Luminal androgen receptor role and pathological complete response rate to neoadjuvant chemotherapy in triple negative breast cancer

Chica-Parrado, María Rosario; Santonja, Ángela; Lluch-Hernandez, A.; Albanell, Joan; Sánchez-Muñoz, Alfonso; Chacón, Ignacio Fernández; Calvo, Lourdes; Sánchez‐Rovira, Pedro; Haba, J.l.a. De; Vicioso, Luís; Martı́n, Miguel; Plazaola, Arrate; Prat, Aleix; Ribelles, Nuria; Sánchez‐Aragó, María; Jerez, José M.; Escudero, M.J.; Caballero, Rosalía; Carrasco, Eva; Conejo, Emilio Alba

doi:10.1093/annonc/mdw364.43

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“…However, our BL2 patients achieved a pCR rate of 47.4%, the second highest rate among our cohort. This finding is supported by other studies that found pCR rates among BL2 of around 35–40% (26). As for LAR tumors, while they have been invariably associated with low response rate to NACT, data regarding long-term survival has been contradictory, displaying the best and worst outcome in different studies (14,15,27).…”

Section: Discussionsupporting

confidence: 89%

“…For instance, according to the original classification, genomic profiling of 350 TNBC revealed that 15% and 6% were BL1 and BL2, 20% IM, 8% LAR, 17% M and 7% MSL (25). Similar distribution was observed in TNBC included in the GEICAM/2006-03 trial (26). It is worth noting that up to 7% of our TNBC patients were classified as ER+ with regards to ESR1 gene expression, with no specific correlation with PAM50 intrinsic subtype.…”

Section: Discussionsupporting

confidence: 75%

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Pathological Response in a Triple-Negative Breast Cancer Cohort Treated with Neoadjuvant Carboplatin and Docetaxel According to Lehmann's Refined Classification

Echavarría

López-Tarruella

Picornell

et al. 2018

Clinical Cancer Research

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Triple-negative breast cancer (TNBC) requires the iden- tification of reliable predictors of response to neoadjuvant chemotherapy (NACT). For this purpose, we aimed to evaluate the performance of the TNBCtype-4 classifier in a cohort of patients with TNBC treated with neoadjuvant carboplatin and docetaxel (TCb). Patients with TNBC were accrued in a nonrandomized trial of neoadjuvant carboplatin AUC 6 and docetaxel 75 mg/m for six cycles. Response was evaluated in terms of pathologic complete response (pCR, ypT0/is ypN0) and residual cancer burden by Symmans and colleagues. Lehmann's subtyping was performed using the TNBCtype online tool from RNAseq data, and germline sequencing of a panel of seven DNA damage repair genes was conducted. Ninety-four out of the 121 patients enrolled in the trial had RNAseq available. The overall pCR rate was 44.7%. Lehmann subtype distribution was 34.0% BL1, 20.2% BL2, 23.4% M, 14.9% LAR, and 7.4% were classified as ER+. Response to NACT with TCb was significantly associated with Lehmann subtype ( = 0.027), even in multivariate analysis including tumor size and nodal involvement, with BL1 patients achieving the highest pCR rate (65.6%), followed by BL2 (47.4%), M (36.4%), and LAR (21.4%). BL1 was associated with a significant younger age at diagnosis and higher ki67 values. Among our 10 germline mutation carriers, 30% were BL1, 40% were BL2, and 30% were M. TNBCtype-4 is associated with significantly different pCR rates for the different subtypes, with BL1 and LAR displaying the best and worse responses to NACT, respectively. .

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