Clinical and pathological response to neoadjuvant chemotherapy with different chemotherapy regimens predicts the outcome of locally advanced breast cancer

Abstract

Background: This retrospective analysis was designed to research whether clinical response partial response (PR)/complete response (CR) and pathological response (PCR) to neoadjuvant chemotherapy can translate into prognosis benefit pathological response in patients with locally advanced breast cancer and whether different chemotherapy regimens will influence the outcomes.Methods: One hundred and thirty-five patients with breast cancer patients who received neoadjuvant chemotherapy were included in the retrospective analysis. Patients were followed up strictly. Overall survival (OS) was evaluated by the Kaplan-Meier analysis. The comparison of the clinical and pathological characteristics and recurrence was performed using the carried out by chi-squared and Fisher's exact tests.Univariate and multivariate analyses were performed by the Cox regression analysis.Results: Clinical response was strongly correlated with lymph nodes status (P=0.032). The OS comparison of pathological response between the pCR group and non-pCR groups did not exhibit statistically significant differences (P=0.400). A similar non-significant response result was observed in the comparison of clinical response between the PR/CR and SD/PD groups group (P=0.108). Univariate and multivariate analyses did not support clinical response (P=0.156 P=0.095 respectively) or pathological response (P=0.600 P=0.144 respectively) as the predictors of prognosis. There were no significant differences in either the comparison of the clinical response group it seems no statistically significance (P=0.496) or the comparison of the pathological response group (P=0.460). OS analyses across different neoadjuvant chemotherapy regimens demonstrated no significant differences (P=0.307). In the PR/CR and PD/SD comparison of every single regimen, there were no significant differences. However, for patients with PR/CR patients from the comparison of five regimens, namely, TAC, FAC, AC-T, AT and TCBP demonstrated a significant difference (P=0.022). In the group of patients with luminal A breast cancer, the result of the Fisher's exact test approached significant (P=0.059).Conclusions: Neither PR/CR nor pCR can translate into long-term outcome benefit. PR/CR and PCR are not independent predictors in patients with advanced breast cancer. Patients who received a taxane + anthracycline regimen exhibited a higher recurrence rate than any other regimens, especially those patients with luminal A breast cancer.

The influence factors of clinical efficacy and prognosis of breast cancer patients treated with neoadjuvant chemotherapy

“…However, the prognosis of patients with high Ki67 expression is often poor. Some previous studies also did not support the use of pCR rates of neoadjuvant chemotherapy as an alternative endpoint for disease-free survival and overall survival [44,45]. Therefore, we think that in the same pathological index (such as similar Ki67 expression level) or the same pathological molecular type (such as triple negative breast cancer) or similar invasive breast cancer cells, and so on, the prognosis of breast cancer patients is predicted by pCR.…”

Contrast-enhanced ultrasound features as a potential biomarker for the prediction of breast cancer recurrence

“…Our study included patients with various subtypes of breast cancer and different chemotherapy regimens. We have shown that combination therapy with anthracyclines and taxanes is associated with worse outcomes, but the reasons are unclear [24] and may be due to the limited sample size and selection bias, because patients without CEUS were excluded. Further research is needed to identify specific therapies for NAC and tumor biology that may improve survival outcomes in the future.…”

Addition of immune checkpoint inhibitors to chemotherapy versus chemotherapy alone in patients with triple‐negative breast cancer: A systematic review and meta‐analysis

“…Similar conclusions were obtained in some of the included studies, such as IMpassion130, Keynote‐355, and Keynote‐522, which may be because PD‐L1 positive patients are more sensitive to ICI drugs. 37 However, IMpassion131 results were inconsistent which might be attributed to differing CT drugs and CT regiments 38 or might be related to varying proportions of random allocation and experimental errors. Nonetheless, our analysis confirmed that ICI plus CT can improve the short‐term pCR rate of patients with TNBC compared with CT alone, as well as improve the ORR of ITT patients and PD‐L1 positive patients.…”