Neoplasicas. We divided TNBC patients in two groups based on WHO classification: Non-obese (BMI: 18.5-29.9) and Obese women (BMI≥30). The survival differences were assessed with log-rank test and prognostic factors were then investigated by Cox regression analysis. Results: The median age was 49.5years (19-89years). Of all registered patients, 389 (27.5%) had obesity and 45% were premenopausal, however obese women were predominantly postmenopausal (55%, p < 0.001). Breast-ovarian cancer family background was present in 16.9%. T3-T4 tumors were 46.1% while 58.8% had nodal involvement. Neoadjuvant treatment was administered to more than a third patients (37.2%), and 430 out of 1415 had conservative surgery. With a median of follow-up of 5.1 years, there were 274 (18.9%) local and 402 (27.8%) distant recurrences registered without differences between groups. In obese women, 5-year DFS was 63%, while non-obese was 65% (HR: 1.10, 95%CI: 0.96-1.4, p = 0.35). 5-year OS, was 65 and 64% in obese and non-obese, respectively (HR: 0.93, 95%CI: 0.8-1.1, p = 0.43). Nevertheless, no significant impact was reached on outcomes at uni or multivariate analysis. In multivariate cox regression analysis, neoadjuvant chemotherapy was related to a better prognosis in DFS and OS; in addition, conservative surgery was a protector factor of OS. On the other hand, T4 and nodal involvement were statistically significant to worse DFS and OS; besides premenopausal status and family background affected the DFS and OS, respectively. Conclusions: In this population of TNBC patients, we did not find negative prognostic impact of obesity in terms of DFS and OS. Others potential factors are needed to be explored in futures studies.
Purpose: Many pathologic response systems have been used since the arrival of NACT. The RCB is a standardized method, but not universally implemented (Symanns WF, et al. J Clin Oncol 2007). The main objective is to apply the RCB and check its prognostic value in patients treated with platinum-based NACT with a long follow up. Methods: Patients diagnosed and treated with platinum based NACT are analyzed. They receive 4 cycles of carboplatin AUC 6 and doxorubicin 50 mg/m2, followed by either docetaxel 75 mg/m2 (4 cycles) or weekly paclitaxel 80 mg/m2 (8 doses), preoperatively. Pathological complete response (PCR) is defined as the absence of invasive tumor in the breast and axillary nodes, allowing the presence of DCIS. RCB system is applied and correlated with disease free survival (DFS) and overall survival (OS) according to Kaplan-Meier method; differences between curves with log rank test. Results: 109 patients (110 tumors) are included from Mar-2004 Mar-2009. Characteristics of patients and tumors: Mean age: 50.9 years (range 28-78 years); Premenopausal: 69 (62.7%). Median tumor diameter: 35 mm (0-90 mm); histology: ductal 85 (77.3%). Stage: IIa 46 (41.4%); IIb 40 (36%); IIIa-11 (10%); IIIb 12 (10.9%); IIIc 1 (0.9%). Phenotypes: luminal A 18 (16.4%); luminal B 36 (32.7%); HER2 luminal B 22 (20%); HER2 13 (11.8%); triple negative 21 (19.1%). Responses: pCR: 17.3%; pCR and RCB-I: 37.3%. Responses according to phenotypes: Surgery: lumpectomy 66 (60%). Follow up: DFS (median follow up 8,2 years (0,5-11,8)): 78,9%; OS (median follow up 8,6 years (0,8-11,41)). OS according to RCB: pCR: 94,7%; RCB-I: 86,4%; RCB-II: 76,6%; RCB-III: 58,8% (p 0,03). Table 1. Pathological response based on RCB and phenotypes Luminal ALuminal BLuminal B HER2HER2TNpCR0 (0%)8 (22,2%)1 (4,5%)4 (30,8%)6 (28,6%)RCB-I2 (11,1%)6 (16,7%)7 (31,8%)5 (38,5%)2 (9,5%)RCB-II13 (72,2%)15 (41,7%)12 (54,5%)1 (7,7%)6 (28,6%)RCB-III2 (11,1%)6 (16,7%)2 (9,1%)2 (15,4%)5 (23,8%)Unknown1 (5,6%)1 (2,8%)0 (0%)1 (7,7%)2 (9,5%)Total18 (100%)36 (100%)22 (100%)13 (100%)21 (100%) Conclusion: RCB is a strong prognostic factor, here validated for a platinum based CT with a long follow up. Additional data on OS according RCB in different phenotypes will be presented at the meeting. Citation Format: de Juan Ferré A, Mayorga Fernández M, Alonso Bartolomé P, Azcarretazabal González-Ontaneda T, Muñoz Cacho P, Múgica Estébanez M, Anchuelo Latorre J, Mata Velasco E, Saíz Isa L, López Vega JM. Residual cancer burden (RCB) as a strong prognosis factor in breast cáncer (BC) patients treated with neoadjuvant chemotherapy (NACT) based on carboplatin, doxorubicin and taxanes [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-16-11.
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