Early response and pathological complete remission in Breast Cancer with different molecular subtypes: a retrospective single center analysis

Abstract

Purpose: To evaluate the association of clinical early response and pathological complete remission (pCR) in breast cancer patients with different molecular subtypes. Materials and methods: Breast cancer patients who received neoadjuvant treatment (NAT) with clinical early response assessment from October 2008 to October 2018 were retrospectively analyzed. Clinical early response was defined as tumor size decreasing ≥30% evaluated by ultrasound after two cycles of NAT. Chi-square test was used to compare the pCR rates between the responder and non-responder groups with different molecular subtypes. Multivariate logistic regression was used to identify independent factors associated with the pCR. Results: A total of 328 patients were included: 100 responders and 228 non-responders. The progesterone receptor (PR) expression was an independent factor associated with clinical early response (OR=2.39, 95%CI=1.41-4.05, P =0.001). The pCR rate of breast was 50.0% for responders and 18.0% for non-responders ( P <0.001). Regarding different molecular subtypes, responders had higher pCR rates than non-responders for patients with HER2 overexpression (OR=10.66, 95%CI=2.18-52.15, P =0.001), triple negative (OR=3.29, 95%CI=1.23-8.84, P =0.016) and Luminal (HER2-) subtypes (OR=8.58, 95%CI=3.05-24.10, P <0.001) respectively. Moreover, pCR rate can be achieved as high as 88.2% in HER2 overexpression patients with early clinical response, which was significantly higher than patients without early response (41.3%, P =0.001). Multivariate analysis showed that clinical early response was an independent factor associated with the pCR rate (OR=4.87, 95%CI=2.72-8.72, P <0.001). Conclusions: Early response was significantly associated with a higher pCR rate in breast cancer patients receiving NAT, especially for patients with HER2 overexpression subtype, which warrants further clinical evaluation.

Neoadjuvant Chemotherapy of Triple-Negative Breast Cancer: Evaluation of Early Clinical Response, Pathological Complete Response Rates, and Addition of Platinum Salts Benefit Based on Real-World Evidence

“…The overall pCR rate of 41% observed in this study and the difference in pCR achievement between early responders and non-responders is concordant with published studies [ 26 , 29 , 57 ]. In this study, a positive influence of platinum salts on pCR was observed in all analyzed subgroups.…”

“…The predictive role of these markers was evaluated more often with regard to pCR achievement than ECR [ 53 , 54 ]. Hong et al retrospectively evaluated different characteristics of responders and non-responders [ 26 ]. Unlike the presented study, patients with different molecular subtypes were included, differences in cT were not found, and the proliferative index was not evaluated.…”

“…The effectiveness of NACT may already be assessed during neoadjuvant therapy by determining early clinical response (ECR). The previously published studies evaluated ECR after the initial two cycles o NACT, wherein favorable response was associated with a higher likelihood of pCR achievement or better long-term treatment outcomes [ 24 , 25 , 26 ].…”

Pathologic Complete Response and Its Impact on Breast Cancer Recurrence and Patient’s Survival after Neoadjuvant Therapy: A Comprehensive Meta-Analysis

“…The 25 included studies involved 8767 patients, and the publication years of articles were from 2015 to 2020. Among them, 18 studies were retrospective cohort studies [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31], and 7 studies were prospective cohort studies [32][33][34][35][36][37][38]. Various types of NAT were utilized in the included studies, including anthracycline-based drugs, taxanes, and platinum plus docetaxel.…”

A phase II study of poziotinib in patients with recurrent and/or metastatic head and neck squamous cell carcinoma

“…PFS and OS were evaluated using the Kaplan–Meier curve and were compared using log‐rank test. All statistical analyses were performed using SPSS version 25.0 17 …”